Which histologic findings are characteristic of true malignant mixed tumor (carcinosarcoma)?

Updated: Dec 01, 2015
  • Author: M Sherif Said, MD, PhD; Chief Editor: M Sherif Said, MD, PhD  more...
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Answer

Answer

A carcinosarcoma neoplasm is a biphasic tumor in which the carcinomatous component is usually a poorly differentiated adenocarcinoma, an undifferentiated carcinoma, or a squamous cell. [25] It may also include adenoid cystic carcinoma, epithelial myoepithelial carcinoma, and salivary duct carcinoma.

The sarcomatous component is usually a chondrosarcoma. Other reported sarcomatous elements include spindle cell sarcoma not otherwise specified (NOS), fibrosarcoma, osteosarcoma, leiomyosarcoma, liposarcoma, follicular dendritic cell sarcoma, undifferentiated sarcoma, myxoid sarcomas, and rhabdomyosarcoma, [26, 16] among others. The relative proportion of the 2 components is variable, and either component may dominate the histologic picture.

In the images below, the sarcomatous (spindle cell sarcoma) component of the tumor is dominant, with the smaller portion being poorly differentiated adenocarcinoma.

The carcinomatous component of a carcinosarcoma of The carcinomatous component of a carcinosarcoma of the parotid gland. In this case, the tumor is a poorly differentiated adenocarcinoma.
The sarcomatous component of a carcinosarcoma of t The sarcomatous component of a carcinosarcoma of the parotid gland. In this case, the tumor is a spindle cell sarcoma not otherwise specified (NOS).

The histologic picture depends on the types of the constituent cells of sarcoma and carcinoma. Extensive infiltration and tissue destruction are common, as are perineural invasion and angioinvasion. Lymphatic spread is less common. [27]

Metastases to other sites or lymph nodes may show the carcinomatous or the sarcomatous components alone, or the components may be mixed.


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