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Sun X, Liu J, Hu T, Wu Y, Zhang H. A rare case of hepatoid adenocarcinoma of the lung. Clin Respir J 2023; 17:1368-1371. [PMID: 38071759 PMCID: PMC10730454 DOI: 10.1111/crj.13724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/12/2023] [Accepted: 11/19/2023] [Indexed: 12/21/2023]
Abstract
Hepatoid adenocarcinoma of the lung is a special type of primary origin in the lung with obvious pathological features and short survival time. However, standard treatment guidelines have not yet been established. Herein, we report a case of hepatoid adenocarcinoma with the primary lesion located in the left upper lung. The tumour size was reduced after four cycles of combined therapy. Subsequent postoperative pathology confirmed complete remission.
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Affiliation(s)
- Xuejian Sun
- The First Clinical Medical College of Lanzhou UniversityLanzhouChina
- Department of Radiologythe First Hospital of Lanzhou UniversityLanzhouChina
| | - Jialin Liu
- The First Clinical Medical College of Lanzhou UniversityLanzhouChina
- Department of Radiologythe First Hospital of Lanzhou UniversityLanzhouChina
| | - Ting Hu
- The First Clinical Medical College of Lanzhou UniversityLanzhouChina
- Department of Radiologythe First Hospital of Lanzhou UniversityLanzhouChina
| | - Yefan Wu
- The First Clinical Medical College of Lanzhou UniversityLanzhouChina
- Department of Radiologythe First Hospital of Lanzhou UniversityLanzhouChina
| | - Hao Zhang
- The First Clinical Medical College of Lanzhou UniversityLanzhouChina
- Department of Radiologythe First Hospital of Lanzhou UniversityLanzhouChina
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Alhusari L, Tahboub I, Masoudi M, Lawrence LM, Jamil M. Unusual Presentation of Primary Pulmonary Sarcomatous Cancer With Brain Metastasis: A Case Report. Cureus 2023; 15:e51361. [PMID: 38292953 PMCID: PMC10825077 DOI: 10.7759/cureus.51361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2023] [Indexed: 02/01/2024] Open
Abstract
Pulmonary sarcomatous carcinoma is a rare subtype of non-small cell lung cancer (NSCLC). This cancer has very low survival rates primarily due to its aggressive nature and propensity for early spread to abdominal organs and the skeletal system. Remarkably, brain metastasis is observed at later stages of the disease, likely attributing to the high fatality rate after the disease progresses to the brain tissue. In our case, a 79-year-old female with a 45-pack-year smoking history sought medical attention at a primary care clinic due to a 3-month history of recurrent right-sided chest pain. Notably, she denied cough, sputum production, palpitations, or syncope. CT chest revealed a 6.8 x 3.5 cm mass in the right upper lobe (RUL) of the lung, with evidence of obstruction and infiltration of the adjacent chest wall. A PET scan indicated increased uptake in the mass and the presence of smaller pulmonary nodules in both lungs, and multiple nodules in the upper left arm, abdomen, right inguinal region, left thigh, and cecum. Importantly, no intracranial lesions were detected. A subsequent colonoscopy yielded normal findings. Histopathologic examination of the lung mass and cell markers was consistent with a diagnosis of sarcomatous carcinoma of the lung. Only three days after the initial clinic visit, the patient presented with numbness and tingling in her lower extremities. Brain MRI revealed multiple bilateral brain metastases accompanied by significant vasogenic edema, prompting treatment with steroid therapy and brain radiation therapy. Subsequent chemotherapy/immunotherapy with Nab-paclitaxel /carboplatin/atezolizumab was initiated but led to significant treatment-related toxicities. Consequently, the treatment plan was adjusted to a single dose of single-agent immunotherapy using pembrolizumab. Unfortunately, the patient chose to discontinue treatment and eventually passed away after 13 days of palliative care. Compared to other lung cancer subtypes, brain metastasis in sarcomatous lung cancer is infrequent due to its lower prevalence among all lung cancer cases. Furthermore, sarcomatous lung cancer has a reduced propensity for developing brain metastasis when compared to other forms of non-small cell lung cancer (NSCLC). Regrettably, the prognosis for sarcomatous lung cancer with brain metastasis remains generally unfavorable, signaling an advanced stage of the disease with limited treatment options.
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Affiliation(s)
- Leena Alhusari
- Internal Medicine Residency Program, Marshall University Joan C. Edwards School of Medicine, Huntington, USA
| | - Ihab Tahboub
- Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, USA
| | - Moh'd Masoudi
- Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Edwards Comprehensive Cancer Center, Huntington, USA
| | - Logan M Lawrence
- Pathology, Marshall University School of Medicine, Clinical Laboratories of the Mountain Health Network, Huntington, USA
| | - Muhammad Jamil
- Hematology and Medical Oncology, Marshall University Joan C. Edwards School of Medicine, Edwards Comprehensive Cancer Center, Huntington, USA
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Bonis A, Dell’Amore A, Verzeletti V, Melan L, Zambello G, Nardocci C, Comacchio GM, Pezzuto F, Calabrese F, Rea F. Hepatoid Adenocarcinoma of the Lung: A Review of the Most Updated Literature and a Presentation of Three Cases. J Clin Med 2023; 12:jcm12041411. [PMID: 36835946 PMCID: PMC9964907 DOI: 10.3390/jcm12041411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023] Open
Abstract
In a Surgical Thoracic Center, two females and a man were unexpectedly diagnosed with hepatoid adenocarcinoma of the lung (HAL) in a single year. HAL is a rare lung cancer with pathological features of hepatocellular carcinoma with no evidence of liver tumor or other primitive sites of neoplasms. As of today, a comprehensive treatment is still not written. We reviewed the most updated literature on HAL, aiming to highlight the proposed treatments available, and comparing them in terms of survival. General hallmarks of HAL are confirmed: it typically affects middle-aged, heavy-smoker males with a median of 5 cm bulky right upper lobe mass. Overall survival remains poor (13 months), with a longer but non-significant survival in females. Treatments are still unsatisfactory today: surgery guarantees a small benefit compared to non-operated HALs, and only N0 patients demonstrated improved survival (p = 0.04) compared to N1, N2, and N3. Even though the histology is fearsome, these are probably the patients who will benefit from upfront surgery. Chemotherapy seemed to behave as surgery, and there is no statistical difference between chemotherapy only, surgery, or adjuvant treatments, even though adjuvant treatments tend to be more successful. New chemotherapies have been reported with notable results in recent years, such as Tyrosine Kinase Inhibitors and monoclonal antibodies. In this complicated picture, new cases are needed to further build shared evidence in terms of diagnosis, treatments, and survival opportunities.
