Cutaneous Carcinosarcoma
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Transcript of Cutaneous Carcinosarcoma
Cutaneous Carcinosarcoma
Katy H. Goldsborough, William B. Laskin, Jeffrey D. Wayne, Mark Agulnik
Department of Medicine, Division of Hematology/ Oncology,Department of Pathology
Department of Surgery, Division of Surgical Oncology
Feinberg School of Medicine,Northwestern University,
Chicago, IL
Carcinosarcomas (CS): Background
• Malignant neoplasm– Biphasic epithelial and mesenchymal
elements– Breast, lung, urogenital, gastrointestinal– Hypothesis- Multiclonal vs. Monoclonal– IHC studies establish 2 distinct populations
• Primary cutaneous CS– Dawson 1972– Basal and squamous cell carcinoma– Pleomorphic/ atypical fibroxanthoma/ MFH
Case Report
• 62 y.o. male• Subcutaneous 4 mm nodule lateral to sternum• Slow growth over 18 months• Excisional bx followed by wide local excision
p63 AE1/AE3
Cam 5.2
CK 5/6
BetaE12/CK903
MNF116 Vimentin S100
BCC + + + + + + - -
Sarcoma - - - - - - + -
Methods
• All case reports and series of CCS
• Search terms:» Carcinosarcoma» Carcinoma and sarcoma» Sarcomatous sarcoma» Biphasic sarcomatoid carcinoma» Spindle cell carcinoma
• 48 publications reviewed
Results• Between 1972 and 2007: 74 cases of CCS have
been reported.Sex- M:F 49:25
Age Range (Mean) 36-93 (71)
Duration
< 3 months
3-6 months
> 6 -12 months
1-2 years
> 2 years
NR/UK
6 weeks- 50 yrs
10
6
5
5
22
26
Size
< 1 cm
1-5 cm
>5-10 cm
> 10 cm
NR/ UK
9
42
13
4
6
EpithelialBCC
SCC
Spiroadenocarcinoma
Pilar Tumor
Pilomatrix Carcinoma
Porocarcinoma
Adenocarcinoma
37
20
11
6
1
1
3
MesenchymalAngiosarcoma
Chondrosarcoma
Fibrosarcoma
Leiomyosarcoma
Osteosarcoma
Pleomorphic
Rhabdomyosarcoma
Spindle cell Sarcoma
1
7
1
5
24
32
4
12
ResultsTreatment Surgery 74
Radiation 10
Chemotherapy 2
Survival AWOD
<6 months
6-12 months
>12 months
38
4
13
21
DWOD
< 12 months
>12 months
7
1
6
AWD
< 12 months
> 12 months
5
3
2
DWD
< 12 months
> 12 months
11
9
2
Unknown 13
Conclusions
• Primary CCS is a rare disease.• 6th-8th decade of life• Survival predicted by:
– Epithelial component– Growth pattern– Tumor size– Duration– LN involvement– Age