A Very Rare Case of Combined Pleomorphic Carcinoma and Small Cell Lung Carcinoma: A Case Report

Abstract

Lung cancer is the most common cause of cancer mortality worldwide. Pleomorphic carcinoma, defined as a poorly differentiated, non-small cell carcinoma, admixed with at least 10% malignant spindle cells and/or giant cells, is a rare tumor with an incidence rate of 0.1-0.3% of all lung tumors. Combined small cell lung carcinoma (SCLC) is also an unusual tumor with a poor prognosis than pure SCLC. A 76-year-old male, a smoker, complained of chest pain and chest X-ray revealed a large lobulated mass in the left lower lung field. Chest computed tomography mainly revealed a 9.7 x 8.7 cm soft tissue mass in the left lower lung. The pathological result of a sample retrieved by thoracotomy revealed combined pleomorphic carcinoma and small cell carcinoma, composed of spindle cell carcinoma (85%), squamous cell carcinoma (10%) and small cell carcinoma (5%). Two months later, the patient died of septic shock with multiple-organ failure without receiving chemotherapy, due to the poor performance status. We reported a relatively rare case of combined pleomorphic carcinoma and SCLC with a poor prognosis. Due to its aggressive behavior and the difficulty of reaching an accurate diagnosis, physicians should be aware of this kind of combined lung cancer, though it is rare.