Sarcomatoid carcinoma of the lung overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Sarcomatoid carcinomas are a type of cancer that looks like a mixture of carcinoma (cancer that begins in the skin or in tissues that line or cover internal organs in the body) and sarcoma (cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue). Sarcomatoid carcinoma are rare, aggressive, malignant cancer and can occur in different organs such as the thyroid gland, bone, skin, breast, pancreas, liver, urinary tract, and lung. Sarcomatoid carcinoma of the lung is a group of poorly differentiated non-small cell lung carcinomas. Sarcomatoid cancer of the lung is a rare type of malignancy and it comprises of only 0.3% to 1.3% of cases of all lung cancers. The pathogenesis of sarcomatoid carcinoma of the lung is characterized by a rare epithelial origin, and morphologic features suggestive of a malignant mesenchymal tumor. The EGFR gene and K-ras mutations have been associated with the development of sarcomatoid carcinoma of the lung. The prevalence of sarcomatoid carcinoma of the lung is approximately 0.4 cases per 100,000 individuals worldwide. Common risk factors in the development of sarcomatoid carcinoma of the lung are smoking, family history of lung cancer, exposure to high levels of air pollution, asbestos, radiation therapy to the chest, radon gas, occupational exposure to chemical carcinogens, and previous lung diseases. If left untreated, the majority of patients with sarcomatoid carcinoma of the lung may develop distant metastasis. Prognosis is generally poor, even worse than other non-small cell carcinoma of the lung. The 5-year survival rate for patients with sarcomatoid cancer of the lung is 28.7%.
Historical Perspective
Sarcomatoid carcinoma is a rare type of malignant tumor. The name sarcomatoid carcinoma was first described by Virchow in 1865 as a “biphasic” lesion of adenocarcinomatous or squamous cell carcinoma with spindle cell or giant cell component.
Classification
Sarcomatoid carcinoma of the lung is a rare type of non-small cell lung cancer. On the basis of histopathological features, sarcomatoid carcinoma of the lung can be classified into 5 subtypes: pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma, and pulmonary blastoma.
Pathophysiology
Sarcomatoid carcinomas are rare, aggressive, malignant cancer and can occur in different organs such as the thyroid gland, bone, skin, breast, pancreas, liver, urinary tract, and lung. Sarcomatoid carcinoma of the lung is a group of poorly differentiated non-small cell lung carcinomas. Sarcomatoid carcinoma is defined as a biphasic tumor with morphological characteristics of both, carcinomatous and sarcomatous components. The exact pathogenesis of sarcomatoid carcinoma of the lung is not fully understood, but the EGFR and K-ras gene mutations have been associated with the development of sarcomatoid carcinoma of the lung.
Causes
The direct cause of sarcomatoid carcinoma of the lung is DNA mutations that often result in either activation of proto-oncogenes (e.g. K-RAS) or the inactivation of tumors suppressor genes (e.g. TP53) or both. The risk of these genetic mutations may be increased following exposure to environmental components.