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

Publication date: Available online 19 August 2017
Source:Human Pathology
Author(s): Yuly Ramirez Urrea, Jonathan I. Epstein
The association of sarcomatoid carcinoma (SC) with small cell carcinoma (SCC) has not been systematically studied. We identified 39 consult cases between 2001–2016 with available slides for review in 28 cases. There were 19 men and 9 women [mean age: 78years (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 in 11 (39%) cases SCC, 6 (21%) urothelial carcinoma, 3 (10%) sarcomatoid, and 8 (29%) equal sarcomatoid and SCC. 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 in 3 (17%) cases 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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