Malignant Transformation of Metaplastic Thymoma into High-Grade Sarcomatoid Carcinoma: A Case Report

2021 ◽  
pp. 106689692110704
Author(s):  
Zheng Hua Piao ◽  
Jin Ping Chen ◽  
Hai Ren Chen ◽  
Xin Cheng Zhou

The correlation of histogenesis between metaplastic thymoma and thymic sarcomatoid carcinoma is unclear. We report a case of metaplastic thymoma transformed into high-grade sarcomatoid carcinoma. A 64  ×  54  ×  32 mm anterior mediastinal mass in a 61-year-old woman microscopically consisted mainly of classic metaplastic thymoma, with the center dominated by high-grade sarcomatoid carcinoma. In some areas, both epithelial and spindle cell components of the metaplastic thymoma showed increased cellular atypia, mitotic activity, and focal necrosis and gradually transformed into the polygonal/pleomorphic and spindle cell components of sarcomatoid carcinoma. Immunohistochemically, the characteristics of the polygonal/pleomorphic sarcomatoid cells were similar to those of the epithelial component of metaplastic thymoma, while the spindle sarcomatoid cells were more similar to the spindle cells component of metaplastic thymoma. The Ki-67 index was less than 5% in the metaplastic thymoma areas but up to 70% in the sarcomatoid carcinoma area. Radical operation and postoperative radiotherapy were performed. Multifocal relapses at the pleura occurred 13 months after surgery.

2007 ◽  
Vol 93 (5) ◽  
pp. 508-510 ◽  
Author(s):  
Brian R Gannon ◽  
Carolyn D O'Hara ◽  
Kenneth Reid ◽  
Phillip A Isotalo

Solitary fibrous tumors are uncommon spindle cell neoplasms originally thought to be restricted to the pleura. We describe a 62-year-old woman who presented with stridor and an anterior mediastinal mass. At thoracotomy, a 10.5 × 6.5 × 5.5 cm, circumscribed, firm mediastinal mass demonstrated no direct cardiac or pulmonary involvement. The tumor consisted of spindle cells organized in a patternless pattern with collagenous stroma and hemangiopericytoma-like vessels. Spindle cells were immunoreactive for CD34, CD99, desmin, vimentin and bcl-2 protein and a diagnosis of mediastinal solitary fibrous tumor was confirmed. The differential diagnosis of mediastinal solitary fibrous tumors is extensive and includes spindle cell thymoma, sarcomatoid carcinoma, malignant mesothelioma, inflammatory myofibroblastic tumor, peripheral nerve sheath tumors and various sarcomas. Despite their rarity in the mediastinum, solitary fibrous tumors can be recognized by their classic patternless morphology and immunophenotypic pattern. Their accurate classification is important, as solitary fibrous tumors are intermediate (rarely metastasizing) neoplasms that require complete surgical excision and long-term clinical follow-up for optimum therapy.


2004 ◽  
Vol 128 (8) ◽  
pp. 918-921
Author(s):  
Michelle Reid-Nicholson ◽  
Muhammed Idrees ◽  
Giorgio Perino ◽  
Prodromos Hytiroglou

Abstract Sarcomatoid carcinoma of the small bowel is rare; to our knowledge, 19 cases have been reported to date in the English literature under several names. We report an additional case occurring in the jejunum of a 55-year-old man. The tumor was a polypoid 7.5-cm mass, which infiltrated the full thickness of the intestinal wall and the serosa of an adhesed loop of small bowel. On microscopic examination, the neoplasm was composed of sheets of spindle cells; focally, an anaplastic component was present, including tumor giant cells with bizarre nuclei. On immunohistochemical stains, tumor cells were positive for cytokeratin 7, cytokeratin AE1/AE3, vimentin, and focally, epithelial membrane antigen. No staining for cytokeratin 20 was found. Sarcomatoid carcinoma must be kept in mind in the differential diagnosis of malignant spindle cell tumors of the small bowel. As consensus regarding the terminology of these rare tumors is being reached, immunohistochemical stains are essential for accurate diagnosis.


2002 ◽  
Vol 126 (7) ◽  
pp. 853-855 ◽  
Author(s):  
Atilla Omeroglu ◽  
Gladell P. Paner ◽  
Eva M. Wojcik ◽  
Kalliopi Siziopikou

Abstract We describe an invasive polypoid carcinosarcoma/sarcomatoid carcinoma arising within a urinary bladder diverticulum in a 65-year-old patient with synchronous, moderately differentiated prostatic adenocarcinoma. Histologically, the diverticular tumor exhibits an admixture of different morphologic components, including invasive high-grade urothelial carcinoma, malignant glandular structures in a cellular background of malignant spindle cells, and areas formed exclusively by spindle and pleomorphic cells. There was full-thickness involvement of the diverticulum with extension of the tumor into the perivesical fat and ipsilateral seminal vesicle. In view of the early invasive behavior of carcinosarcoma/sarcomatoid carcinoma combined with the paucity of the muscular layer in the diverticulum wall, a graver prognosis was expected for this aggressive tumor that occurred in this unusual site.


