Carcinosarcoma of the pancreas: comprehensive clinicopathological and molecular characterization

Li, Jin; Tao, Wei; Zhang, Jian; Wei, Shumei; Chen, Qi; Chen, Bryan Wei; Zhou, Yue; Wen, Liang; Qin, Hao; Bai, Xueli; Liang, Tingbo

doi:10.1016/j.hpb.2020.01.017

Cited by 11 publications

(16 citation statements)

References 23 publications

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“…From the clinical point of view, compared to conventional PDAC, UC usually show a worse prognosis, whereas UCOGC is generally associated to a better prognosis, when not associated with a PDAC component [3,5,6]. Some studies have demonstrated that UC and UCOGC have a molecular landscape very similar to PDAC, based on alterations that affect the classic PDAC drivers, including the oncogene KRAS and the tumor suppressor genes TP53, SMAD4, and CDKN2A [5,7,8]. As such, somatic mutations are unlikely to explain the unique phenotype of UC and UCOGC.…”

Section: Introductionmentioning

confidence: 99%

Epithelial-mesenchymal transition in undifferentiated carcinoma of the pancreas with and without osteoclast-like giant cells

et al. 2020

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Undifferentiated carcinoma (UC) and undifferentiated carcinoma with osteoclast-like giant cells (UCOGC) are peculiar variants of pancreatic ductal adenocarcinoma (PDAC), characterized by hypercellularity and absence of glandular patterns. The inflammatory microenvironment is peculiar in UCOGC, since it is dominated by macrophages and osteoclast-like giant cells. However, from a molecular point of view, both UC and UCOGC are very similar to conventional PDAC, sharing alterations of the most common genetic drivers. Clinically, UC usually show a worse prognosis, whereas UCOGC may show a better prognosis if it is not associated with a PDAC component. To highlight potential biological differences between these entities, we investigated the role of the epithelial to mesenchymal transition (EMT) in UC and UCOGC. Specifically, we analyzed the immunohistochemical expression of three well-known EMT markers, namely Twist1, Snai2, and E-cadherin, in 16 cases of UCOGC and 10 cases of UC. We found that EMT is more frequently activated in UC (10/10 cases) than in UCOGC (8/16 cases; p = 0.05). Furthermore, in UCOGC, EMT was activated with a higher frequency in cases with an associated PDAC component. Snai2 was the most frequently and strongly expressed marker in both tumor types (10/10 UC, 8/16 UCOGC), and its expression was higher in UC than in UCOGC (mean immunohistochemical score: 4.8 in UC vs. 2.1 in UCOGC, p < 0.01). Our results shed new light on the biology of UC and UCOGC: EMT appeared as a more important process in UC, and Snai2 emerged as a central EMT effector in this setting.

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Section: Introductionmentioning

confidence: 99%

Epithelial-mesenchymal transition in undifferentiated carcinoma of the pancreas with and without osteoclast-like giant cells

et al. 2020

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“…In the interim of tions, c.35G>A and c.35G>T at codon 12 and codon 34. [3][4][5][6][7][8] KRAS Q61H and TP53 Q100X mutations are also recently discovered to be present in both components. 3 In a case series by Ruess, molecular analysis of these tumors revealed that pancreatic carcinosarcomas are of monoclonal origin.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7][8] KRAS Q61H and TP53 Q100X mutations are also recently discovered to be present in both components. 3 In a case series by Ruess, molecular analysis of these tumors revealed that pancreatic carcinosarcomas are of monoclonal origin. KRAS mutation is a distinctive driver mutation in pancreatic ductal adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…2 In a 6-year institutional review at Zhejiang University in China, only 9 carcinosarcomas were identified among 1,824 cases of pancreatic ductal adenocarcinoma. 3 The purpose of this paper is to show the gross, histology, and immunohistochemistry profile of a case of pancreatic carcinosarcoma with multiple nodal metastases and to review the literature.…”

Section: Introductionmentioning

confidence: 99%

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A Case Report on Carcinosarcoma of the Pancreas with a Concise Literature Review

Santos¹,

Samonte²

2022

PJP

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“…Previous studies suggested that most pancreatic carcinosarcomas appear to be of monoclonal origin and seem to arise from a carcinoma via metaplastic transformation of a subclone of the tumor, probably by the epithelial–mesenchymal transition mechanism [ 3 , 7 ]. In one report, clonality of the two distinct tumor components was assessed by microdissection with subsequent genetic analysis for KRAS and TP53 gene mutation and showed the same genetic alterations in the carcinomatous and the sarcomatous components, strongly suggesting a common origin [ 8 ]. Another study demonstrated that an identical mutation (G to A transition) at exon 2 of the KRAS gene was detected in both the carcinomatous and sarcomatous components [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Carcinosarcoma, a Rare Malignant Neoplasm of the Pancreas

et al. 2021

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Carcinosarcoma of the pancreas is a rare entity with poor prognosis. Here, we report a case of pancreatic carcinosarcoma in a 68-year-old male patient who underwent a pancreatoduodenectomy for a unilocular cystic mass in the head of the pancreas. Histologically, the lesion showed a biphasic tumor with a carcinoma component and a spindle cell sarcomatous component, which were intimately intermingled. Most of the carcinoma components are well-differentiated ductal adenocarcinoma with small areas of moderately to poorly differentiated ductal adenocarcinoma. The sarcomatous component is a high-grade highly cellular spindle cell tumor with frequent mitosis and apoptosis. Immunohistochemical studies demonstrated that the carcinomatous component was positive for epithelial markers and cyclin D1, and the sarcomatous component was negative for these markers while positive for vimentin, p16, and DOG1 with patchy positivity for S100. Other markers, including SOX10, CD117, Melan A, HMB45, actin, desmin, myogenin, beta-catenin, TLE1, and p53, were negative in both components. Molecular studies demonstrated that the tumor was microsatellite stable. Whole exome next generation sequencing analysis was performed and no pathogenic alterations in the genes were identified.

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Carcinosarcoma of the pancreas: comprehensive clinicopathological and molecular characterization

Cited by 11 publications

References 23 publications

Epithelial-mesenchymal transition in undifferentiated carcinoma of the pancreas with and without osteoclast-like giant cells

Epithelial-mesenchymal transition in undifferentiated carcinoma of the pancreas with and without osteoclast-like giant cells

A Case Report on Carcinosarcoma of the Pancreas with a Concise Literature Review

Carcinosarcoma, a Rare Malignant Neoplasm of the Pancreas

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