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      Cutaneous Carcinosarcoma with Metastasis to the Parotid Gland


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          Cutaneous carcinosarcoma is a rare malignancy that exhibits both mesenchymal and epithelial components. It is similar to nonmelanoma skin cancers in terms of risk and prognostic factors. However, these malignancies are known to have a propensity for local recurrence and metastasis, even with adequate resection margins. Here we report a case of metastatic cutaneous carcinosarcoma to the parotid gland and review the relevant literature.

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          Most cited references21

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          Malignant biphasic uterine tumours: carcinosarcomas or metaplastic carcinomas?

          Uterine carcinosarcomas (malignant mixed Mullerian tumours) are highly aggressive and have traditionally been regarded as a subtype of uterine sarcoma. However, in recent years convincing evidence has suggested that most, but not all, are monoclonal in origin rather than true collision tumours. Data confirm that the carcinomatous element is the "driving force" and that the sarcomatous component is derived from the carcinoma or from a stem cell that undergoes divergent differentiation. Thus, uterine carcinosarcomas are best regarded as metaplastic carcinomas, although the designation carcinosarcoma is likely to remain. Adjuvant treatment for uterine carcinosarcoma should probably be similar to that directed against aggressive high grade endometrial carcinomas rather than being sarcoma based. Importantly, a small proportion of uterine carcinosarcomas are true collision tumours and should be recognised as such because, in some instances, the prognosis may be better than for a similar stage carcinosarcoma.
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            Cutaneous carcinosarcoma: adnexal vs. epidermal types define high- and low-risk tumors. Results of a meta-analysis.

            We report four cases of cutaneous carcinosarcoma (CS) and perform a meta-analysis of the cutaneous CS literature.
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              Biphasic sarcomatoid basal cell carcinoma (carcinosarcoma): four cases with immunohistochemistry and review of the literature.

              Biphasic sarcomatoid carcinoma (BSC), or carcinosarcoma, is an uncommon biphasic neoplasm that has been reported in diverse anatomical sites. The tumor is composed of a malignant epithelial component intimately associated with a malignant mesenchymal component, which may be homologous or heterologous. Twenty-three cases of primary cutaneous BSC have been reported in the English literature. In only eight of these cases was basal cell carcinoma the epithelial component. We report a further four cases of primary cutaneous biphasic basal cell carcinoma, and include the clinical, histological and immunohistochemical features. The four cases showed basal cell carcinoma associated with a pleomorphic sarcomatous stroma. In addition, myofibroblastic differentiation and foci of osteoid were present in one case, and leiomyosarcomatous areas in another. The epithelial components were positive for several epithelial markers. The mesenchymal components were positive for vimentin and CD99, and negative for epithelial markers. p53 was positive with equal intensity in both epithelial and mesenchymal components. A significantly worse outcome was observed in patients with tumors measuring 40 mm or more at excision. The sarcomatous component of the tumor is best regarded as a metaplastic transformation of the carcinomatous component. These tumors are potentially aggressive if incompletely excised, and complete resection is recommended.

                Author and article information

                Case Rep Otolaryngol
                Case Rep Otolaryngol
                Case Reports in Otolaryngology
                Hindawi Publishing Corporation
                25 September 2014
                : 2014
                1Department of Surgery, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW 2010, Australia
                2Department of Anatomical Pathology, Westmead Hospital, Cnr Hawkesbury Road & Darcy Road, Westmead, NSW 2145, Australia
                3Department of Otolaryngology, Head and Neck Surgery, Nepean Hospital, Derby Street, Penrith, NSW 2750, Australia
                4Department of Surgery, The Whiteley-Martin Research Centre, Nepean Hospital, Derby Street, Penrith, NSW 2750, Australia
                Author notes

                Academic Editor: Juan I. De Diego

                Copyright © 2014 Tze Ling Loh et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Case Report


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