Carcinosarcoma, formerly known as malignant mixed Mullerian tumors (MMMTs) are highly aggressive tumors that include both malignant epithelial and mesenchymal or stromal elements. The most common site of carcinosarcomas in a female reproductive organ is the endometrium with an incidence of 2/100,000 females, whereas carcinosarcomas arising from the paratubal mass are extremely rare malignancies accounting for fewer than 0.1% of MMMTs. Carcinosarcomas of the Fallopian tube usually occur in the fifth to sixth decades in postmenopausal women with the most common presenting symptom of abdominal pain, followed by vaginal bleeding and abdominal distention. There have been limited published cases worldwide, that is, it has been a thing of interest to be analyzed in today’s era. A rare case of paratubal carcinosarcoma is highlighted in this paper as it discourses its clinicopathological characteristics and assesses the prognostic factors associated with treatment outcome and survival.
Carcinosarcoma

Carcinosarcoma is a rare neoplasm that most commonly affects the uterus. In the pancreas, fewer than thirty cases are reported worldwide. We present a 47-year-old female with epigastric pain, and jaundice. Histopathology revealed a pancreatic head mass showing a biphasic tumor composed of seventy percent Pancreatic Ductal Adenocarcinoma, and thirty percent High Grade Sarcoma with immunohistochemistry using Pancytokeratin, Vimentin, Desmin, S-100, Smooth Muscle Actin, CD34, and Ki-67.
Pancreas ; Carcinosarcoma ; Immunohistochemistry ; Pathology, Surgical ; Diagnosis

Objective: To investigate the clinicopathological characteristics, treatment and prognosis of head and neck carcinosarcoma. Methods: The clinical data of 14 patients with head and neck carcinosarcoma treated in the First Affiliated Hospital of Zhengzhou University from January 2010 to May 2020 were retrospectively analyzed, including 11 males and 3 females, with age range from 30 to 72 years old. Clinicopathological characteristics, treatments and follow-up results of patients were evaluated. Kaplan-Meier method was used to estimate the cumulative survival rate. Results: Histopathological examination showed the co-existence of malignant epithelial and mesenchymal components in all cases. Immunohistochemical staining of 13 cases showed cytokeratin and epithelial membrane antigens were positively expressed in the epithelial areas, whereas vimentin was positive in the malignant mesenchymal tissue area. Among 14 cases, 5 cases were treated with surgery, 3 cases with surgery and radiotherapy, and 6 cases with surgery, radiotherapy and chemotherapy. The follow-up time was 2-81 months, with a median follow-up time of 22.5 months. Except for one patient who was lost to follow-up in 21 months after treatment, among the remaining 13 patients, 4 patients had recurrence, 8 patients died, and 5 patients had a tumor-free survival. The Kaplan-Meier analysis showed that the 1, 3, and 5-year cumulative survival rates of 14 patients with head and neck carcinosarcoma were 64.3%, 57.1%, and 42.9%, respectively. Conclusions: Carcinosarcoma of the head and neck is rare in clinic, histopathological and immunohistochemical examinations are important basis for diagnosis, and surgery is a preferred treatment. Carcinosarcoma of the head and neck has a poor prognosis, and patients should be followed up for a long time.
Adult ; Aged ; Carcinosarcoma/therapy* ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies

Yolk sac tumor is the second most common subtype of ovarian germ cell tumors and is rare in postmenopausal women. The few cases in literature have found that in this age group, yolk sac tumors more commonly present as a mixed component, combined with epithelial tumors. We report a case of a 60-year-old female who presented with an enlarging abdominopelvic mass. Imaging pointed to an ovarian new growth. Total abdominal hysterectomy with bilateral salpingo-oophorectomy revealed a tumor with three populations composed of carcinomatous, sarcomatous, and germ cell components, which was ultimately diagnosed as an ovarian carcinosarcoma with concurrent yolk sac tumor based on histomorphology and immunohistochemical staining. This report also discusses the proposed pathogenesis, treatment, and prognosis of this uncommon entity.
Carcinosarcoma ; Endodermal Sinus Tumor ; Ovary

carcinosarcoma and uterine sarcoma, 8. Treatment of trophoblastic disease, 9. Document collection; and nine algorithms: 1-3. Initial treatment of endometrial cancer, 4. Postoperative adjuvant treatment for endometrial cancer, 5. Treatment of recurrent endometrial cancer, 6. Fertility-sparing therapy, 7. Treatment for uterine carcinosarcoma, 8. Treatment for uterine sarcoma, 9. Treatment for choriocarcinoma. Each chapter includes overviews and clinical questions, and recommendations, objectives, explanation, and references are provided for each clinical question. This revision has no major changes compared to the 3rd edition, but does have some differences: 1) an explanation of the recommendation decision process and conflict of interest considerations have been added in the overview, 2) nurses, pharmacists and patients participated in creation of the guidelines, in addition to physicians, 3) the approach to evidence collection is listed at the end of the guidelines, and 4) for clinical questions that lack evidence or clinical validation, the opinion of the Guidelines Committee is given as a “Recommendations for tomorrow”.]]>
Carcinosarcoma ; Choriocarcinoma ; Conflict of Interest ; Endometrial Neoplasms ; Female ; Gestational Trophoblastic Disease ; Humans ; Japan ; Pharmacists ; Pregnancy ; Sarcoma ; Trophoblasts

