Immunohistochemistry:
Undifferentiated tumor cells showed the following immunohistochemistry:
CK: Positive (Figure1 B), P40: Negative, SALL 4(Figure-1 D): Negative,
Synaptophysin: Negative (Figure-1 C), Vimentin: Negative, Desmin:
Negative, CD20: Negative.
Squamous differentiated tumor area showed the following
immunohistochemistry: CK (Cytokeratin): Positive (Figure 1-B), P40
(marker to distinguish squamous cell carcinoma from adenocarcinoma):
Positive (Figure-3), SALL4 (transcription factor associated with
embryonic cell pluripotency): Negative, Synaptophysin: Negative. The
Ki67 (a marker of cell proliferation) index was 45-50%.
After the cumulative information from clinical, radiological,
histomorphological, and immunohistochemical studies, the diagnosis of
Undifferentiated carcinoma and squamous cell carcinoma arising in the
background of MCTO was made. The patient was discharged without any
postoperative complications. The patient is under adjuvant chemotherapy
with Paclitaxel and carboplatin three weekly [Treatment line(L1),
Cycle(Cl) completed]. She is tolerating the chemotherapy well and is
stable without any complaints at two months of follow-up.