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Primary Cutaneous Carcinosarcoma (PCCS0 Aka Metaplastic Carcinoma)
Author(s) -
Ram Ramin,
Saadat Payam,
Vadmal Manju
Publication year - 2005
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2005.320fu.x
Subject(s) - pathology , histogenesis , sarcoma , carcinosarcoma , cytokeratin , myoepithelial cell , metastasis , vimentin , carcinoma , dermis , leiomyosarcoma , biology , medicine , cancer , immunohistochemistry , genetics
We describe a case of PCCS in a 73 year‐old male who presented with a rapidly growing tumor of 6 months duration on the right ear. Clinical examination revealed a 5 × 4 × 4‐cm ulcerated, crusted, exophytic tumor on the superior aspect of the helix. Histologically, the mass revealed a biphasic tumor with malignant epithelial and mesenchymal components. The epithelial component consisted of a few foci of basal cell carcinoma (BCC). The majority of the tumor was composed of osteogenic sarcoma and malignant fibrous histiocytoma (MFH). An intricate transition of BCC into sarcoma was noted in a few foci. Atypical mitosis and necrosis were common. The BCC and tumor giant cells in the MFH area showed positive immunoreaction for cytokeratin and CD68 respectively. The tumor was negative for S‐100 protein, HMB‐45, muscle actins, chromogranin, and synaptophysin. In conclusion, a PCCS growing predominantly as osteosarcoma and MFH is reported. Although the exact histogenesis of PCCS is unknown, primitive mesenchymal cells of the dermis, surrounding the follicular units, are capable of pluripotent differentiation and are likely the source of origin of the sarcoma. The known aggressive biological behavior warrants wide excision and given the rare reports of metastasis and death, regular follow‐up is required