上顎洞と喉頭の癌肉腫2症例

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Carcinosarcoma, showing simultaneous presence of malignant epithelial and non-epithelial elements, is rare and verification of this diagnosis requires detailed histopathological examination. We observed both malignant epithelial and non-epithelial elements in each tumor of two cases in the maxillary sinus and larynx, using light and electron microscopy.The first case was found in a 66-year-old female. Under diagnosis of malignant maxillary tumor, she was treated by irradiation, chemotherapy, cryosurgery and surgery, but death followed with a metastases to the cervical vertebra and cervical lymphnodes.Non-epithelial elements were composed of interlacing bundles and whorls of atypical spindle cells. Under electron microscopy, the cytoplasm revealed an abundant rough endoplasmic reticulum. The intercellular spaces contained varying amounts of collagen and flocculent material. Epithelial elements were islands of tumor cells in the stroma. Under electron microscopy, tonofibrils and desmosomes were noted.The second case concerned a 78-year-old male. Under a diagnosis of malignant laryngeal tumor, total laryngectomy was successfully performed. On the surface layer of the tumor mass, well differentiated squamous cell carcinoma was noted, while in the subepithelial tissue, interlacing bundle of many atypical spindle cells and a few giant cells were confirmed as fibrosarcoma cells since the morphological character of fibroblasts was evident.Thus the combined use of electron and light microscopes using different stains is required for the diagnosis of carcinosarcoma.
耳鼻咽喉科臨床学会の論文

上顎洞と喉頭の癌肉腫2症例

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