Primary Heterologous Carcinosarcoma of the Ureter with Necrotic Malignant Polyps

Abstract

Carcinosarcoma is a rare and aggressive disease characterized by biphasic neoplasms with distinct mesenchymal and epithelial components. We report a case of ureteral carcinosarcoma with malignant necrotic polyps. The patient was a 58-year-old woman with painless hematuria, who was later diagnosed as having ureteral carcinosarcoma. Three long pendulous polypoid-shape tumors consisting of high-grade transitional cell carcinoma with chondrosarcomatous and osteosarcomatous elements were found. Two months after nephroureterectomy, the tumor relapsed in the bladder. Despite anterior exenteration, the patient died of local recurrence 6 months after her initial visit. To our knowledge, only 10 cases of this disease have been reported in the literature.

Molecular genetic findings in two cases of sarcomatoid carcinoma of the ureter: evidence for evolution from a common pluripotent progenitor cell?

“…A similar case with a protracted course was published by others [13]. In the majority of cases, however, the prognosis is poor and patients seldom survive longer than 3 years [10,19,24].…”

“…The epithelial component is most often a transitional cell carcinoma, but squamous cell carcinomas, adenocarcinomas, and in rare cases small cell neuroendocrine carcinomas may occur [10,14,23]. The mesenchymal component can consist of chondrosarcoma, osteosarcoma, rhabdomyosarcoma, or, rarely, liposarcoma [10,19].…”

“…Tobacco smoking and irradiation of the genital tract in gynecological patients have been considered risk factors for the development of SC [19]. Men appear to be affected more often [10,18,19]. Most of the patients are over 60 years of age.…”

“…Most of these uncommon tumors are combinations of a transitional cell carcinoma and one or more different types of sarcoma, such as osteosarcoma, chondrosarcoma, or rhabdomyosarcoma. Apart from transitional cell carcinoma, other kinds of carcinoma have been described, including basaloid, squamous, and undifferentiated carcinoma [10,18,24].…”

Sarcomatoid urothelial carcinoma with chondrosarcomatous differentiation of the ureter: A case report and review of the literature

“…The presence of a sarcomatoid component has been associated with a dismal prognosis and an increased risk of metastasis (21,29,30). Previously reported cases of urothelial carcinoma with sarcomatoid differentiation exhibited systemic metastasis to sites including the bone, liver, lung and lymph nodes (23,24,30). The majority of these tumors are high-grade in histology (16).…”