Carcinosarcoma of Head and Neck; Clinicopathological Characteristics, Treatment and Outcomes of Unique Neoplasm

Abstract

Background: Carcinosarcoma of the Head and neck is rare neoplasm with incidence of <1%. This is biphasic tumor with epithelial and mesenchymal components. Rarity of this neoplasm is major obstacle to establish proper guidelines. Only few case series and reports are available. Aim:The aim of this study was to evaluate clinicopathological characteristics, treatment and its outcome to contribute in part to the better understanding and awareness of this rare malignancy. Material and Methods:Retrospectively data of histological proven carcinosarcoma of head and neck from 2013 to 2015 was retrieved and evaluated for various parameters and also compared with both Indian and western data. Results:Total of 5 patients of carcinosarcoma were registered within selected timeframe. The mean age of 44.8years ranged from 27years to 68years. Male predominance was reported with M:F ratio 4:1.Oral cavity is most common site of tumor followed by oropharynx .Surgery is primary modality of treatment followed by adjuvant radiotherapy as per indication .Shortest follow up was 11month and longest was 31months. Only One patient was presented with recurrence. Conclusion:The diagnosis of carcinosarcoma is challenging so histopathology along with immunohistochemistry is needed for appropriate diagnosis. Oral cavity seems to be the most common site with younger age group in present study which is supported by other Indian studies. Future studies are needed to define the geographical variation with clinicopathological character as well as treatment protocol for this relatively rare entity.

Carcinosarcoma of Tongue with Predominant Osteosarcomatous Component

“…It has been reported in the tongue, lower gingiva, and floor of the mouth [3]. In the oral cavity, it usually occurs in males during 6th and 7th decades of life (similar to our case) [5]. The usual clinical presentation of carcinosarcoma in the head and neck region is of a painful or painless mass that may undergo a sudden increase [6].…”

“…Our patient presented with a painful lesion and trismus. Predisposing factors are smoking, alcohol consumption, and previous radiation exposure [5]. The latter two were present in our patient.…”

Carcinosarcoma of the nasopharynx: a case report

“…Carcinosarcoma of the head and neck is an uncommon clinical entity that mimics common squamous cell carcinoma. 2 Carcinosarcoma may arise from any squamous epithelia of the body such as the gastrointestinal tract, pelvis, and aerodigestive tract. 6 In the head and neck, it is common in the larynx and salivary glands.…”

“…Carcinosarcoma is a malignant tumor consisting of a mixture of two cell lineage, carcinomatous and mesenchymal (a term broadly used to include cartilage, bone, fat, and hematopoietic tissues). 1,2 Carcinosarcoma is also referred to as a true malignant mixed tumor. 2,3 The early pathologist, like Rudolph Virchow has always considered that the origin of this pathology has a dual origin and thus labelled it as carcinosarcoma.…”

“…1,2 Carcinosarcoma is also referred to as a true malignant mixed tumor. 2,3 The early pathologist, like Rudolph Virchow has always considered that the origin of this pathology has a dual origin and thus labelled it as carcinosarcoma. 1 Virchow believed that the component of both sarcomatous and carcinomatous was simultaneously triggered to undergo malignant changes.…”