Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-14T06:31:13.607Z Has data issue: false hasContentIssue false

Polypoidal carcinosarcoma of the oropharynx: a clinicopathological and immunohistochemical study

Published online by Cambridge University Press:  29 June 2007

Lars Trier Hansen
Affiliation:
Departments of Otolaryngology, Central Hospital, Esbjerg, Denmark.
Søren Kristensenan*
Affiliation:
Departments of Otolaryngology, Central Hospital, Esbjerg, Denmark.
Jørgen Moesner
Affiliation:
Department of Pathology, Central Hospital, Esbjerg, Denmark.
*
Address for correspondence: Dr Søren Kristensen, Departments of Otolaryngology, Central Hospital, 6700 Esbjerg, Denmark.

Abstract

Polypoidal squamous cell carcinomas, with a sarcomatous stroma, in the upper aerodigestive tract are very rare but well described tumours. They are associated with a multifario?sjiomenclature because of different opinions regarding their histology and histogenesis. The main issue is whether the stroma component is a true sarcoma or a benign reactive lesion.

In order to draw the attention of otolaryngologists and pathologists to the characteristic features of this rare tumour, two cases originating from the oropharynx are presented. Both tumours were pedunculated and polypoidal, and their bulk consisted of a bizarre sarcoma-like stroma covered with granulation tissue. In some areas of the surface, however, atypical squamous cell epithelium with foci of invasive carcinoma was found. In the vicinity of the latter both tumours contained areas of adenocarcinoma. After surgical excision followed by radiation therapy, there was no recurrence after two and five years, respectively.

The histological and immunohistochemical findings support the assumption that these two tumours are carcinosarcomas. Adenocarcinomatous elements in this type of tumour have to our kowledge been reported only twice previously and have never been observed in the pharynx.

