Metastatic cutaneous carcinosarcoma to the tongue

Comprehensive analyses of intraoral spindle cell carcinoma: A rare disease entity revisited

OBJECTIVE

The present study was aimed to comprehensively characterize the epidemiological, clinicopathological characteristics, treatments, and prognosis of intraoral spindle cell carcinoma (SpCC).

MATERIALS AND METHODS

Patients diagnosed with intraoral SpCC at our institution in the past 15 years (2005-2019) were screened from inpatient disease registry. All relevant data concerning patients with intraoral SpCC were retrieved. Previous reports about intraoral SpCC with adequate clinicopathological data in both English literature and Chinese literature were collected. Eligible cases were further reviewed and pooled for statistical analyses.

RESULTS

Six patients (5 females and 1 male; average age: 59 years) with intraoral SpCC were histopathologically diagnosed and surgically treated at our institution. The literature review identified another 63 published cases from 34 articles. Most cases were presented in the fifth to seventh decade of life with a male preponderance. Gingiva (23/69, 33.3%) was the most common site followed by the tongue (19/69, 27.5%) and buccal mucosa (8/69, 11.6%). Complete surgical ablation remains the primary treatment option. Tumor size, pathological grades, cervical node metastasis, and distant metastasis were significantly associated with reduced survival.

CONCLUSIONS

Intraoral SpCC is an uncommon and aggressive malignancy with dismal prognosis. Much attention and effort are needed to characterize this rare entity and improve its clinical outcomes.

A Case Report of Carcinosarcoma of the Tongue Mimicking a Fibroma: An Enigmatic Lesion With a Diagnostic Dilemma

Carcinosarcoma of the tongue is a rare biphasic tumor composed of squamous cell carcinoma (SCC), either in situ and/or in invasive form, and a mesenchymal component but of epithelial origin. It is important to diagnose this variant because of its aggressive nature and tendency to metastasize early. The present report describes the case of a carcinosarcoma of the tongue in a 48-year-old male with a short history of 30 days, the clinical feature of which resembles that of an irritational fibroma. The diagnosis often represents a clinicopathological challenge where the study with immunohistochemical technique (IHC) is key to the histopathological diagnosis. We here present a case report of this rare tumor, with an unusual presentation, to contribute in part to better understanding and awareness of this rare malignancy.

Metastasis to the oral soft tissues: A review of 412 cases

The present review article analyzes the characteristics of metastases to the oral soft tissues from 1937 to 2015. An extensive literature search was performed. All variables such as age, gender, and primary and secondary tumor sites were analyzed. Metastases to the major salivary glands were not included in this review. In general, there were 412 metastatic lesions developed in the oral soft tissues. The male-to-female ratio was approximately 1.8:1. The mean age of the patients at diagnosis was 58. The lung was the most common primary site and the gingiva was the most common metastatic site. The greater part of the histological examination yielded adenocarcinoma. The diagnosis of a metastatic lesion in the oral cavity is a challenge to the clinicians due to the lack of pathognomonic signs and symptoms. Oral metastases usually occur in the advanced stages of cancers, and the interval between appearance and death is usually short. The oral soft tissue metastasis can be easily recognized compared to the metastasis of jawbones. Early detection of oral lesions is important in the case of being the first sign of a malignancy in other parts of body.

Primary Cutaneous Carcinosarcoma of the Basal Cell Subtype Should Be Treated as a High-Risk Basal Cell Carcinoma

BACKGROUND

Cutaneous carcinosarcoma is a rare primary tumor of the skin, characterized by biphasic epithelial and mesenchymal differentiation.

OBJECTIVE

Due to the limited number of cases reported, there is no consensus regarding treatment and prognosis. Some authors suggest that cutaneous carcinosarcomas should be viewed as aggressive tumors, with ancillary imaging used to evaluate potential metastatic disease. Other reports demonstrate an indolent disease course, especially with epidermal-type cutaneous carcinosarcomas.

METHODS

We report a case of cutaneous carcinosarcoma, which we treated with electrodessication and curettage following a shave biopsy. The tumor had an epithelial component resembling a basal cell carcinoma and a fibrosarcomatous stroma.

RESULTS

At 1-year follow-up, our patient did not show evidence of recurrence or metastasis.

CONCLUSIONS

Our case suggests that a cutaneous carcinosarcoma with an epithelial component composed of basal cell carcinoma can be regarded as a high-risk nonmelanoma skin cancer.

Cutaneous carcinosarcoma with metastasis to the parotid gland

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.

Metastatic carcinomas to the oral cavity and oropharynx

Background

Metastases to the oral/oropharynx are very rare and their diagnosis is challenging.

Methods

We reviewed pathologic data for malignant tumors of the oral/oropharynx that were diagnosed at the Asan Medical Center, Seoul, Korea from 1995 until 2010.

Results

Twenty-nine cases of oral/oropharyngeal metastases were retrieved, comprising 2.0% of 1,445 malignancies. The most common primary sites were the liver and lung, followed by the stomach, colon, breast, prostate, and kidney. The gingiva was the most common metastatic site, followed by the tonsil/pillar, mandible, tongue, tongue base, palate mucosa, mouth floor, and buccal mucosa. Intervals between detection of primary tumors and metastases were variable, from -1 month to 104 months. Ten patients with lung (7 cases), liver, stomach, and kidney carcinomas manifested with oral/oropharyngeal metastases as the first sign of systemic metastases. The majority of patients had died within one year of the onset of an oral/oropharyngeal metastasis, but exceptionally long-lived cases were also present. The survival periods of patients with lung cancers were longer than those of patients with non-pulmonary tumors.

Conclusions

An awareness of the incidence, common primary sites, metastatic subsites, and metastatic courses or patterns of oral/oropharyngeal metastases is helpful in the diagnosis of metastatic carcinomas.