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Vol.50 No.2 contents | Japanese/English |
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- Case Report -
A Case of Pulmonary Carcinosarcoma with Multiple Carcinomatous and Sarcomatous Components
Yusuke Takayama1, Hiromi Egawa1, Yumi Nakamura1, Fumihiro Sugahara1, Hidenori Mukaida2, Mayumi Kaneko31Department of Respiratory Medicine, 2Department of Thoracic Surgery, 3Department of Pathology, Hiroshima City Asa Hospital, Japan
Background. Pulmonary carcinosarcoma is an extremely rare tumor among lung cancers, having a mixture of carcinoma and sarcoma features histologically, and it is difficult to establish a correct diagnosis preoperatively. Case. A 67-year-old man presented with hemoptysis and chest pain. Chest CT showed a 40-mm tumor in the apex of the right lung. Because malignancy was highly suspected, surgery was performed. The tumor had invaded the chest wall, therefore a right upper lobectomy and chest wall partial resection were performed. On histopathological examination, the tumor mainly showed features of anaplastic carcinoma, but also a small area of a squamous cell carcinoma with distinct keratinization and a large cell neuroendocrine carcinoma (LCNEC). Moreover, small foci of chondrosarcoma were also recognized. According to these histopathological findings, this case was diagnosed as pulmonary carcinosarcoma. The postoperative stage diagnosis was pT3N0M0, stage IIB. Because the histological findings contained LCNEC, chemotherapy with cisplatin and etoposide was performed. However, we performed only 1 cycle of chemotherapy because of the development of herpes zoster. Two years postoperatively, the patient has had no recurrence. We collected and reviewed 87 cases of pulmonary carcinosarcoma reported in the Japanese literature during the past 20 years, with special consideration of their histopathological findings. Conclusion. We report 1 case of pulmonary carcinosarcoma with various pathological features including LCNEC, and reviewed the cases of pulmonary carcinosarcoma reported in the Japanese literature.
key words: Lung cancer, Pulmonary carcinosarcoma, Large cell neuroendocrine carcinoma (LCNEC)
Received: June 1, 2009
Accepted: December 18, 2009
JJLC 50 (2): 151-156, 2010