2012 ◽  
Vol 02 (01) ◽  
pp. 45-47
Author(s):  
Shetty K. Padma ◽  
Harish S. Permi ◽  
C.N. Patil ◽  
Michelle Mathias

AbstractSarcomatoid carcinoma occurring in the small intestine is very rare. They can be monophasic or biphasic. We report a rare case of monophasic Sarcomatoid carcinoma of the small intestine in a 60 year old male patient. The tumor was an ulceronodular mass involving the ileum circumferentially. The tumor infiltrated the full thickness of the intestinal wall and the serosa of an adjacent loop of ileum. Microscopically, the tumor was composed of sheets of malignant spindle cells. The carcinomatous nature of the tumor was evident only after Immunohistochemistry. The diagnosis of sarcomatoid carcinoma should be considered in the differential diagnosis of malignant spindle cell tumor of small intestine and immunohistochemical stains are required for the correct diagnosis.


1990 ◽  
Vol 14 (4) ◽  
pp. 384-389 ◽  
Author(s):  
Ralph H. Hruban ◽  
Michael May ◽  
Ralph C. Marcove ◽  
Andrew G. Huvos

2014 ◽  
Vol 138 (9) ◽  
pp. 1233-1237 ◽  
Author(s):  
Lakshmi Vemavarapu ◽  
Irene Czyszczon ◽  
Joseph C. Parker ◽  
Stephanie Wagner ◽  
Todd Vitaz ◽  
...  

We report a case of an intraventricular tumor with features of atypical central neurocytoma with a sarcomatous component in a 44-year-old woman who presented with headaches and vomiting. Magnetic resonance imaging revealed a 3.4-cm lobulated enhancing mass in the occipital horn of the left lateral ventricle, and the patient subsequently underwent a left occipital-parietal craniotomy for debulking. The tumor contained 2 cell populations: round cells with perinuclear halos in a fibrillary background, and spindle cells with oval nuclei arranged in interlacing fascicles with focal necrosis. The round cells had diffuse synaptophysin immunopositivity, while the spindle cells were diffusely immunopositive for vimentin and had intercellular reticulin. The mitotic activity (8 mitotic figures per 10 high-power fields) and the high Ki-67 proliferation index (15.0%) were consistent with atypical central neurocytoma with a sarcomatous component. Although different histologic variants have been described, this is the first reported case, to our knowledge, of central neurocytoma with spindle cell sarcomatous features.


2011 ◽  
Vol 01 (04) ◽  
pp. 40-42
Author(s):  
Harish S Permi ◽  
Samaga B N. ◽  
Subramanyam K. ◽  
Jayaprakash Shetty K. ◽  
Teerthanath S. ◽  
...  

AbstractLymphatic filariasis is common in tropical countries and is endemic in South India. Filariasis presenting with pericardial effusion is rare, coexisting with spindle cell thymoma is still very rare. We report a case of a 53-year-old male who was admitted to cardiac intensive care unit with severe breathless since two days. Cardiac Echocardiogram showed massive pericardial effusion with cardiac tamponade and large anterior mediastinal mass. Pericardial fluid aspiration drained 1.5 litres of hemorrhagic fluid. Cytology examination revealed microfilaria of Wutchereria bancrofti. FNAC and trucut biopsy from anterior mediastinal mass showed features of spindle cell thymoma. He was treated with diethyl carbamazine thrice daily for one month. He refused for excision of thymoma. This case report is a rare coexistence of microfilaria in pericardial effusion with spindle cell thymoma. We stress the need to consider filariasis as differential diagnosis in the evaluation of hemorrhagic pericardial effusion especially in endemic areas.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Montserrat Reyes ◽  
Gina Pennacchiotti ◽  
Fabio Valdes ◽  
Rodrigo Montes ◽  
Marcelo Veloso ◽  
...  

Sarcomatoid Carcinoma (SC) is an unusual and aggressive variant of squamous cell carcinoma, which frequently recurs and metastasizes; for this reason, the right diagnosis is very important. It is considered to be a biphasic tumor made up of cells from squamous and spindle cells carcinoma with a sarcomatous aspect, but of epithelial origin. The diagnosis often represents a clinical-pathological challenge where the study with immunohistochemical technique (IHC) is key to the histopathological diagnosis. The reported cases related to oral mucosa are limited. In this work we present two SC cases where the use of IHC allowed us to achieve a conclusive diagnosis.


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