Epithelial–mesenchymal transition in pulmonary carcinosarcoma: case report and literature review

Abstract

Pulmonary carcinosarcoma is a rare and aggressive neoplasm that has both epithelial and mesenchymal components. We report on a 63-year-old woman who was found to have a right upper-lobe pulmonary carcinosarcoma with metastases to the liver and gastric fundus. There are currently no published guidelines on the treatment of pulmonary sarcomatoid carcinomas. However, with our expanding knowledge of cancer metastasis, cases of carcinosarcoma illustrate our current understanding of epithelial-mesenchymal transition in action. Here, we discuss the development and treatment of these biphasic tumors and the possible role of epithelial-mesenchymal transition.

Gingival metastasis of a mediastinal pulmonary sarcomatoid carcinoma: a case report

“…Recently, a study indicated that carcinosarcoma and pulmonary blastoma are histogenetically and morphologically distinct from the remaining tumors of this group, and its accurate subtyping and molecular and genetic classification could eventually lead to better therapy [4]. To date, the origin of the sarcoma component of PSC remains unclear, although previous studies have speculated that this is a clonal evolution [5, 6], which induced PSC to have the histological characteristics of both epidermal and mesenchymal tumors. Using immunohistochemistry, the present PSC case was confirmed with the positive staining of epithelial markers (CK and EMA) and a mesenchymal marker (Vimentin), while Ki67 positivity confirmed the aggressiveness of PSC in tumor cell proliferation.…”

Imaging, Histopathologic, and Treatment Nuances of Pulmonary Carcinosarcoma

“…Finally, a third theory suggests that the lesion arises from a multipotent cell with potential for both, mesenchymal and epithelial differentiation [ 8 ]. Currently, the second and third theories are favoured over the first, but there is still considerable disagreement in the literature [ 12 ].…”

Clinical Impact of the Epithelial-Mesenchymal Transition in Lung Cancer as a Biomarker Assisting in Therapeutic Decisions

“…For example, in a study by Dauphin et al [2013], up to 50% of tumor cells had a mesenchymal phenotype. Mesenchymal traits were shown to be even more frequent in other lung histological types, such as large-cell neuroendocrine carcinomas [Galván et al, 2014], sarcomatoid carcinomas [Thomas et al, 2012], or pleomorphic carcinomas, which are typi-cally reflect the mesenchymal switch [Miyahara et al, 2015;Kondo et al, 2018]. Mesenchymal features have also been associated with a low degree of differentiation in NSCLC [Dauphin et al, 2013;Matsubara et al, 2014;Bian et al, 2019;Z.…”