Objective: We rep.rt four cases of cutaneous carcinosarcoma (CS)and p.rform a meta-analysis of the cutaneous CS literature. Results: CS occurred in elderly p.tients (mean of 80 years) on sun-damaged skin, and were ker...
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Objective: We rep.rt four cases of cutaneous carcinosarcoma (CS)and p.rform a meta-analysis of the cutaneous CS literature. Results: CS occurred in elderly p.tients (mean of 80 years) on sun-damaged skin, and were keratotic p.p.les of short duration. They did not recur after excision. CS exhibited basal cell carcinoma mixed with atyp.cal fibroxanthoma cell p.p.lations. Immunop.enotyp.ng revealed vimentin+ /keratin-sp.ndle cells and vimentin-/keratin+ ep.thelial cells. Three cases exhibited p.3 p.otein exp.ession of both carcinomatous and sarcomatous comp.nents. Literature review identified 38 cases of cutaneous CS that could be broadly classified into two distinct group.. Ep.dermal-derived (basal or squamous cell carcinoma ep.thelial comp.nent) CS arose on the sun- damaged skin of the head and neck of elderly males (mean age 72 years) and had a 70% 5- year disease- free survival. In contrast, adnexal CS (sp.radenocarcinoma,p.rocarcinoma,p.oliferating tricholemmal cystic carcinoma,or matrical carcinoma)occurred in younger p.tients (mean age 58 years), showed recent growth in a long- standing nodule and had a 25% 5- year disease-free survival. Age less than 65 years, recent growth, long-standing skin tumor, and tumor size greater than 2 cm significantly correlated with p.or outcome. Conclusions: Cutaneous CS is an aggressive skin cancer with high risk for advanced disease. Significant risk factors exist whose identification will allow for better management of CS p.tients.
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