Salivary Carcinosarcoma: An Extremely Rare and Highly Aggressive Malignancy

Laryngoscope. 2020 May;130(5):E335-E339. doi: 10.1002/lary.28183. Epub 2019 Jul 10.


Objectives/hypothesis: Carcinosarcomas represent a rare entity of mixed malignant tumors of the salivary gland with limited evidence regarding management strategies. We aim to demonstrate the incidence, prognostic factors, and conduct a survival analysis for this aggressive malignancy.

Study design: Retrospective database review.

Methods: The Surveillance, Epidemiology, and End Results database was queried for all cases of major salivary carcinosarcoma and its incidence from 1973 to 2015 to identify 66 patients.

Results: The incidence of this tumor was 0.02 cases per 1 million, with a rising number of absolute cases in the past 2 decades. The parotid gland was the most common site (78.8%) of involvement. The 5-year overall survival was 37% and 5-year disease-specific survival was 62%. Surgery was most common management strategy (95.5%), with total parotidectomy and facial nerve sacrifice procedures for those with parotid disease. Radiotherapy was commonly performed (75.8%) and chemotherapy use was rare (18.2%). Patients with distant metastasis had a greater than threefold increase in mortality, and those with total parotidectomy surgery had decreased mortality.

Conclusions: Carcinosarcomas of major salivary glands are extremely rare and highly aggressive tumors. We recommend prompt surgical management and postoperative radiation for this tumor with a poor prognosis.

Level of evidence: NA Laryngoscope, 130:E335-E339, 2020.

Keywords: Carcinosarcoma; malignant mixed tumor; parotid gland; salivary malignancies.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinosarcoma / diagnosis
  • Carcinosarcoma / epidemiology*
  • Carcinosarcoma / therapy
  • Combined Modality Therapy
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prognosis
  • Rare Diseases
  • Retrospective Studies
  • SEER Program*
  • Salivary Gland Neoplasms / diagnosis
  • Salivary Gland Neoplasms / epidemiology*
  • Salivary Gland Neoplasms / therapy
  • Survival Rate / trends
  • United States / epidemiology