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Vol.61 No.4 contents | Japanese/English |
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- Case Report -
A Long-term Survival in Two Cases of Pulmonary Spindle Cell Carcinoma Treated with Pembrolizumab
Yuki Oshiro1, Shigeki Suzuki1, Akihisa Sakurada1, Kenichi Hamada1, Michiko Yamamoto2, Akio Kazama31Department of General Thoracic Surgery, 2Department of Respiratory Medicine, 3Department of Pathology, Sagamihara Kyodo Hospital, Japan
Background. Pulmonary spindle cell carcinoma is a rare disease with a poor prognosis; it accounts for only about 0.2% of primary lung cancer. We herein report two patients with recurrent/unresectable spindle cell carcinoma who maintained a good response for a long time. Case 1. A 70-year-old man felt chest pain, and a mass (47 mm) was identified in the left-anterior segment. We clinically suspected lung cancer with chest wall invasion (cT3N0M0) and performed left upper lobectomy combined with chest wall resection. Finally, the pathological diagnosis was pulmonary spindle cell carcinoma. Four months after surgery, chest computed tomography detected recurrent lesions in the left axillary lymph node, left adrenal gland, and pancreas. He received pembrolizumab monotherapy. He has since finished 23 courses of pembrolizumab, and his disease has remained stable. Metastatic lesions are now present only in his pancreas. Case 2. A 75-year-old woman was suspected of having ascending colon cancer due to right lower abdominal pain. A close examination revealed multiple lesions in multiple organs, including the colon and left lung. This was considered to be multiple metastases from a malignant tumor. A computed tomography-guided lung biopsy did not lead to a definitive diagnosis, and ascending colectomy was performed to improve the abdominal pain. Pathologically, the tumor in the colon was diagnosed as spindle-shaped malignant tumor, which led to suspicion of primary lung cancer. Partial resection of the left lower lobe was performed to achieve a diagnosis and as treatment, and the tumor was diagnosed as pulmonary spindle cell carcinoma (pT2N0M1c). We selected pembrolizumab monotherapy. At present, after 29 courses of pembrolizumab, no obvious lesions can be seen radiologically. Conclusion. While pulmonary spindle cell carcinoma is a histological type with a poor prognosis, in some cases, pembrolizumab is effective, and a long-term survival can be achieved.
key words: Pulmonary spindle cell carcinoma, Immune-checkpoint inhibitor, Multimodality treatment
Received: January 26, 2021
Accepted: April 5, 2021
JJLC 61 (4): 327-335, 2021