Type
Pathology in Focus
Copyright
Copyright © JLO (1984) Limited 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Azumi, N., Battifora, H. (1987) The distribution of vimentin and keratin in epithelial and non-epithelial neoplasms: a comprehensive immunohistochemical study on formalinand alcohol-fixed tumors. American Journal of Clinical Pathology 88: 286296.CrossRefGoogle Scholar
BÁrtek, J., Bártková, J., Vojtesek, B., Stasková, Z., Lukás, J., Rejthar, A., Kovarik, J., Midgley, C. A., Gannon, J. V., Lane, D. P. (1991) Aberrant expression of the p53 oncoprotein is a common feature of a wide spectrum of human malignancies. Oncogene 6: 16991703.Google ScholarPubMed
Batsakis, J. G. (1979) Neoplasms of the larynx. In Tumors of the Head and Neck: Clinicat and Pathotogicat Considerations. 2nd Edition. Williams and Wilkins, Baltimore, pp 200225.Google Scholar
Batsakis, J. G. (1981) ‘Pseudosarcoma’ of the mucous membranes in the head and neck. Journal of Laryngology and Otology 95: 311316.CrossRefGoogle ScholarPubMed
Battifora, H. (1976) Spindle-cell carcinoma: ultrastructural evidence of squamous origin and collagen production by the tumor cells. Cancer 37: 22752282.3.0.CO;2-3>CrossRefGoogle ScholarPubMed
Brodsky, G. (1984) Carcino(pseudo)sarcoma of the larynx: thecontroversy continues Otolaryngologic Clinics of North America 17: 185197.CrossRefGoogle ScholarPubMed
DuBoulay, C. E., Isaacson, P. (1981) Carcinoma of the oesophagus with spindle-cell features Histopathology 5: 403414.Google Scholar
Goeliner, J. R., Devine, K. D., Weiland, L. H. (1973) Pseudosarcoma of the larynx. American Journal of Clinical Pathology 59: 312326.CrossRefGoogle Scholar
Hellquist, H., Olofsson, J. (1989) Spindle-cell carcinoma of the larynx. Acta Pathologica, Microbiologica et Immunologica Scandinavica 97: 11031113.CrossRefGoogle ScholarPubMed
Herzheimer, G. (1918) Ueber das carcinosarcoma des oesophagus Centralblatt für Ailgemeine Pathologie und Pathologishe Anatomie 29: 16.Google Scholar
Herzog, G. (1914) Em scheinbares sarkokarzinom des Osophagus Verhandlungen der Deutchen Pat hologisches Gesellschaft 17: 346351.Google Scholar
Hyams, V. J. (1975) Spindle-cell carcinoma of the larynx. Canadian Journal of Otolaryngology 4: 307313.Google ScholarPubMed
John, D. G., Cross, S. S., Lewis, M. S. (1988) Pseudosarcoma of the oesophagus Journal of Laryngology and Otology 102: 954958.CrossRefGoogle Scholar
Kaufman, M. W., Marti, J. R., Gallager, H. S., Hoehn, J. L. (1984) Carcinoma of the breast with pseudosarcomatous metaplasia. Cancer 53: 19081917.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
Kettle, E. H. (1912) On polymorphism of the malignant epithelial cell. Lancet 2: 750751.CrossRefGoogle Scholar
Klijanienko, J., Vielh, P., Duvillard, P., Luboinski, B. (1992) True carcinosarcoma of the larynx. Journal of Laryngology and Otology 106: 5860.CrossRefGoogle ScholarPubMed
Lane, N. (1957) Pseudosarcoma (polypoid sarcoma-like masses) associated with squamous cell carcinoma of the mouth, fauces and larynx: report of ten cases Cancer 1941.Google ScholarPubMed
Martin, M. R., Kahn, L. B. (1977) So-called pseudosarcoma of the esophagus Archives of Pathology and Laboratory Medicine 101: 604609.Google Scholar
Minckler, D. S., Meligro, C. H., Norris, H. T. (1970) Carcinosarcoma of the larynx: case report with metastases of epidermoid and sarcomatous elements Cancer 26: 195200.Google ScholarPubMed
Osamura, R. Y., Shimamura, K., Hata, J., Tamaoki, N., Watanabe, K., Kubota, M., Yamazaki, S., Mitomi, T. (1978) Polypoid carcinoma of the esophagus: an unifying term for carcinosarcoma and pseudosarcoma. American Journal of Surgical Pathology 2: 201208.CrossRefGoogle ScholarPubMed
Saphir, O., Vass, A. (1938) Carcinosarcoma. American Journal of Cancer 33: 331361.Google Scholar
Sherwin, R. P., Strong, M. T., Vaughin, C. W. (1963) Polypoid and junctional squamous cell carcinoma of the tounge and larynx with spindle-cell carcinoma (‘pseudosarcoma’) Cancer 16: 5160.3.0.CO;2-2>CrossRefGoogle Scholar
Slootweg, P. J., Roholl, P. J., Muller, H., Lubsen, H. (1989) Spindle-cell carcinoma of the oral cavity and larynx: immunohistochemical aspects Journal of Cranio-MaxilloFacial Surgery 17: 234236.CrossRefGoogle ScholarPubMed
Spraggs, P. D., Rose, D. S., Path, D. R., Grant, H. R. (1994) Post-irradiation carcinosarcoma of the parotid gland. Journal of Laryngology and Otology 108: 443445.CrossRefGoogle ScholarPubMed
Srinivasan, U., Talvalkar, G. V. (1979) True carcinosarcoma of the larynx: a case report. Journal of Laryngology and Otology 93: 10311035.CrossRefGoogle ScholarPubMed
Stout, A. P., Lattes, R. (1957) Tumors of the esophagus In Atlas of Tumor Pathology, Sect. 5, Fasc. 20, Armed Forces Institute of Pathology, Washington, D.C., pp 95103.Google Scholar
Stout, A. P., Humphreys, G. H., Rottenberg, L. A. (1949) A case of carcinosarcoma of the esophagus American Journal of Roentgenology 61 461469.Google Scholar
Takubo, K., Tsuchiya, S., Nakagawa, H., Futatsuki, K., Isbibashi, I., Hirata, F (1982) Pseudosarcoma of the esophagus Human Pathology 13: 503505.CrossRefGoogle Scholar
Toda, S., Yonemitsu, N., Miyabara, S., Sugihara, H., Maehara, N. (1989) Polypoid squamous cell carcinoma of the larynx: an immunohistochemical study for ras p21 and cytokeratin. Pathology, Research and Practice 185: 860866.CrossRefGoogle ScholarPubMed
Virchow, R. L. (1864) Die Krankhaften geschwulste. In Vorlesungen uber pathologie. (Virchow, R. L., ed.). Vol. 2. Verlag von August Hirschwald, Berlin, pp 135207.Google Scholar
Weidner, N. (1987) Sarcomatoid carcinoma of the upper aerodigestive tract. Seminars in Diagnostic Pathology 4: 157168.Google ScholarPubMed