Carcinosarcomas are a group of biphasic tumours. They are composed of co-existing malignant epithelial and mesenchymal components. They are extremely rare in the skin. We present a case of a 43 year old female patient who came as a referral from a local district hospital with a chronic painless mass for 7 years. It had ulcerated 6 months prior to presentation with bleeding. The scalp mass was resected with a 10 mm margin. The histological diagnosis was carcinosarcoma as both carcinomatous and sarcomatous. Diagnosis of carcinosarcoma rests on demonstration of pleomorphic spindle cells with pressence of both epithelial and mesenchymal elements within the same tumour. The biphasic nature of the tumour may be seen on light microscopy showing atypical squamoid epithelial cells admixed with mucoid secreting variants as shown in our case. Immunopositivity to both cytokeratin and vimentin on a background of the described light microscopy findings confirms the diagnosis. Generally, surgery with resection of at least 10mm margin is the primary therapeutic modality. Local spread is rare. In conclusion, cutaneous carcinosarcoma of the scalp is rare and management is patient dependant with surgery being the mainstay treatment.
| Published in | International Journal of Neurosurgery (Volume 2, Issue 2) |
| DOI | 10.11648/j.ijn.20180202.15 |
| Page(s) | 39-42 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2018. Published by Science Publishing Group |
Carcinosarcoma, Cutaneous Fibro-sarcoma, Surgical Resection
| [1] | Ram R, Saadat P, Peng D, Vadmal M. Primary cutaneous carcinosarcoma. Ann Clin Lab Sci. 2005; 35(2): 189–194. |
| [2] | Mahadevan P. Pathology of Uterine Sarcomas. In: Rajaram S, K C, Maheshwari A, editors. Uterine Cancer [Internet]. New Delhi: Springer India; 2015 [cited 2017 Nov 2]. p. 123–43. Available from: http://link.springer.com/10.1007/978-81-322-1892-0_11. |
| [3] | Kwon JH, Kang YN, Kang KJ. Carcinosarcoma of the liver: a case report. Korean J Radiol. 2007; 8(4): 343–347. |
| [4] | Mukhopadhyay S, Shrimpton AE, Jones LA, Nsouli IS, Abraham Jr NZ. Carcinosarcoma of the urinary bladder following cyclophosphamide therapy: evidence for monoclonal origin and chromosome 9p allelic loss. Arch Pathol Lab Med. 2004; 128(1): e8–e11. |
| [5] | Zidar N, Gale N. Carcinosarcoma and spindle cell carcinoma–monoclonal neoplasms undergoing epithelial-mesenchymal transition. Virchows Arch. 2015; 466(3): 357. |
| [6] | Loh TL, Tomlinson J, Chin R, Eslick GD. Cutaneous Carcinosarcoma with Metastasis to the Parotid Gland [Internet]. Case Reports in Otolaryngology. 2014 [cited 2017 Nov 2]. Available from: https://www.hindawi.com/journals/criot/2014/173235/. |
| [7] | Wick MR, Swanson PE. Carcinosarcomas: current perspectives and an historical review of nosological concepts. Semin Diagn Pathol. 1993 May; 10(2): 118–27. |
| [8] | Gorstein F, Anderson TL. Malignant mixed mesodermal tumors: carcinoma, sarcoma, or both? Hum Pathol. 1991; 22(3): 207–209. |
| [9] | Thompson L, Chang B, Barsky SH. Monoclonal origins of malignant mixed tumors (carcinosarcomas): evidence for a divergent histogenesis. Am J Surg Pathol. 1996; 20(3): 277–285. |
| [10] | Halachmi S, DeMarzo AM, Chow N-H, Halachmi N, Smith AE, Linn JF, et al. Genetic alterations in urinary bladder carcinosarcoma: evidence of a common clonal origin. Eur Urol. 2000; 37(3): 350–357. |
| [11] | El Harroudi T, Ech-Charif S, Amrani M, Jalil A. Primary carcinosarcoma of the skin. J Hand Microsurg. 2010; 2(2): 79–81. |
| [12] | Dawson EK (1972)Carcino-sarcoma of the skin. J R Coll Surg Edinburgh 17: 43–246. |
| [13] | Izaki S, Hirai A, Yoshizawa Y, Kitamura K, Inoue T, Hatoko M, Itoyama S, Inazu M (1993) Carcinosarcoma of the skin: immunohistochemical and electron microscopic observations. J Cutan Pathol 20: 272–2. |
| [14] | Brooks JJ (1986) The significance of double terns and markers in human sarcomas. Am J Pathol 125(1). |
APA Style
Hlatywayo Lawrence, Nyamapfene Brighton Valentine, Nathaniel Zimani, Aaron Musara, Khita Phiri, et al. (2018). Cutaneous Carcinosarcoma of the Scalp - A Case Report and Literature Review. International Journal of Neurosurgery, 2(2), 39-42. https://doi.org/10.11648/j.ijn.20180202.15
