Primary Sarcomatoid Carcinoma of the Anterior Mediastinum: A Case Report

Introduction: Sarcomatoid carcinoma represents an infrequent and highly aggressive malignant tumor that is characterized by both epithelial and mesenchymal differentiation.It forms a small subset of nonsmall cell lung cancers and is associated with rapid progression and poorer clinical outcomes.Case description: An 80-year-old hypertensive, nonsmoking female presented with gradually worsening breathlessness, chest discomfort, cough, hemoptysis, and bilateral pleural effusions.Imaging revealed a heterogeneous anterior mediastinal mass with nodular pleural and pericardial involvement.Pleural cytology was transudative and nonmalignant.Ultrasonography (USG)-guided biopsy and immunohistochemistry [cytokeratin (CK), p40, and vimentin positive; WT-1 negative] confirmed the diagnosis of sarcomatoid carcinoma.Conclusion: This report emphasizes the importance of maintaining diagnostic vigilance for rare and biphasic mediastinal malignancies in elderly patients and highlights the indispensable role of histopathology with immunohistochemistry in establishing the final diagnosis.