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Carcinosarcoma and adenoid basal carcinoma (ABC) are both rare lesions in uterine cervix. There were only 5 cases of cervical carcinosarcoma combined with ABC and/without cervical intraepithelial neoplasia (CIN) reported in English literature. These limited studies showed that there was a strong association between HPV, carcinosarcoma, ABC and CIN, suggesting a common etiology for these lesions. Here, we present the case of a 65-year-old woman with cervical carcinosarcoma combined with ABC and CIN III. However, HPV-16, 18, 31 and 33 was negative in the cervical carcinosarcoma tissue by in situ hybridization detection. It indicated that there might be other subtype of HPV involved, or, HPV might play a role in some but not all cervical carcinosarcomas., (Copyright © 2017 Elsevier GmbH. All rights reserved.)

Sarcomatoid carcinomas are rare tumors predominantly composed of spindle cells. This report describes two cases of penile sarcomatoid carcinoma with similar clinicopathological findings. Distinctive features of these tumors were the focal immunostaining that showed the sarcoma-like cells with keratin, smooth muscle actin and p16, and the absence of immunostaining of these cells with p53, S100 protein and desmin. Polymerase chain reaction (PCR) using the GP5+/GP6+ set of primers was positive in both cases. The sequences of the amplified products showed that the implicated genotypes were Human papillomavirus (HPV) 16 and HPV18. To the best of our knowledge, there has been no report in the English literature of HPV-associated penile sarcomatoid carcinoma. These cases might represent an unusual presentation of dedifferentiated carcinoma in which HPV could be shown by a sensitive technique of PCR.

A case of carcinosarcoma associated with an adenoid basal carcinoma of the uterine cervix in an 84-year-old woman is described. The tumor formed a pelvic mass, and total hysterectomy with bilateral salpingo-oophorectomy was performed. The tumor was 17 cm in maximal dimension, arose in the posterior wall of the uterine cervix, and had a solid and cystic, focally myxoid sectioned surface. The tumor was composed of keratinizing squamous cell carcinoma and a mostly nonspecific sarcomatous component with focal chondrosarcomatous differentiation. Multiple foci of adenoid basal carcinoma were observed in the adjacent cervical wall. The HPV L1 gene was detected by PCR in each of the carcinomatous and sarcomatous components of the carcinosarcoma and the adenoid basal carcinoma. To our knowledge, this is the fifth case of coexisting carcinosarcoma and adenoid basal carcinoma of the uterine cervix in the English language literature.

Carcinosarcomas (malignant Müllerian mixed tumors [MMMTs]) of the uterine cervix are rare neoplasms. This report describes the morphology, immunohistochemical profiles, and human papillomavirus (HPV) status of eight cervical MMMTs. Patients' ages ranged from 32 to 93 years (mean, 61 years). Seven cases showed in situ squamous cell carcinoma (SCC). The invasive epithelial component (EC) was composed of combined adenoid basal carcinoma, basaloid SCC, and adenoid cystic carcinoma (ACC) in two cases. Keratinizing SCC, large cell nonkeratinizing SCC, undifferentiated carcinoma, and basaloid SCC predominated in the remaining tumors, one of which had admixed ACC. The sarcomatous component (SC) was homologous and spindled with admixed myxoid areas in three lesions. The ECs and SCs in six MMMTs showed dual immunostaining with epithelial membrane antigen and the pan-keratin marker, MNF116. The SC was vimentin-positive in seven cases. Five tumors had a vimentin-positive EC. The SC was positive for muscle specific actin and/or smooth muscle actin in seven lesions, of which four were desmin-positive. Polymerase chain reaction (PCR) using GP5+/GP6+ L1 consensus primers detected HPV DNA in all eight cases. Nonisotopic in situ hybridization with digoxigenin-labeled probes to HPV types 6, 11, 16, 18, 31 and 33 demonstrated integrated HPV 16 in three cases, not only in the EC, but also in nuclei of the SC. This is the first study to implicate HPV in the evolution of cervical MMMTs. The above observations lend support to a metaplastic theory of histogenesis.

Carcinosarcoma is a rare neoplasm that displays morphological features of both an adenocarcinoma and a sarcoma. The question is whether two tumors co-exist or whether the two morphological aspects represent sequential steps in tumor progression. We report a case of carcinosarcoma of the caecum in a young female. To characterize the two tumor cell populations and to gain insight into the pathogenesis of the lesion, we conducted immunohistochemical and ultrastructural analyses of the tumor. The biphasic aspect of the tumor showed an admixture of carcinoma and spindle-cell sarcomatoid areas. Both adenocarcinoma and sarcomatous cells were positive for cytokeratins. Vimentin was undetectable in the epithelial portion, but many of the sarcomatous cells stained for vimentin. Electron microscopic analyses of the sarcomatous portion revealed budding of "retroviral particles" from the rough endoplasmic reticulum cisternae. Our data support the contention that "carcinosarcoma" is a part of a single clinicopathological continuum with "spindle-cell carcinoma", the former being the biphasic expression of the neoplasia, the latter the monophasic expression; the presence of productive retroviral infection in the sarcomatous cells could constitute one of the additional support in tumor progression from the carcinomatous to the sarcomatous phase.