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. 2023 Dec;128(8):1446-1452.
doi: 10.1002/jso.27433. Epub 2023 Aug 31.

Metastatic sarcomatoid carcinoma to bone

Samir Sabharwal  1 , Christa L LiBrizzi  1 , Sintawat Wangsiricharoen  2 , John M Gross  2 , Sophia A Strike  1 , Adam S Levin  1 , Carol D Morris  3
Affiliations

Metastatic sarcomatoid carcinoma to bone

Samir Sabharwal et al. J Surg Oncol. 2023 Dec.

Abstract

Background and objectives: Distinguishing sarcomatoid carcinoma from primary sarcoma is clinically important. We sought to characterize metastatic sarcomatoid bone disease and its management.

Methods: We analyzed the characteristics of all cases of sarcomatoid carcinoma to bone at a single institution from 2001 to 2021, excluding patients with nonosseous metastases. Survival was evaluated using the Kaplan-Meier method.

Results: We identified 15 cases of metastatic sarcomatoid carcinoma to bone. In seven cases the primary cancer was unknown at presentation. Renal cell carcinoma was suspected or confirmed in nine cases. Nine patients presented with pathologic fracture and two with concomitant visceral metastases. All patients underwent image-guided core needle or open biopsy. Ten required surgery for discrete osseous metastases; in four cases definitive surgery was delayed (median delay, 19 days) due to inability to rule out sarcoma with frozen section. No patients required reoperation or had construct failure. Thirteen died of disease; median survival was 17.5 months (interquartile range, 6.2-25.1).

Conclusions: Metastatic sarcomatoid carcinoma is a clinically challenging entity. Multidisciplinary input and communication are key to identifying the primary carcinoma, locating osseous metastases, and defining an operative fixation that will survive the remainder of the patient's life.

Keywords: biopsy; metastatic bone disease; sarcomatoid carcinoma.

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References

REFERENCES

    1. Farrow GM, Harrison Jr. EG, Utz DC. Sarcomas and sarcomatoid and mixed malignant tumors of the kidney in adults-part III. Cancer. 1968;22(3):556-563. doi:10.1002/1097-0142(196809)22:3<556::AID-CNCR2820220310>3.0.CO;2-N
    1. Meis JM, Ordóñez NG, Gallager HS. Sarcomatoid carcinoma of the breast: an immunohistochemical study of six cases. Virchows Arch A Pathol Anat Histopathol. 1987;410(5):415-421. doi:10.1007/BF00712761
    1. Shannon RL, Ro JY, Grignon DJ, et al. Sarcomatoid carcinoma of the prostate. A clinicopathologic study of 12 patients. Cancer. 1992;69(11):2676-2682. doi:10.1002/1097-0142(19920601)69:11<2676::aid-cncr2820691109>3.0.co;2-p
    1. Fukuda T, Kamishima T, Ohnishi Y, Suzuki T. Sarcomatoid carcinoma of the small intestine: histologic, immunohistochemical and ultrastructural features of three cases and its differential diagnosis. Pathol Int. 1996;46(9):682-688. doi:10.1111/j.1440-1827.1996.tb03672.x
    1. Erstine EM, Tetzlaff MT, Ko JS, Prieto VG, Cheah AL, Billings SD. Living on the edge: diagnosing sarcomatoid melanoma using histopathologic cues at the edge of a dedifferentiated tumor: a report of 2 cases and review of the literature. Am J Dermatopathol. 2017;39(8):593-598. doi:10.1097/DAD.0000000000000716

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