title: Metastasizing vulvar carcinosarcoma with squamous carcinomatous and leiomyosarcomatous differentiation: genetic evidence of clonal origin.
abstract: In this report, we present the first case of a vulvar carcinosarcoma with squamous carcinomatous and leiomyosarcomatous differentiation. Comparative genomic hybridization was used to analyze clonality of the two tumor components. A widely identical pattern of genetic imbalances in the comparative genomic hybridization analysis in both the carcinomatous and the sarcomatous tumor component strongly supported the concept of a bidirectionally differentiated neoplasm. In both tumor components and two lymph node metastases, an amplicon was detected on chromosome 11q12-q13, homing the cyclin D1 gene locus. In contrast, exclusively in the sarcomatoid component, a characteristic amplicon on 12q13-q14 was found. The cytogenetic profile of the lymph node metastases revealed an increase in imbalances compared with the primary tumor. In summary, we found strong indications for a clonal origin of the two tumor components in a vulvar carcinosarcoma and a good correlation of the histological morphology with the pattern of genetic imbalances.
authors.affiliation: Pathologisches Institut, Universität Würzburg, 97080 Würzburg, Germany. patrick.adam@mail.uni-wuerzburg.de
authors.forename: Patrick
authors.initials: P
authors.lastname: Adam
authors.forename: Andreas
authors.initials: A
authors.lastname: Zettl
authors.forename: Ursula
authors.initials: U
authors.lastname: Zollner
authors.forename: Johannes
authors.initials: J
authors.lastname: Dietl
authors.forename: Hans Konrad
authors.initials: HK
authors.lastname: Müller-Hermelink
authors.forename: Matthias
authors.initials: M
authors.lastname: Eck
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D002232:Carbocyanines; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000473:pathology*; D002296:Carcinosarcoma / Q000235:genetics* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D002454:Cell Differentiation; D002869:Chromosome Aberrations; D002881:Chromosomes, Human, Pair 12; D002999:Clone Cells / Q000473:pathology; D004273:DNA, Neoplasm / Q000235:genetics; D004801:Eosine Yellowish-(YS); D017809:Fatal Outcome; D005260:Female; D016650:Fluorescein-5-isothiocyanate; D005456:Fluorescent Dyes; D006416:Hematoxylin; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D007211:Indoles; D007890:Leiomyosarcoma / Q000378:metabolism / Q000473:pathology*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D013194:Staining and Labeling; D014846:Vulvar Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000473:pathology / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor; D002232:Carbocyanines; D004273:DNA, Neoplasm; D005456:Fluorescent Dyes; D007211:Indoles; C089187:cyanine dye 3; C007293:DAPI; D016650:Fluorescein-5-isothiocyanate; D004801:Eosine Yellowish-(YS); D006416:Hematoxylin