Endobronchial Sarcoma: A Case Report and Review of Literature

Abstract

Pulmonary sarcomatoid carcinomas (PSCs) are poorly differentiated non-small cell lung carcinomas (NSCLCs) that, loosely, consist of a sarcoma-like element and/or a sarcomatous component - they represent one of the rarest sub-types of lung tumors. Pre-operative analysis with bronchoscopic biopsy is often an underrepresentation of tissue structure in its entirety, leading to hindrance in definitive diagnosis. Here we present the case of a male presenting with progressive dyspnea, ultimately diagnosed with a pulmonary sarcomatoid tumor with extensive local infiltration on bronchoscopy. Given the relatively low incidence of this cancer, we discuss the epidemiology, risk factors, and diagnostic tools used in characterization of tumors. Most pulmonary sarcomatoid carcinomas contain features and immunophenotypes consistent with conventional NSCLC, lending itself to the idea that this group of tumors falls along a spectrum that represents common origin from a totipotent stem cell. This allows for alignment of a cancer with typically poor prognosis and limited treatment options with one with greater possibilities for therapeutic intervention. Despite the ultimate decision for palliation seen in this case, it is of value for clinicians to be aware of the focus on research into the areas of molecular targeted therapy and immunotherapy for treatment of pulmonary sarcomatoid carcinomas, given success with treatment of non-small cell lung cancers.