Cazzato Gerardo, Colagrande Anna, Caputo Valentina, Ingravallo Giuseppe, Cascardi Eliano, Fortarezza Francesco, Bonoldi Emanuela, Rongioletti Franco
Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", 70124 Bari, Italy.
U.O. Anatomia Patologica, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy.
Dermatopathology (Basel). 2024 Jul 15;11(3):209-217. doi: 10.3390/dermatopathology11030022.
A cutaneous carcinosarcoma (cCS) is a rare and aggressive skin cancer characterized by both carcinomatous (epithelial) and sarcomatous (mesenchymal) components, making it a biphasic tumor. Despite its occurrence in various organs, a cCS is exceptionally rare in the skin, predominantly affecting older males. The etiology of a cCS is unclear, but it may originate from a single progenitor cell capable of dual differentiation or from a collision of carcinoma and sarcoma cells. Clinically, a cCS presents as a rapidly growing, painful, ulcerated nodule or plaque on sun-exposed skin, with a high risk of local invasion and metastasis. Histopathologically, a cCS includes various epithelial components, such as squamous cell carcinoma and basal cell carcinoma, along with undifferentiated sarcomatous components resembling atypical fibroxanthoma. The tumor may also exhibit heterologous differentiation like angiosarcomatous or rhabdomyosarcomatous features. We present three cases of a cCS, highlighting their clinical and histological characteristics and comparing them with previously reported cases. Understanding a cCS is complicated by its rarity and diverse presentation, emphasizing the need for further research to elucidate its pathogenesis and optimal management.
皮肤癌肉瘤（cCS）是一种罕见且侵袭性强的皮肤癌，其特征为同时具有癌性（上皮性）和肉瘤性（间叶性）成分，使其成为一种双相肿瘤。尽管它可发生于多个器官，但在皮肤中极为罕见，主要影响老年男性。cCS的病因尚不清楚，但它可能起源于能够进行双分化的单个祖细胞，或者源于癌细胞与肉瘤细胞的碰撞。临床上，cCS表现为暴露于阳光下的皮肤处迅速生长、疼痛、溃疡的结节或斑块，具有较高的局部侵袭和转移风险。组织病理学上，cCS包括各种上皮成分，如鳞状细胞癌和基底细胞癌，以及类似于非典型纤维黄色瘤的未分化肉瘤成分。该肿瘤还可能表现出异源性分化，如血管肉瘤或横纹肌肉瘤样特征。我们报告了3例cCS病例，突出了它们的临床和组织学特征，并与先前报道的病例进行了比较。由于cCS罕见且表现多样，对其的认识较为复杂，这强调了进一步研究以阐明其发病机制和最佳治疗方法的必要性。