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Affiliation(s)
- Alessandro Bonis
- Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health–DSCTV, University of Padova, 35122 Padova, Italy
| | - Andrea Dell’Amore
- Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health–DSCTV, University of Padova, 35122 Padova, Italy
- Correspondence: ; Tel.: +39-0498-218-740
| | - Vincenzo Verzeletti
- Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health–DSCTV, University of Padova, 35122 Padova, Italy
| | - Luca Melan
- Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health–DSCTV, University of Padova, 35122 Padova, Italy
| | - Giovanni Zambello
- Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health–DSCTV, University of Padova, 35122 Padova, Italy
| | - Chiara Nardocci
- Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health–DSCTV, University of Padova, 35122 Padova, Italy
| | - Giovanni Maria Comacchio
- Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health–DSCTV, University of Padova, 35122 Padova, Italy
| | - Federica Pezzuto
- Pathology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health–DSCTV, University of Padova, 35122 Padova, Italy
| | - Fiorella Calabrese
- Pathology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health–DSCTV, University of Padova, 35122 Padova, Italy
| | - Federico Rea
- Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health–DSCTV, University of Padova, 35122 Padova, Italy
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Campisi A, Dell'Amore A, Bertolaccini L, Ricci C, Cancellieri A, Stella F. Sialadenoma papilliferum of the bronchus: a rare tumour of salivary gland origin. Adv Respir Med 2021; 88:267-270. [PMID: 32706109 DOI: 10.5603/arm.2020.0111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 12/08/2019] [Indexed: 11/25/2022]
Abstract
Sialadenoma papilliferum is a benign salivary tumour which rarely occurs in the bronchial tree. Up to now, only four cases of pulmonary papillary sialadenoma have been reported in the literature. We discuss the case of a male patient with an accidental finding of a middle lobe nodule. The patient underwent a minimally invasive anatomical resection of the lobe to remove the lesion; the postoperative course was regular, and he was healthy at the last follow-up.
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Affiliation(s)
- Alessio Campisi
- Department of Cardiothoracic Surgery, S. Orsola Malpighi Hospital, Bologna, Italy.
| | - Andrea Dell'Amore
- Department of Cardiothoracic Surgery, S. Orsola Malpighi Hospital, Bologna, Italy
| | - Luca Bertolaccini
- Department of Cardiothoracic Surgery, S. Orsola Malpighi Hospital, Bologna, Italy
| | - Costantino Ricci
- Department of Pathology, S. Orsola Malpighi University Hospital, Bologna, Italy
| | | | - Franco Stella
- Department of Cardiothoracic Surgery, S. Orsola Malpighi Hospital, Bologna, Italy
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Ammar A, Ellis A, Hegert J, Jones TW, Khan R. Postmortem Investigation of Immunohistochemical Staining and Gross Description of Sarcomatoid Carcinoma of the Lung in a Patient With Extreme Leukemoid Reaction. J Investig Med High Impact Case Rep 2019; 7:2324709619860547. [PMID: 31272237 PMCID: PMC6613054 DOI: 10.1177/2324709619860547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
A 72-year-old male smoker was brought into the emergency department complaining of 4 months of progressive dyspnea and fatigue. Computed tomography angiogram of the lungs was negative for pulmonary embolism; however, a 10 cm right upper lobe mass and multiple bilateral pulmonary nodules were identified. While computed tomography scan of the head showed no lesions in the brain, there was osseous destruction of the right mandible. Records obtained from an outside hospital indicated that he had 2 prior biopsies of this lung mass that failed to show malignant cells. In addition, an outpatient positron emission tomography scan had shown increased tracer uptake in this mass as well as multiple nodules in the contralateral lung and in the left adrenal gland. This gentleman was admitted for sepsis and was started on broad-spectrum antibiotics. He continued to have respiratory compromise and required transfer to the intensive care unit for intubation and mechanical ventilation. Over the next 4 days, the patient progressed into septic shock requiring vasopressors and developed worsening respiratory failure. His white blood cell count continued to rise and peaked at 157 × 103 cells/µL. The patient’s wife decided to proceed with comfort measures and the patient subsequently expired. Autopsy was consistent with sarcomatoid carcinoma, also known as giant cell carcinoma of the lung. Immunohistochemical staining was also performed, which identified several tumor markers as well as distant metastasis, hemorrhage, and multi-organ necrosis.
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Affiliation(s)
| | | | - Julia Hegert
- 2 Arnold Palmer Hospital for Children, Orlando, FL, USA
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