Primary cutaneous carcinosarcoma: case report with expanded immunohistochemical analysis

Brašanac, Dimitrije; Boričić, Ivan; Todorovic, Vesna; Tomanović, Nada

doi:10.1111/j.1365-4632.2008.03427.x

Cited by 28 publications

(28 citation statements)

References 30 publications

(71 reference statements)

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“…The results showed that Ab 3 (NCL-L-hTERT antibody) was not absorbed any more with the nucleolin peptide than were the other anti-hTERT antibodies. In agreement with other researchers (27,70,71,(88)(89)(90)(91)(92)(93)(94)(95)(96)(97) and despite the objection raised by Wu et al (64) the Ab 3 proved suitable for hTERT detection. Mitsuishi et al (98) not only confirmed the consideration of Wu et al (64), but also found excellent correlation between nucleolin expression and telomerase activity levels in Bowens's disease and in normal sunexposed skin.…”

Section: Comparison Of Htert Results In Basal Cell Carcinomas and Squsupporting

confidence: 77%

“…Since then many researchers have applied this protocol for proof of telomerase activation in basal cell carcinomas (23,24,26,(38)(39)(40)(41)45,47,48,50). Up to now only a few studies with in situ localization of hTERT in BCCs have been published: immunohistochemical studies by Park et al (25), Brasnac et al (70) and Perrem et al (71), an in situ hybridization study by Guttman-Yassky et al (72) and a fluorescence in situ hybridization study by Perrem et al (71). Immunohistochemical investigations on cryo sections are missing altogether.…”

Section: Discussionmentioning

confidence: 99%

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Localization of telomerase hTERT protein in frozen sections of basal cell carcinomas (BCC) and tumor margin tissues

Fabricius

Kruse-Boitschenko²,

Khoury³

et al. 2009

Int J Oncol

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Abstract.In previous studies we demonstrated telomerase activity in frozen tissues from BCC and their tumor-free margins by the PCR ELISA. In this study we examined in the same frozen sections immunohistochemical presence of hTERT in the nucleus. After fixation in acetone and methanol followed by steaming we used for visualization the antigenantibody reactions by APAAP. This was the best method of preparation of the frozen sections in our preliminary hTERT-study with squamous cell carcinomas. This study was supplemented with antibodies against Ki-67, nucleolin, common leucocyte antigen CD45 and mutated p53. The immunoreactive scores were determined and included the comparison with telomerase activity. The investigation of hTERT expression was performed in the tissues of 41 patients with BCC and control tissues of 14 patients without tumor. Eleven commercial antibodies were used for a nuclear staining of hTERT expression. With the anti-hTERT antibodies we looked for both satisfactory distribution and intensity of immunohistochemical labeling in the carcinomas and in the squamous epithelia of the tumor centers, of the tumor-free margins and of the control tissues. The hTERT expression in the BCC was distributed heterogeneously. The score values established by the anti-hTERT antibodies used were variably or significantly increased. In the stroma they tended to be negative, so we disregarded stroma hTERT. Proof of hTERT did not differ uniformly from telomerase activity. We compared the high with the lower median hTERT values in the Kaplan-Meier curve. Patients with lower hTERT scores in the center or tumor margin as shown by some of the antibodies suffered relapse earlier. Finally, we compared the hTERT expression in BCC tissues with the hTERT scores in HNSCC tissues from our previous study. Only one anti-hTERT antibody (our Ab 7) yielded significantly higher scores in BCC than in HNSCC.

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Section: Comparison Of Htert Results In Basal Cell Carcinomas and Squsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Localization of telomerase hTERT protein in frozen sections of basal cell carcinomas (BCC) and tumor margin tissues

Fabricius

Kruse-Boitschenko²,

Khoury³

et al. 2009

Int J Oncol

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“…[1][2][3] They are most commonly located in the female genital tract but are also encountered in other tissues including the gastrointestinal tract, male reproductive tract, and urinary tract. 4 Cutaneous carcinosarcomas are rare.…”

