- Case Report
- Open Access
Lung carcinosarcoma as a rare biphasic sarcomatoid carcinoma: a case report
- Kaushik Sanyal1Email author and
- Kanagasabesan Sabanathan2
Received: 3 December 2008
Accepted: 26 December 2008
Published: 10 June 2009
Abstract
Introduction
A fit, 57-year-old man admitted with chest pain and haemoptysis turned out to have a primary tumour in the left lung.
Case presentation
In this 57-year-old Caucasian man, the diagnosis followed a computed tomography scan and histopathological evidence gained post-resection. The biopsy showed a uniform, spindle shape with focal pleomorphism which was suggestive of lung carcinosarcoma.
Conclusions
The authors report this case in literature and discuss how a rare malignant tumour can be found in those presenting with trivial chest symptoms.
Keywords
- Migraine
- Carcinosarcoma
- Left Pulmonary Artery
- Histopathological Evidence
- Sarcomatoid Carcinoma
Introduction
The description of lung carcinosarcoma was developed in the early 20th century. It is a rare tumour, accounting for 0.3% of primary lung malignancy. The diagnosis is made through histopathological evidence. The patients presenting with this commonly undergo resection.
Case presentation
Left lung mass.
CT scan of carcinosarcoma of the left lung.
Discussion and conclusion
This is a rare malignant tumour which has a mixture of carcinoma and sarcoma consisting of differentiated mesenchymal elements [1]. Regional and distant metastases are infrequent [2]. The peak age for development is in the 5th to the 7th decade of life [3] and there is greater preponderance in men. Final diagnosis is attainable through histological examination combined with the use of different methods, including monoclonal antibody reactions. Expression of cytokeratin and vimentin confirm the diagnosis of the tumour. This usually produces endobronchial irritation and occlusion and the location explains the symptom. Radical tumour resection and post-operative adjuvant chemotherapy are the best treatments.
Review of current literature
Lung carcinosarcoma is a rare malignancy with a poor prognosis. It accounts for 0.3 % of pulmonary malignancies [4, 5] and it is divided into endobronchial (squamous type) and peripheral (glandular type) categories. There are strong associations with smoking and asbestosis. In the endobronchial type, coughing and blood-tinged sputum usually occur; peripheral tumours are asymptomatic. WHO has added the criterion that pulmonary carcinosarcoma should show differentiation of mesenchymal components into specific tissues. Immunohistochemical differential diagnosis of sarcomatoid carcinoma of the airway in the tumour type leiomyosarcoma is: vimentin +ve, leu-7 antigen +ve, collagen type IV +ve, desmin +ve, smooth-muscle actin +ve [6].
For patients with pulmonary carcinosarcoma, the treatment of choice with a clear margin is complete resection [7]. The rate of reversibility ranged from 87-93 % [8]. Adjuvant or neoadjuvant therapy can be considered in selected cases.
Consent
Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
Abbreviations
None.
Declarations
Authors’ Affiliations
References
- Koss MN, Hochholzer L, et al: Carcinosarcoma of the lung. The American Journal Of Surgical Pathology. 1999, 23: 1514-1526. 10.1097/00000478-199912000-00009.View ArticlePubMedGoogle Scholar
- Jenkins BJ, et al: Carcinosarcoma of the lung. Report of a case and review of the literature. Journal of Thoracic and Cardiovascular Surgery. 1968, 55: 657-661.PubMedGoogle Scholar
- limmermann E, Huwer H, Seitz G: Carcinosarcoma of the lung, a tumour which has a poor prognosis and is extremely rarely diagnosed preoperatively. Thoracic And cardiovascular surgeon. 1990, 38: 247-250. 10.1055/s-2007-1014027.View ArticleGoogle Scholar
- Carbarcos A, Gomez Dorronsoro M, Lobo Beristain JL: Pulmonary carcinosarcoma: a case study and review of the literature. Br J Dis Chest. 1985, 79: 83-86. 10.1016/0007-0971(85)90011-7.View ArticleGoogle Scholar
- Ishida T, Tateishi M, Kaneko S: Carcinosarcoma and spindle cell carcinoma of the Lung: clinicopathologic and immunohistochemical studies. J Thorac Cardiovasc Surg. 1990, 100: 844-852.PubMedGoogle Scholar
- Humphrey PA, Scroggs MW, Roggi VL, Shelbourne JD: Pulmonary carcinoma with a sarcomatoid element. Hum Pathol. 1988, 19: 155-165. 10.1016/S0046-8177(88)80343-5.View ArticlePubMedGoogle Scholar
- Petrov DB, Vlassov VI, Kalaydjiev GT, Plochev MA, Obretenov ED, Stanoev VI: Primary pulmonary sarcomas and carcinosarcoma - postoperative results and comparative survival Analysis. Eur J Cardiothorac Surg. 2003, 23: 461-466. 10.1016/S1010-7940(03)00024-1.View ArticlePubMedGoogle Scholar
- Heremans A, Verbekan E, Deneffe G, Demedts M: Carcinosarcoma of the lung: report of two Cases and review of the literature. Acta Clin Belg. 1989, 44: 110-115.PubMedGoogle Scholar
Copyright
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
