Aurello Paolo, Cicchini Claudia, D'Angelo Francesco, Mingazzini Pietro Luigi, Ramacciato Giovanni, De Angelis Renato
Department of Surgery Pietro Valdoni, University of Rome La Sapienza, Rome, Italy.
Anticancer Res. 2003 May-Jun;23(3C):3073-6.
Carcinosarcoma is one of the less common tumors of the lung and is composed of a mixture of malignant epithelial and mesenchymal elements of the type ordinarily seen in malignancies of adults. The carcinomatous component is mostly epidermoid and sometimes adenomatoid or undifferentiated. The mesenchymal part is mostly a spindle cell sarcoma and sometimes a polymorphocellular sarcoma. Differentiation as osteosarcoma and chondrosarcoma is rare.
This report describes the case of a patient with carcinosarcoma of the lung composed of epidermoid carcinoma and chondrosarcoma. A left hilar mass was incidentally diagnosed. The patient was submitted to surgical exploration and a left lower lobectomy with dissection of local lymph nodes was performed. At microscopy the tumor was composed of both epithelial and stromal malignant component. The epithelial component consisted of poorly-differentiated squamous cell carcinoma and the stromal component consisted of chondrosarcoma. He remains well 30 months later.
The prognosis of patients with carcinosarcoma is not always unfavourable. Potentially curative surgical resections should always be attempted. Pathologists should be aware of a wrong diagnosis of undifferentiated small cell lung carcinoma which eliminates the patient from surgery.
癌肉瘤是肺部较少见的肿瘤之一，由通常在成人恶性肿瘤中所见的恶性上皮和间充质成分混合组成。癌性成分大多为表皮样，有时为腺样或未分化型。间充质部分大多为梭形细胞肉瘤，有时为多形细胞肉瘤。分化为骨肉瘤和软骨肉瘤的情况罕见。
本报告描述了一例由表皮样癌和软骨肉瘤组成的肺癌肉瘤患者的病例。偶然诊断出左肺门肿块。患者接受了手术探查，并进行了左下叶切除及局部淋巴结清扫。显微镜检查显示肿瘤由上皮和间质恶性成分组成。上皮成分由低分化鳞状细胞癌组成，间质成分由软骨肉瘤组成。30个月后他情况良好。
癌肉瘤患者的预后并非总是不良。应始终尝试进行可能治愈的手术切除。病理学家应注意避免将未分化小细胞肺癌误诊，否则患者将失去手术机会。