Section: Discussionmentioning

confidence: 99%

A Growing Scalp Nodule

Evanson

Carroll²,

Stetson³

2016

The American Journal of Dermatopathology

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ANSWERCutaneous carcinosarcoma. MICROSCOPIC FINDINGS AND CLINICAL COURSEHistopathological evaluation showed an ulcerated malignant tumor filling the dermis. The tumor was composed of 2 distinct morphologies. There were atypical spindle cells and epithelioid cells with foamy cytoplasm present within the dermis. In addition, infiltrating strands of keratinizing cells were seen. Pan-cytokeratin, high molecular weight keratin, and P63 stained the epithelial strands of this tumor while CD-68 stained diffusely within the dermal component. S-100 and HMB-45 were negative. DISCUSSIONCarcinosarcoma is a biphasic malignancy composed of admixed neoplastic epithelial (carcinoma) and mesenchymal (sarcoma) cells. 1-3 They are most commonly located in the female genital tract but are also encountered in other tissues including the gastrointestinal tract, male reproductive tract, and urinary tract. 4 Cutaneous carcinosarcomas are rare. 2 Thus far, over 90 cases have been reported in the literature, and this malignancy might be underdiagnosed. 2,5 Varying nomenclature has been used to report this entity including metaplastic carcinoma, biphasic sarcomatoid carcinoma, sarcomatoid basal cell carcinoma, and primary cutaneous carcinosarcoma (PCS). 2 PCS has been offered as the standard because it is descriptive of its diagnostic process, avoids assumptions about its pathogenesis, and limits confusion with other tumors. 5 Although the pathogenesis of PCS is not fully understood, several theories are proposed. The collision theory, which is the least convincing but may account for a minority of tumors, proposes that 2 concomitantly growing tumors become entwined. The conversion theory, favored by some, states that the sarcomatous portion is derived from the carcinoma during the evolution of the tumor. Another plausible theory is the monoclonal or divergent theory, which maintains PCS has a common monoclonal origin-an epithelial stem cell-from which the 2 malignant cell types arise. 3,6 The monoclonal theory is substantiated by a recent case report demonstrating a common point mutation in both portions of 1 PCS tumor. 3 Diagnosis of PCS can be difficult. Hematoxylin and eosin staining shows its biphasic nature, but immunohistochemistry is needed to solidify the diagnosis. The epithelial and mesenchymal components stain with cytokeratins and vimentin (or CD-68), respectively. 2 The epithelial portion of the tumor is most commonly basal cell carcinoma followed by various adnexal tumors and squamous cell carcinoma. 1 The mesenchymal component is most commonly undifferentiated sarcoma followed by atypical fibroxanthoma. 1 Features of malignancy, such as mitotic figures, necrosis, pleomorphic cells, and nuclear atypia should be present. 7 More recently, p63, which is a protein homologue of p53 found in poorly differentiated epithelial cells, has been reported to be a useful marker in PCS tumors with poorly differentiated epithelial components. 8 Primary cutaneous carcinosarcoma can be stratified using a classification scheme by Tran et al. Th...

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“…[50% cells stained. Proliferative activity assessed by the Ki-67 labeling index (LI), and immunopositivity for p27 protein, Rb protein, HDAC1, HDAC2 and HDAC3 were analyzed using images taken with digital camera as previously described [22].…”

Section: Pathologic Findingsmentioning

confidence: 99%

Large-cell neuroendocrine carcinoma of the ampulla of Vater

et al. 2009

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Large-cell neuroendocrine carcinoma is a high-grade neuroendocrine carcinoma, originally described in the lung. The tumor rarely occurs in extrapulmonary sites like the gastrointestinal tract, and only few examples have been described in the ampulla of Vater. A new case of large-cell neuroendocrine carcinoma of the ampulla of Vater in a 60-year-old man is reported. After pancreatoduodenectomy, macroscopic examination revealed ulcerated tumor in the region of the ampulla of Vater. Microscopically, the tumor exhibited organoid, predominantly nested growth pattern, consisting of large, polygonal cells with pleomorphic nuclei. Average number of mitoses was 36 per 10 high-power fields. Small and large areas of necrosis were identified. Immunohistochemically, the tumor cells were positive for synaptophysin, chromogranin A, PGP 9.5, neuron-specific enolase, pancytokeratin, CK8 and somatostatin and negative for CK7, CK20, S-100, TTF-1, HMB-45, CD117, E-cadherin and regulatory peptides. Ki-67 proliferative index was 41%. Histone deacetylase (HDAC) analysis showed almost identical results for HDAC1, HDAC2 and HDAC3--60, 60.3 and 61%, respectively. Two months after surgery, liver metastases occurred, confirming highly aggressive behavior of large-cell neuroendocrine carcinoma.

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Primary cutaneous carcinosarcoma: case report with expanded immunohistochemical analysis

Cited by 28 publications

References 30 publications

Localization of telomerase hTERT protein in frozen sections of basal cell carcinomas (BCC) and tumor margin tissues

Localization of telomerase hTERT protein in frozen sections of basal cell carcinomas (BCC) and tumor margin tissues

A Growing Scalp Nodule

Large-cell neuroendocrine carcinoma of the ampulla of Vater

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