ACS Style
Hlatywayo Lawrence; Nyamapfene Brighton Valentine; Nathaniel Zimani; Aaron Musara; Khita Phiri, et al. Cutaneous Carcinosarcoma of the Scalp - A Case Report and Literature Review. Int. J. Neurosurg. 2018, 2(2), 39-42. doi: 10.11648/j.ijn.20180202.15
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author = {Hlatywayo Lawrence and Nyamapfene Brighton Valentine and Nathaniel Zimani and Aaron Musara and Khita Phiri and Kazadi Kalangu and Rudo Makunike Mutasa},
title = {Cutaneous Carcinosarcoma of the Scalp - A Case Report and Literature Review},
journal = {International Journal of Neurosurgery},
volume = {2},
number = {2},
pages = {39-42},
doi = {10.11648/j.ijn.20180202.15},
url = {https://doi.org/10.11648/j.ijn.20180202.15},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20180202.15},
abstract = {Carcinosarcomas are a group of biphasic tumours. They are composed of co-existing malignant epithelial and mesenchymal components. They are extremely rare in the skin. We present a case of a 43 year old female patient who came as a referral from a local district hospital with a chronic painless mass for 7 years. It had ulcerated 6 months prior to presentation with bleeding. The scalp mass was resected with a 10 mm margin. The histological diagnosis was carcinosarcoma as both carcinomatous and sarcomatous. Diagnosis of carcinosarcoma rests on demonstration of pleomorphic spindle cells with pressence of both epithelial and mesenchymal elements within the same tumour. The biphasic nature of the tumour may be seen on light microscopy showing atypical squamoid epithelial cells admixed with mucoid secreting variants as shown in our case. Immunopositivity to both cytokeratin and vimentin on a background of the described light microscopy findings confirms the diagnosis. Generally, surgery with resection of at least 10mm margin is the primary therapeutic modality. Local spread is rare. In conclusion, cutaneous carcinosarcoma of the scalp is rare and management is patient dependant with surgery being the mainstay treatment.},
year = {2018}
}
TY - JOUR T1 - Cutaneous Carcinosarcoma of the Scalp - A Case Report and Literature Review AU - Hlatywayo Lawrence AU - Nyamapfene Brighton Valentine AU - Nathaniel Zimani AU - Aaron Musara AU - Khita Phiri AU - Kazadi Kalangu AU - Rudo Makunike Mutasa Y1 - 2018/12/17 PY - 2018 N1 - https://doi.org/10.11648/j.ijn.20180202.15 DO - 10.11648/j.ijn.20180202.15 T2 - International Journal of Neurosurgery JF - International Journal of Neurosurgery JO - International Journal of Neurosurgery SP - 39 EP - 42 PB - Science Publishing Group SN - 2640-1959 UR - https://doi.org/10.11648/j.ijn.20180202.15 AB - Carcinosarcomas are a group of biphasic tumours. They are composed of co-existing malignant epithelial and mesenchymal components. They are extremely rare in the skin. We present a case of a 43 year old female patient who came as a referral from a local district hospital with a chronic painless mass for 7 years. It had ulcerated 6 months prior to presentation with bleeding. The scalp mass was resected with a 10 mm margin. The histological diagnosis was carcinosarcoma as both carcinomatous and sarcomatous. Diagnosis of carcinosarcoma rests on demonstration of pleomorphic spindle cells with pressence of both epithelial and mesenchymal elements within the same tumour. The biphasic nature of the tumour may be seen on light microscopy showing atypical squamoid epithelial cells admixed with mucoid secreting variants as shown in our case. Immunopositivity to both cytokeratin and vimentin on a background of the described light microscopy findings confirms the diagnosis. Generally, surgery with resection of at least 10mm margin is the primary therapeutic modality. Local spread is rare. In conclusion, cutaneous carcinosarcoma of the scalp is rare and management is patient dependant with surgery being the mainstay treatment. VL - 2 IS - 2 ER -
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