A combined small cell lung carcinoma patient with only small cell carcinoma components in mediastinal lymph node metastasis and chondrosarcoma-like components in liver metastasis.

IF 0.8 Q4 RESPIRATORY SYSTEM

Respirology Case Reports Pub Date : 2024-06-20 eCollection Date: 2024-06-01 DOI:10.1002/rcr2.1416

Takako Kawaguchi, Kei Yamasaki, Saki Shigemi, Hiroki Dosaka, Riho Hirosawa, Taiga Nagasawa, Satoshi Fujimoto, Shohei Shimajiri, Kazuhiro Yatera

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引用次数: 0

Abstract

A 69-year-old ex-smoker Japanese man presented with a left mediastinal lymph node and left upper lobe tumour. Bronchoscopic biopsy specimens from the enlarged left mediastinal lymph node and left upper lobe tumour revealed small cell lung carcinoma (SCLC). He was treated with first-line chemotherapy with carboplatin, etoposide, and atezolizumab for four courses and subsequent atezolizumab maintenance therapy. However, his left upper lobe lung tumour only increased in size, and left upper lobectomy revealed combined SCLC (adenocarcinoma and chondrosarcoma-like features). Four months after lobectomy, liver metastasis of chondrosarcoma-like features (similar to pathological findings of the left upper lobe tumour) were observed. Combined SCLC, including sarcomatous components, is rare and poorly responds to chemotherapy. The metastases of combined SCLC in this patient were of only one type of histological component, making diagnosis and treatment difficult. If treatment for SCLC responds inadequately, considering combined SCLC and actively re-examining histological diagnosis is necessary.

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一名合并小细胞肺癌的患者，纵隔淋巴结转移中仅有小细胞癌成分，肝脏转移中则有软骨肉瘤样成分。

一名 69 岁的前吸烟日本男子因左纵隔淋巴结和左肺上叶肿瘤就诊。从肿大的左纵隔淋巴结和左上叶肿瘤中取出的支气管镜活检标本显示为小细胞肺癌（SCLC）。他接受了卡铂、依托泊苷和阿特珠单抗四疗程的一线化疗，随后接受了阿特珠单抗维持治疗。然而，他的左上肺叶肿瘤只是增大了，左上肺叶切除术后发现合并了SCLC（腺癌和软骨肉瘤样特征）。左上肺叶切除术后四个月，观察到软骨肉瘤样特征的肝转移（与左上肺叶肿瘤的病理结果相似）。包括肉瘤成分在内的合并 SCLC 非常罕见，且对化疗反应差。该患者的合并 SCLC 转移瘤只有一种组织学成分，给诊断和治疗带来了困难。如果对SCLC的治疗反应不佳，有必要考虑合并SCLC，并积极重新检查组织学诊断。

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来源期刊

Respirology Case Reports RESPIRATORY SYSTEM-

CiteScore

1.40

自引率

0.00%

发文量

178

审稿时长

8 weeks

期刊介绍： Respirology Case Reports is an open-access online journal dedicated to the publication of original clinical case reports, case series, clinical images and clinical videos in all fields of respiratory medicine. The Journal encourages the international exchange between clinicians and researchers of experiences in diagnosing and treating uncommon diseases or diseases with unusual presentations. All manuscripts are peer-reviewed through a streamlined process that aims at providing a rapid turnaround time from submission to publication.