Sarcomatoid carcinoma of the urinary bladder: the final common pathway of urothelial carcinoma dedifferentiation

Sarcomatoid carcinoma of the urinary bladder is an unusual malignancy composed of both carcinomatous and sarcomatous components. It is an aggressive tumor that presents at an advanced stage and confers a much poorer prognosis than conventional urothelial carcinoma. The proper nomenclature and histog...

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Published inThe American journal of surgical pathology Vol. 35; no. 5; p. e34
Main Authors Cheng, Liang, Zhang, Shaobo, Alexander, Riley, Maclennan, Gregory T, Hodges, Kurt B, Harrison, Beth T, Lopez-Beltran, Antonio, Montironi, Rodolfo
Format Journal Article
LanguageEnglish
Published United States 01.05.2011
Subjects
Carcinoma - classification
Carcinoma - genetics
Carcinoma - pathology
Carcinoma, Transitional Cell - classification
Carcinoma, Transitional Cell - genetics
Carcinoma, Transitional Cell - pathology
Diagnosis, Differential
Humans
Urinary Bladder Neoplasms - classification
Urinary Bladder Neoplasms - genetics
Urinary Bladder Neoplasms - pathology
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Summary:Sarcomatoid carcinoma of the urinary bladder is an unusual malignancy composed of both carcinomatous and sarcomatous components. It is an aggressive tumor that presents at an advanced stage and confers a much poorer prognosis than conventional urothelial carcinoma. The proper nomenclature and histogenesis of these tumors have been subjects of debate for some time. There is an emerging consensus that sarcomatoid carcinoma is the most appropriate term for these neoplasms. The recent World Health Organization classification has applied this term to all tumors showing morphologic and/or immunologic evidence of both malignant epithelial and mesenchymal differentiation. Such tumors have been postulated to represent either multiclonal collision tumors or monoclonal cancers with divergent differentiation; recent molecular studies favor the latter theory. In this study, we discuss the nomenclature, clinical features, pathology, differential diagnosis, molecular genetics, and histogenesis of sarcomatoid carcinoma. We emphasize the importance of molecular genetic studies in providing insight into the histogenesis of this neoplasm. Sarcomatoid carcinoma seems to represent the final common pathway of urothelial carcinoma dedifferentiation.
ISSN:1532-0979
DOI:10.1097/PAS.0b013e3182159dec