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Pathology of Carcinosarcoma of the Esophagus

Dr Sampurna Roy MD



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Esophageal carcinosarcoma is a rare malignant tumor.

The tumour is composed of both carcinomatous and sarcomatous elements.

The multiple designations of names such as pseudosarcoma, pseudosarcomatous carcinoma, polypoid carcinoma etc.reflect the controversy on the nature of sarcomatous component of this lesion.

Age- Occurs in middle aged male.

Clinical presentation- Dysphagia and weight loss.

Macroscopic features-

Present in mid & lower esophagus.Bulky, polypoid, intraluminal tumour.

Microscopic features-

Characterized by:

- Biphasic histologic pattern.  

(i) Malignant spindle cells

(ii) In-situ or invasive squamous cell carcinoma (occasionally adenocarcinoma)

-The malignant spindle cells (predominant component) arranged in interlacing fascicles.

-Numerous mitotic figures and bizarre giant cells.

-Malignat heterologous elements (bone, cartilage, striated muscle).

-The tumour infiltration is usually superficial (accounts for better prognosis).

-The metastatic tumour may contain one or both components.


Spindle cells may be positive with cytokeratin.  Smooth muscle  and neural markers are usually negative.

Differential diagnosis-

-Polypoid leiomyosarcoma - Multiple deeper blocks are necessary to demonstrate in-situ or invasive carcinoma.

Immunohistochemistry is also useful in establishing the diagnosis.

-Squamous cell carcinoma of the esophagus.

-Basaloid squamous cell carcinoma.

-Adenocarcinoma of the esophagus.

-Granulation tissue with bizarre stromal cells.

Visit: Biphasic Epithelial/Mesenchymal Lung Tumours ; Pulmonary Carcinosarcoma ; Pulmonary Blastoma ; Leiomyosarcoma of the Soft Tissue.

Further reading:

True carcinosarcoma of the esophagus.

Esophageal carcinosarcoma with basaloid squamous carcinoma and rhabdomyosarcoma components with TP53 mutation.

Carcinosarcoma of the esophagus characterized by myoepithelial and ductal differentiations.

Esophageal carcinosarcoma.

Carcinosarcoma of the esophagus--pattern of recurrence.

Rapid-growing carcinosarcoma of the esophagus arising from intraepithelial squamous cell carcinoma: report of a case.

Clinicopathological studies of esophageal carcinosarcoma: analyses of its morphological characteristics using endoscopic, histological, and immunohistochemical procedures.

Carcinosarcoma of the esophagus with metastases showing osteosarcoma: a case report and review of the literature.

p53 immunoreactivity in carcinosarcoma of the esophagus.

Polypoid adenosquamous carcinoma of the esophagus with prominent spindle cells. Report of a case with immunohistochemical and ultrastructural studies.

Polypoid squamous cell carcinoma of the esophagus.

Polypoid tumor of the esophagus.

Esophageal carcinoma with prominent spindle cells.

Carcinosarcoma of the esophagus. An immunohistochemical and electron microscopic study.

Clinical and pathological characteristics of carcinosarcoma of the esophagus: report of four cases.

Polypoid squamous carcinoma of the esophagus. A case report with immunostaining for keratin.

Carcinoma of the oesophagus with spindle cell features.

Polypoid carcinoma of the esophagus. A unifying term for "carcinosarcoma" and "pseudosarcoma".



 GI Path Online- Home Page


Esophageal Pathology- Home Page    



Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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