Murata T, Soga T, Tajima K, Saito K, Komeda Y, Ioshii S O, Shiraishi T, Sakakura T, Yatani R
Division of Pathology, JA Suzuka Hospital, Suzuka, Japan.
Pathol Int. 1994 Feb;44(2):138-44. doi: 10.1111/j.1440-1827.1994.tb01698.x.
Sarcomatoid carcinoma is a rare variant of malignant tumor arising from the urinary tract. This tumor had been termed carcinosarcoma because of its carcinomatous and sarcomatous components. There is still some confusion in the terminology between true carcinosarcoma and sarcomatoid carcinoma; however, the latter is now regarded as primarily a malignant epithelial tumor with pseudosarcomatous transformation. Four cases of sarcomatoid carcinoma arising from the urinary tract are reported. The patients were a 77 year old female, and three males aged 62, 69 and 80 years. All but the eldest patient complained of gross hematuria. Surgical removal was performed in the younger three cases, and an autopsy was done in the remaining case. All the tumors were macroscopically polypoid. Histopathologic examination revealed fasciculated spindle-cell tumors with myxoid stroma or malignant fibrous histiocytoma-like spindle cell tumors. The epithelial nature was proven in these sarcomatous cells by immunohistochemical and/or electron-microscopic examinations. Only a small amount of squamous cell carcinoma components was also evident in the latter three cases. Although the younger three patients were alive at 44, 23 and 39 months' follow-up, respectively, constant careful monitoring is recommended.
肉瘤样癌是一种起源于泌尿道的罕见恶性肿瘤变体。由于其癌性和肉瘤性成分，这种肿瘤曾被称为癌肉瘤。在真正的癌肉瘤和肉瘤样癌的术语之间仍然存在一些混淆；然而，后者现在主要被视为一种具有假肉瘤样转化的恶性上皮肿瘤。本文报告了4例起源于泌尿道的肉瘤样癌病例。患者为1名77岁女性和3名年龄分别为62岁、69岁和80岁的男性。除最年长的患者外，所有患者均主诉肉眼血尿。较年轻的3例患者接受了手术切除，其余1例进行了尸检。所有肿瘤在肉眼下均呈息肉状。组织病理学检查显示为有黏液样基质的束状梭形细胞瘤或恶性纤维组织细胞瘤样梭形细胞瘤。通过免疫组织化学和/或电子显微镜检查在这些肉瘤样细胞中证实了其上皮性质。在后3例中也仅可见少量鳞状细胞癌成分。尽管较年轻的3例患者在分别随访44个月、23个月和39个月时仍存活，但建议持续进行仔细监测。
