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Review article: pulmonary sarcomatoid carcinomas: a practical overview.

Giuseppe Pelosi¹, Angelica Sonzogni, Tommaso De Pas

¹Division of Pathology and Laboratory Medicine, University of Milan School of Medicine, Milan. giuseppe.pelosi@ieo.it

International Journal of Surgical Pathology

|January 7, 2009

Summary

Pulmonary sarcomatoid carcinomas (PSCs) are aggressive non-small-cell lung cancers with sarcoma-like features. Targeting their epithelial-mesenchymal transition may offer new therapeutic strategies for these challenging tumors.

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Area of Science:

Pulmonary pathology
Oncology
Cancer biology

Background:

Pulmonary sarcomatoid carcinomas (PSCs) are rare, aggressive non-small-cell lung cancers.
They exhibit features of both carcinoma and sarcoma, presenting diagnostic challenges.
PSCs encompass five histological variants: pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma, and pulmonary blastoma.

Purpose of the Study:

To define pulmonary sarcomatoid carcinomas (PSCs) as a distinct clinicopathologic entity.
To explore the potential origin and evolution of PSCs.
To identify potential therapeutic targets for PSCs.

Main Methods:

Morphological and histological analysis of PSCs.
Review of clinical behavior and genotypic/phenotypic attributes.
Analysis of carcinogenesis pathways, including epithelial-mesenchymal transition.

Main Results:

PSCs demonstrate distinct clinicopathologic, behavioral, and molecular features justifying their segregation.
These tumors follow an aggressive clinical course and pose diagnostic difficulties.
The sarcomatoid component is hypothesized to arise from carcinoma cells via epithelial-mesenchymal transition.

Conclusions:

Pulmonary sarcomatoid carcinomas represent a family of tumors undergoing transition.
The epithelial-mesenchymal transition pathway is implicated in PSC development.
Targeting epithelial-mesenchymal transition presents a potential therapeutic avenue for PSCs.