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Vol.60 No.7 contents

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- Case Report -

A Case of Radical Resection of a Low-grade Fetal Adenocarcinoma of the Lung Greater than 7 cm in Size

Atsushi Kamigaichi¹, Takeshi Mimura¹, Hiroaki Harada², Kazuya Kuraoka³, Mineyo Mito⁴, Kikuo Nakano⁴, Yoshinori Yamashita^1
1Department of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Japan, ²Department of Thoracic Surgery, National Hospital Organization Higashihiroshima Medical Center, Japan, ³Department of Diagnostic Pathology, ⁴Department of Respiratory Medicine, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Japan

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Background. Fetal adenocarcinoma is a rare tumor classified as a special type of lung adenocarcinoma by the World Health Organization classification (4th edition). It occurs in relatively young patients and has a good prognosis. Case. A 33-year-old woman was referred to our hospital because of an abnormal shadow on a chest roentgenogram. Chest computed tomography showed a 7.5-cm tumor in the right upper lobe, which was in contact with the superior vena cava and chest wall. Bronchoscopy revealed an exposed tumor in the upper lobe of the bronchus, and a biopsy was performed. The tumor was diagnosed as a lung adenocarcinoma (cT4N0M0 Stage IIIA). We considered performing neoadjuvant chemoradiation; however, we decided to perform upfront surgery because no mediastinal lymph node metastasis was found and invasion of the surrounding organs was not confirmed. We performed a right upper lobectomy with bronchial wedge resection and bronchoplasty. The tumor was completely resected grossly without any invasion of the neighboring organs. Histopathologically, the tumor was a low-grade fetal adenocarcinoma (pT4N0M0 Stage IIIA). Adjuvant chemotherapy was administered, and the patient lived recurrence-free for three and a half years after surgery. Conclusion. In relatively young patients with large lung tumors, we should consider low-grade fetal adenocarcinoma as a differential diagnosis and discuss the treatment plan.
key words: Fetal adenocarcinoma of the lung, Bronchoplasty

Received: July 21, 2020
Accepted: August 20, 2020

JJLC 60 (7): 995-1000, 2020