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Wu Y, Guan W, Deng J, Mo W, Xu B, Zhang J, Jiang H, Liu J, Lin X, Zhou C. Pulmonary alveolar proteinosis complicated by lung cancer with favorable prognosis: a case report and literature review. Front Oncol 2024; 14:1434631. [PMID: 39328200 PMCID: PMC11424375 DOI: 10.3389/fonc.2024.1434631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 08/26/2024] [Indexed: 09/28/2024] Open
Abstract
With the increasing incidence of lung cancer, the coexistence of pulmonary alveolar proteinosis (PAP) and lung cancer is becoming more common. However, the standard treatment protocols for patients with both conditions are still being explored. The conflict between the rapidly evolving therapeutic approaches for tumors and the limited treatment options for PAP presents a significant challenge for clinicians. Determining the optimal timing of treatment for both conditions to maximize patient benefit is a clinical conundrum. Here, we report a rare case of PAP complicated by lung adenocarcinoma, where interstitial lung changes worsened after neoadjuvant therapy but improved significantly following surgical resection of the lung adenocarcinoma. This case highlights the importance of prioritizing tumor treatment in patients with lung cancer complicated by PAP and examines the interplay between the two conditions, as well as potential therapeutic strategies.
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Affiliation(s)
- Ying Wu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for
Respiratory Disease, National Center for Respiratory Medicine, Department of Respiratory and
Critical Care Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, Guangdong, China
- Graduate School, Guangzhou Medical University,
Guangzhou, China
| | - Wenhui Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for
Respiratory Disease, National Center for Respiratory Medicine, Department of Respiratory and
Critical Care Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, Guangdong, China
- Graduate School, Guangzhou Medical University,
Guangzhou, China
| | - Jiaxi Deng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for
Respiratory Disease, National Center for Respiratory Medicine, Department of Respiratory and
Critical Care Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, Guangdong, China
- Graduate School, Guangzhou Medical University,
Guangzhou, China
| | - Wenwei Mo
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for
Respiratory Disease, National Center for Respiratory Medicine, Department of Respiratory and
Critical Care Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, Guangdong, China
- Graduate School, Guangzhou Medical University,
Guangzhou, China
| | - Beini Xu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for
Respiratory Disease, National Center for Respiratory Medicine, Department of Respiratory and
Critical Care Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, Guangdong, China
- Graduate School, Guangzhou Medical University,
Guangzhou, China
| | - Jiahao Zhang
- Graduate School, Sun Yat-sen University,
Guangzhou, China
| | - Huixin Jiang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for
Respiratory Disease, National Center for Respiratory Medicine, Department of Respiratory and
Critical Care Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, Guangdong, China
- Graduate School, Guangzhou Medical University,
Guangzhou, China
| | - Jie Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for
Respiratory Disease, National Center for Respiratory Medicine, Department of Respiratory and
Critical Care Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xinqing Lin
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for
Respiratory Disease, National Center for Respiratory Medicine, Department of Respiratory and
Critical Care Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Chengzhi Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for
Respiratory Disease, National Center for Respiratory Medicine, Department of Respiratory and
Critical Care Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, Guangdong, China
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Horie M, Nakashima K, Amano Y, Shiratsuki Y, Murakami K, Isobe T, Tsubata Y. Primary lung cancer with pulmonary alveolar proteinosis treated with immune checkpoint inhibitor: A case report. Respir Med Case Rep 2023; 47:101976. [PMID: 38235162 PMCID: PMC10793160 DOI: 10.1016/j.rmcr.2023.101976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/22/2023] [Indexed: 01/19/2024] Open
Abstract
Primary lung cancer with pulmonary alveolar proteinosis (PAP) is a rare condition. We present a case of a patient with primary lung cancer with PAP treated with an immune checkpoint inhibitor (ICI). A 62-year-old man was diagnosed with autoimmune PAP 8 years prior to current admission. Lung adenocarcinoma was found in his right lung, and platinum-based chemotherapy was administered, followed by atezolizumab. He experienced disease progression after atezolizumab treatment, whereas ICI-induced pneumonia or exacerbation of PAP did not occur. This indicates that ICI may be safely used in patients with primary lung cancer with PAP.
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Affiliation(s)
- Mika Horie
- Department of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Kazuhisa Nakashima
- Department of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yoshihiro Amano
- Department of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yohei Shiratsuki
- Department of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Kotaro Murakami
- Department of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Takeshi Isobe
- Department of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yukari Tsubata
- Department of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
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