Kajo Karol, Zubor Pavol, Spacek Josef, Ryska Ales
Department of Pathology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic.
Pathol Res Pract. 2007;203(10):753-8. doi: 10.1016/j.prp.2007.05.010. Epub 2007 Jul 25.
Carcinosarcomas (CSs) are rare biphasic neoplasms of the female genital tract, with the presence of malignant epithelial and mesenchymal components. The occurrence of non-epithelial or non-mesenchymal differentiations in CSs is extremely rare. A case of a 54-year-old woman with a history of treatment for breast carcinoma is reported. The patient presented with a uterine tumor showing histological, immunohistochemical, and ultrastructural features of an extremely rare CS, with signs of melanocytic differentiation. The lesion was a 7.0 x 5.6 cm polypoid tumor mass arising from the endometrium and metastasizing in the abdominal cavity as a malignant melanoma - the most aggressive component of CS. Despite adjuvant chemotherapy, she died 8 months after the initial diagnosis due to the metastatic spread of CS. In line with current knowledge, we assess the melanocytic differentiation as one of a hypothetic differential line with the ability of multidirectional stem cell differentiation. We discuss a possible pathogenesis of this lesion and the role of tamoxifen in the tumor development as well. To the best of our knowledge, only one case of uterine CS with melanocytic differentiation has been reported in the English literature.
癌肉瘤（CSs）是女性生殖道罕见的双相性肿瘤，同时存在恶性上皮和间叶成分。CSs中出现非上皮或非间叶分化极为罕见。本文报道了一例54岁有乳腺癌治疗史的女性病例。该患者子宫肿瘤具有极其罕见的CS组织学、免疫组化和超微结构特征，并伴有黑素细胞分化迹象。病变为一个7.0×5.6厘米的息肉样肿瘤块，起源于子宫内膜，并以恶性黑色素瘤（CS最具侵袭性的成分）形式转移至腹腔。尽管接受了辅助化疗，她在初次诊断后8个月因CS转移扩散而死亡。根据目前的认知，我们将黑素细胞分化评估为具有多向干细胞分化能力的一种假设性分化谱系之一。我们还讨论了该病变可能的发病机制以及他莫昔芬在肿瘤发生发展中的作用。据我们所知，英文文献中仅报道过一例具有黑素细胞分化的子宫CS病例。
