Sarcomatoid carcinomas: pathological and histopathogenetic considerations

Guarino, Marcello; Tricomi, Paolo; Giordano, F.; Cristofori, E

doi:10.1080/00313029600169224

Cited by 84 publications

(78 citation statements)

References 67 publications

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“…Sarcomatoid carcinoma contains both a conventional epithelial squamous component and a sarcomatous spindle cell component [2,3,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. As also noted in our study, epithelial differentiation evident within the tumor is reported to be highly variable with either changes in the overlying epithelium in the form of dysplasia or carcinoma in situ or as part of the infiltrating tumor [1][2][3].…”

Section: Histomorphologysupporting

confidence: 57%

“…As also noted in our study, epithelial differentiation evident within the tumor is reported to be highly variable with either changes in the overlying epithelium in the form of dysplasia or carcinoma in situ or as part of the infiltrating tumor [1][2][3]. The latter may be demonstrable at light microscopy or by the expression of epithelial markers at immunohistochemistry, electron microscopy or at the molecular level [2,3,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. The degree and intensity of epithelial marker expression is also reported to vary [3] as was observed in our study as well.…”

Section: Histomorphologymentioning

confidence: 75%

“…Both the sarcomatoid as well as conventional squamous carcinoma components have now been proven to arise monoclonally from a single stem cell, and there is further evidence to prove that the sarcomatoid component represents a dedifferentiation and suggests molecular progression of the conventional component [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. The clinical behavior of sarcomatoid carcinoma is however reported to parallel that of conventional squamous carcinoma with the outcome being determined by the location and clinical stage [2,3,19].…”

Section: Discussionmentioning

confidence: 99%

“…It has been demonstrated that the phenotypic plasticity of interconversion of epithelium to mesenchyme cells (as seen during embryogenesis) is expressed by a loss of intercellular cohesion, elongation of the cells, loss of basement membrane, production of connective tissue (collagen), and invasion into the stroma [3,20,[28][29][30].…”

Section: Histomorphologymentioning

confidence: 99%

“…These tumors have now been proved to be monoclonal, evolving from conventional squamous carcinoma with dedifferentiation associated with sarcomatoid transformation [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. They pose a significant diagnostic challenge to the pathologist with remarkable morphological and immunohistochemical overlap with other benign and malignant spindle cell tumors [1,3].…”

Section: Introductionmentioning

confidence: 99%

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Sarcomatoid (Spindle Cell) Carcinoma of the Head and Neck Mucosal Region: A Clinicopathologic Review of 103 Cases from a Tertiary Referral Cancer Centre

Viswanathan

Rahman

Pallavi

et al. 2010

Head and Neck Pathol

167

177

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Sarcomatoid carcinomas are biphasic tumors proven to be monoclonal dedifferentiated forms of conventional squamous carcinomas. This study evaluates their clinicopathologic characteristics in head and neck mucosal sites and the problems in distinguishing them from other spindle cell tumors. A total of 103 cases with a confirmed diagnosis of sarcomatoid carcinoma accessioned in the pathology department of a tertiary referral cancer centre over a period of 7 years (2004)(2005)(2006)(2007)(2008)(2009)(2010) were studied. An algorithm used for their diagnosis is presented. Ages of the patients were 22-90 years (median 53 years), and male:female ratio was 3.7:1. Site distribution was oral cavity (n = 65, 63.1%), larynx (18, 17.5%), oropharynx/hypopharynx (12, 10.7%), maxilla (6, 5.8%) and metastatic nodes (2, 1.9%). A large number of patients (95%) presented with a mass lesion of less than 1 year duration. Histopathologically, epithelial differentiation was evident on morphology in 48 (46.6%) cases, only on IHC in 34 (33%) cases, and in 21 (20.4%) no epithelial differentiation was seen. Typically, tumors were polypoidal (92, 89.3%) and ulcerated (95, 92.2%) with cells arranged predominantly in fascicles (59, 57.3%) or storiform pattern (17, 16.5%) amidst collagenous (50, 48.5%) or myxoid matrix (35, 34%). Anaplasia (2?/3?) and mitosis[10 per 10 HPF were noted in 96 (93.2%) cases. IHC was done in 82 cases; 55 (66.7%) showed positivity for epithelial markers with aberrant expression of mesenchymal markers in 43 (41.7%). Diagnosis of sarcomatoid squamous carcinoma is challenging because of overlapping histopathological features with other spindle cell tumors. Understanding their clinicopathologic characteristics facilitates their diagnosis and appropriate clinical management.

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