Sarcomatoid Carcinoma (Carcinosarcoma) of the Prostate Gland: A Review of the Literature | Chapter 02 | New Insights into Disease and Pathogen Research Vol. 4

Background: Adenocarcinomas of the prostate gland are commonly encountered globally but other uncommon variants of carcinoma of the prostate are sporadically encountered including primary sarcomatoid carcinoma of the prostate (PSCP).

Aims: To review the literature of PSCP.

Methods: Various internet search engines were searched for literature on PSCP.

Literature Review: About 100 cases of PSCP have so far been reported. PSCP may develop de novo or may emanate following hormonal therapy or radiotherapy for adenocarcinoma of prostate; PSCP may present with LUTS, haematuria, perineal/back pain. Histology of prostate biopsy tends to show a biphasic tumour which has an adenocarcinoma component as well as a second component which is a clearly recognizable type of sarcoma component which could be angiosarcoma, chondrosarcoma, leiomyosarcoma, osteosarcoma or rhabdomyosarcoma. With regard to immunohistochemistry, the epithelial component of sarcomatoid carcinoma of prostate stains positively for cytokeratin and PAP and negatively for PSA; the sarcoma component stains negatively for PSA, EMA and keratin. There is no consensus opinion on treatment. TURP has been performed for lower urinary tract obstruction symptoms and urinary retention, radical prostatectomy, pelvic exenteration, and chemotherapy are some of the treatments employed. A number of cases of PSCP had presented at advanced stages of the disease. PCSP is aggressive with poor prognosis; however, early aggressive surgery in some cases had resulted in survival.

Conclusions: A multi-centre trial is required to determine the best treatment option for PSCP. Perhaps patients with progressing prostate cancer following radiotherapy of castrate resistant prostate cancer should have repeat prostate biopsies to determine if they have developed dedifferentiation into PSCP or other variants of prostate cancer and to try cases of PSCP on chemotherapy as a trial.

Author(s) Details

Mr Anthony Kodzo-Grey Venyo [MB ChB FRCS(Ed) FRCSI FGCS Urol. LLM]
Department of Urology, North Manchester General Hospital, Delaunays Road Manchester, United Kingdom.

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Carcinosarcoma of Ovary, It’s Histopathological, Management and Prognostic Analysis with Review of Literature | Chapter 15 | New Insights into Disease and Pathogen Research Vol. 2

Carcinosarcoma is a mixed malignant biphasic tumour representing a rare entity and comprises of both epithelial and mesenchymal components. Primary ovarian carcinosarcoma is a rare neoplasm with a number of cases reported in the literature in the hundreds. It accounts for less than 1% of all ovarian tumours. These tumours are usually diagnosed at older age and advanced stage. It has aggressive clinical behaviour and survival depends on stage at presentation. Radiological imagings cannot differentiate carcinosarcomas from other ovarian cancers. Diagnosis is based upon histological findings. Cytoreductive debulking surgery is a crucial part in the treatment of carcinosarcoma of ovary. The role of adjuvant chemotherapy regimen is still controversial. Combination chemotherapy with taxane and platinum based regimen or ifosfamide and platinum based regimen are considered as adjuvant treatment. Despite aggressive treatment modalities such as surgery and chemotherapy, the outcome is poor. Response to therapy and overall survival for carcinosarcoma are poor in comparison to that of epithelial ovarian malignancies. Due to rarity of the disease, such poor prognosis needs collaboration of studies with molecular analysis to obtain new therapeutic guidelines to improve survival of the patients.

Author(s) Details

Dr. Priyanka Priyadarshini
Department of Obstetrics and Gynaecology, Calcutta National Medical College and Hospital, Kolkata, West Bengal, 700014, India.

Dr. Tapan Kumar Sahoo
Department of Radiotherapy, Acharya Harihara Regional Cancer Centre, Cuttack, Odisha, 753007, India.

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View Volume: https://doi.org/10.9734/bpi/nidpr/v2