BACKGROUND: Cutaneous carcinosarcoma is a rare biphasic tumor comprising malignant epithelial and heterologous mesenchymal elements. Data on the clinical and histopathologic characteristics of this tumor in Asian populations are not available. The purpose of this study was to investigate the clinicopathologic and immunohistochemical features of cutaneous carcinosarcoma in the Korean population. METHODS: We retrospectively reviewed the records of 11 patients with cutaneous carcinosarcoma who were diagnosed from 2006 to 2016. RESULTS: The mean patient age at diagnosis was 71.5 years (range, 43–96 years) and there was a men predilection. The most common site of cutaneous carcinosarcoma was the head and neck (8/11, 72.7%). Histopathologically, most tumors showed a characteristic morphology consisting of two types of tumor cells, varied differentiated epithelial cells (such as basal or squamous cells) and spindle cells with transition zones between the two components. These two cell types also demonstrated variable immunohistochemical characteristics. CONCLUSION: Although the number of cases in this study was limited, our results provide valuable insight into the clinical and histopathologic characteristics of cutaneous carcinosarcoma in the Korean population.
Asian Continental Ancestry Group ; Carcinosarcoma* ; Diagnosis ; Epithelial Cells ; Head ; Humans ; Male ; Neck ; Pathology ; Retrospective Studies

In this study, we summarize the clinical role of magnetic resonance imaging (MRI) in the diagnosis of patients with malignant uterine neoplasms, including leiomyosarcoma, endometrial stromal sarcoma, adenosarcoma, uterine carcinosarcoma, and endometrial cancer, with emphasis on the challenges and disadvantages. MRI plays an essential role in patients with uterine malignancy, for the purpose of tumor detection, primary staging, and treatment planning. MRI has advanced in scope beyond the visualization of the many aspects of anatomical structures, including diffusion-weighted imaging, dynamic contrast enhancement-MRI, and magnetic resonance spectroscopy. Emerging technologies coupled with the use of artificial intelligence in MRI are expected to lead to progressive improvement in case management of malignant uterine neoplasms.
Adenosarcoma ; Artificial Intelligence ; Carcinosarcoma ; Case Management ; Diagnosis ; Endometrial Neoplasms ; Female ; Humans ; Leiomyosarcoma ; Magnetic Resonance Imaging* ; Magnetic Resonance Spectroscopy ; Sarcoma ; Sarcoma, Endometrial Stromal ; Uterine Neoplasms*

Carcinosarcomas, also known as true malignant mixed tumors, are rare tumors of the salivary gland and are composed of both malignant epithelial and malignant mesenchymal elements. They may occur in pre-existing pleomorphic adenomas or arise de novo. Here we report the first case of carcinosarcoma of the parotid gland composed of mucoepidermoid carcinoma and osteosarcoma. The tumor had originated from the parotid gland and extended into the parapharyngeal space. To the best of our knowledge, there have been no reports on mucoepidermoid carcinoma mixed with osteosarcoma ex pleomorphic adenoma in the parotid gland.
Adenoma, Pleomorphic ; Carcinoma, Mucoepidermoid ; Carcinosarcoma ; Mixed Tumor, Malignant ; Osteosarcoma ; Parotid Gland ; Salivary Glands

Since sarcomatoid carcinoma in the common bile duct (CBD) is rarely reported, the clinical course and prognosis after surgery are unclear. We report a case of a patient who died within 1 month after surgery due to rapid tumor progression. A 65-year-old woman had abdominal pain with jaundice. She was diagnosed with CBD cancer and underwent pancreatoduodenectomy. Pathologic examination revealed sarcomatoid carcinoma. There was no postoperative complication, but multiple liver metastasis was diagnosed on computed tomography at 7 days after surgery. Also, the patient complained of abdominal pain and had jaundice with elevated liver enzyme on the 14th postoperative day. Her general condition was getting worse and she died of hepatic failure 23 days after surgery. We report a case of sarcomatoid carcinoma of the CBD that progressed very rapidly. Further research and case reports are needed to establish proper diagnostic and treatment tools.
Abdominal Pain ; Aged ; Carcinosarcoma ; Common Bile Duct ; Female ; Humans ; Jaundice ; Liver ; Liver Failure ; Neoplasm Metastasis ; Pancreaticoduodenectomy ; Postoperative Complications ; Prognosis

Carcinosarcoma ex pleomorphic adenoma of the salivary gland is an extremely rare tumor of the
major and minor salivary glands that is composed of a mixture of both carcinomatous and sarcomatous
elements with an identifiable benign epithelial and mesenchymal tumor counterpart.

This report describes a rare case of carcinosarcoma ex pleomorphic adenoma involving the left parotid
gland in a 61-year-old female with no history of a long-standing pleomorphic adenoma, nor a recurrent
pleomorphic adenoma, and describes its morphology and important immunohistochemistry findings.
Carcinosarcoma ex pleomorphic adenoma contains features of the two tumors under malignant mixed
tumors, which are carcinosarcoma and carcinoma ex pleomorphic adenoma. Immunohistochemistry
studies were done to document the epithelial and mesenchymal areas from both the malignant and
benign sections of the tumor and to classify the carcinoma and sarcoma component, consisting of
adenocarcinoma, not otherwise specified for the carcinoma component, and myxoid chondrosarcoma
and mesenchymal chondrosarcoma for the sarcoma component.

The paucity of documented cases of carcinosarcoma ex pleomorphic adenoma in prior scientific
publications requires reporting cases such as this. Furthermore, the report provides an insight into
the more complex molecular and structural changes that manifest as cancer behavior in the tumors
of the salivary gland. The case contributes to the fund of knowledge for diagnosis and improvement
of quality of care.