A Case Relapsing into So-Called "Carcinosarcoma" Following Radiation Therapy for Hypopharyngeal Cancer.
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概要
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We encountered so-called "carcinosarcoma, " i.e., mixed carcinoma and sarcoma in the same tissue. A 73-year-old man attained "complete" recovery (CR) in chemotherapy and radiation therapy for moderately differentiated squamous cell carcinoma of the hypopharynx, classified as T2N0M0. During followup, an irregular grayish white mass of 3 cm was detected. Based on a diagnosis of recurrent hypopharyngeal carcinoma, we conducted pharyngolaryngoesophagectomy, bilateral modified dissection, and reconstruction with a free jejunal graft. The resected specimen, stained with HE, was histopathologically determined to be squamous cell carcinoma with styloid cornification tendency, whereas spindle cells markedly proliferated over the entire mass. On immunohistological staining, sarcomatous spindle cells were positive for EMA and cytokeratin, showing they were derived from the epithelium, resulting in a definite diagnosis of so-called "carcinosarcoma" thought to result from transformation from squamous cell carcinoma to the sarcomatous tumor due to radiation therapy. This patient has remained relapse-free in the 3.5 years since the last operation.
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