Minimally invasive carcinosarcoma ex pleomorphic adenoma: A case report and literature review with cytohistological correlation

Abstract

This is the third case report of the cytological features of Ca ex PA of the salivary gland, with histologic correlation. It further illustrates the oncogenic relationship between epithelial and myoepithelial elements in the early stages of carcinosarcomatous transformation. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2483-E2489, 2016.

Recurrent Parotid Carcinosarcoma in an Asymptomatic Patient

“…It is believed that carcinosarcoma spreads using both hematogenous and lymphatic routes owing to its bimodal cell population. 3,9 However, when taken together the most critical prognostic factors include facial nerve palsy, as seen in this case, the tumor grade as well as the stage, and finally the extent of spread. 10 …”

“…2,4 In general, radical surgical exploration coupled with high dosage chemotherapy coupled with radiation are necessary for treatment. However, even with this aggressive regimen disease reoccurs in about 66% of patients, with metastatic dissemination in about 50% 8,9 (Table 1). Interestingly, the lungs seem to be the most common site of dissemination, but this was not seen in the present case.…”

“…Other cases have seen a wide variety of cell origins including elements of the following: chondrosarcoma, fibrosarcoma, leiomyosarcoma, osteosarcoma, and malignant fibrous histiocytoma. 2,3,9,11,12 …”

A case of giant sarcomatoid carcinoma ex-pleomorphic adenoma of the parotid gland

“…Generally, Ca ex PA is a neoplasm that affects older patients (mean age, 58 years), with a wide age range of 14-87 years. There is no sex difference [ 10 ]. Ca ex PA can be asymptomatic as most of the cancers that are not widely invasive and they often have similar clinical presentations as PA.…”

“…Rapid growth, change in consistency, pain and onset of facial nerve deficit are signs of carcinomatous transformation, the incidence of which increases with duration of a known PA [ 10 , 11 ]. In our case, the tumor had a lateral development outside the facial nerve which explains its asymptomatic character despite its large size.…”