Urinary system sarcomatoid carcinoma and carcinosarcoma: report of 8 cases

Abstract

Objective To investigate the histological features.clinical manifestations,treatment options and prognosis of urinary system sarcomatoid carcinoma and carcinosarcoma. Methods Pa- thological and clinical records of 8 patients with urinary systemic sareomatoid carcinoma and carcino- sarcoma admitted from April 200 1 to May 2006 were reviewed.Four patients were with bladder sarco- matoid carcinoma.They were 3 males and 1 female with age ranged 58 to 79 years and mean tumor size of 4.5 cm(range 1.5 to 6.7 cm).The tumor consisted of an interlaced spindle cell malignancy with coexistent of the higher grade urothelial carcinoma.One patient was kidney sarcomatoid carcino- ma with adrenal gland and pancrease metastasis.He was a male,64 years and underwent radical ne- phrectomy and partial panereectomy.One patient was with metastatic adrenal sarcomatoid carcinoma from lung.He was a male,47 years and underwent adrenalectomy and pneumonectomy.One patient was with renal pelvic earcinosarcoma.She was a female,64 years and underwent left nephrectomy, ureterectomy and partial cystectomy.One patient was with bladder carcinosarcoma.He was a male. 77 years and received TURBt and systemic chemotherapy.All the patients underwent operation and were followed up(from 36 to 96 months). Results Follow-up of 4 bladder sarcomatoid carcinoma patients revealed that 1 patient(T2.,TURBt+intravesical chemotherapy)was alive with tumor-free at 96 months;1 patient(T1+T18,radical cystectomy)survived 36 months with tumor-free;1 patient (T3b.partial cystectomy+radiation)survived 36 months with tumor-free;1 patient(T4.,partial cystectomy)died of the tumor at 2 months after surgery.The kidney sarcomatoid carcinoma and me- tastasis of adrenal gland and pancreas patient died of the tumor at 5 months after surgery even he re- ceived one cycle chemotherapy after surgery.The metastatic adrenal sarcomatoid carcinoma from lung patient died of the tumor at 7 months after surgery even he accepted three cycle chemotherapy after- wards.The renal pelvic careinosarcoma patient was followed up for 60 months and showed that this patient was alive with tumor-free.The bladder carcinosarcoma patient received TURBt and systemic chemotherapy.He died of obstructive emphysema and pneumonia at 1 2 months after surgery. Con- clusions The urinary systemic sarcomatoid carcinoma and carcinosarcoma are rare neoplasms,which usually happen on old males.The tumors are highly aggressive malignancies with poor prognosis.The tumor stage and treatment are predictive factors of survival.The early diagnosis and aggressive treat- ment may obtain better effect and prolonged survival. Key words: Urologic neoplasms; Sarcoma; Carcinosarcoma; Pathology,clinical