Sarcomatoid carcinoma associated with small cell carcinoma of the urinary bladder: a series of 28 cases

Yuly Ramirez Urrea, Jonathan Ira Epstein

Research output: Contribution to journalArticle

Abstract

The association of sarcomatoid carcinoma (SC) with small cell carcinoma (SCC) has not been systematically studied. We identified 39 consult cases between 2001 and 2016 with available slides for review in 28 cases. There were 19 men and 9 women (mean age: 78 years [51-89]). In 26 (92.8%) cases, the sarcomatoid component had nonspecific malignant spindle cells, 4 (14%) chondrosarcoma, 2 (7%) myxoid sarcomatous, 1 (3.5%) osteosarcoma, and 1 (3.5%) rhabdomyosarcoma. The predominant component was SCC in 11 (39%) cases, urothelial carcinoma in 6 (21%), sarcomatoid in 3 (10%), and equal sarcomatoid and SCC in 8 (29%). There were 3 morphological groups: group 1 (18/28 [64%]) showed a gradual transition from SCC to other components; group 2 (5/28 [18%]) had an abrupt transition from SCC to other components; and in group 3 (5/28 [18%]), the SCC was separate from other components. In group 1, 12 (66%) cases of SCC showed a gradual transition to sarcomatoid areas; 3 (17%) to urothelial carcinoma; and 3 (17%) to multiple components including squamous cell carcinoma, urothelial carcinoma, and sarcomatoid. Mortality did not differ based on pathological groups. The 36-month actuarial risk of death was 64.3%. The multitude of different components in these tumors is further evidence of the remarkable ability of carcinoma of the bladder to show divergent differentiation with, in some cases, gradual transition between SCC and other elements including sarcomatoid. Greater recognition of this entity with chemotherapy targeted to the various histological elements may have important therapeutic implications.

Original languageEnglish (US)
Pages (from-to)169-175
Number of pages7
JournalHuman Pathology
Volume67
DOIs
StatePublished - Sep 1 2017

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Small Cell Carcinoma
Urinary Bladder
Carcinoma
Chondrosarcoma
Osteosarcoma
Squamous Cell Carcinoma
Drug Therapy
Mortality

Keywords

  • Bladder neoplasm
  • Carcinosarcoma
  • Sarcomatoid carcinoma
  • Small cell carcinoma
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Sarcomatoid carcinoma associated with small cell carcinoma of the urinary bladder : a series of 28 cases. / Urrea, Yuly Ramirez; Epstein, Jonathan Ira.

In: Human Pathology, Vol. 67, 01.09.2017, p. 169-175.

Research output: Contribution to journalArticle

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abstract = "The association of sarcomatoid carcinoma (SC) with small cell carcinoma (SCC) has not been systematically studied. We identified 39 consult cases between 2001 and 2016 with available slides for review in 28 cases. There were 19 men and 9 women (mean age: 78 years [51-89]). In 26 (92.8{\%}) cases, the sarcomatoid component had nonspecific malignant spindle cells, 4 (14{\%}) chondrosarcoma, 2 (7{\%}) myxoid sarcomatous, 1 (3.5{\%}) osteosarcoma, and 1 (3.5{\%}) rhabdomyosarcoma. The predominant component was SCC in 11 (39{\%}) cases, urothelial carcinoma in 6 (21{\%}), sarcomatoid in 3 (10{\%}), and equal sarcomatoid and SCC in 8 (29{\%}). There were 3 morphological groups: group 1 (18/28 [64{\%}]) showed a gradual transition from SCC to other components; group 2 (5/28 [18{\%}]) had an abrupt transition from SCC to other components; and in group 3 (5/28 [18{\%}]), the SCC was separate from other components. In group 1, 12 (66{\%}) cases of SCC showed a gradual transition to sarcomatoid areas; 3 (17{\%}) to urothelial carcinoma; and 3 (17{\%}) to multiple components including squamous cell carcinoma, urothelial carcinoma, and sarcomatoid. Mortality did not differ based on pathological groups. The 36-month actuarial risk of death was 64.3{\%}. The multitude of different components in these tumors is further evidence of the remarkable ability of carcinoma of the bladder to show divergent differentiation with, in some cases, gradual transition between SCC and other elements including sarcomatoid. Greater recognition of this entity with chemotherapy targeted to the various histological elements may have important therapeutic implications.",
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