Aramendi Teresa, Fernández-Aceñero M Jesús, Villanueva M Concepción
Department of Surgical Pathology, Hospital General de Móstoles, Móstoles, Madrid, Spain.
Pathol Res Pract. 2003;199(5):345-8. doi: 10.1078/0344-0338-0428.
Carcinosarcoma is a rare tumor that shows both epithelial and stromal malignant differentiation. Most reported cases of carcinosarcoma affect the female genital tract (and are called malignant mixed müllerian tumors), but there are also some isolated reports of cases affecting the lung and the head and neck area. Carcinosarcomas only rarely affect the gastrointestinal tract, mainly the esophagus. To the best of our knowledge, only eight cases of carcinosarcoma of the colon have been reported to date. For some lesions, the term 'sarcomatoid carcinoma' is preferred to 'carcinosarcoma', as both stromal and epithelial cells have shown cytokeratin expression on immunohistochemistry. The expression 'carcinosarcoma' should be applied only to those lesions, the stromal elements of which do not express epithelial markers. We report a new case of carcinosarcoma affecting the left colon. The most unique feature of this tumor is that it shows chondro-and osteosarcomatous differentiation, a feature that has been described previously in only one colonic carcinosarcoma. We discuss the histopathological and immunohistochemical features of this lesion as well as its possible histogenesis.
癌肉瘤是一种罕见的肿瘤，具有上皮和间质恶性分化。大多数报道的癌肉瘤病例累及女性生殖道（称为恶性混合苗勒管肿瘤），但也有一些孤立的病例报道累及肺以及头颈部区域。癌肉瘤很少累及胃肠道，主要是食管。据我们所知，迄今为止仅报道了8例结肠癌肉瘤。对于某些病变，“肉瘤样癌”这一术语比“癌肉瘤”更可取，因为在免疫组织化学检查中，间质细胞和上皮细胞均显示细胞角蛋白表达。“癌肉瘤”这一表述仅应适用于那些间质成分不表达上皮标志物的病变。我们报告了1例累及左半结肠的癌肉瘤新病例。该肿瘤最独特的特征是显示软骨肉瘤和骨肉瘤分化，这一特征此前仅在1例结肠癌肉瘤中被描述过。我们讨论了该病变的组织病理学和免疫组织化学特征及其可能的组织发生。
