Long-term survival after an aggressive surgical resection and chemotherapy for stage IV pulmonary giant cell carcinoma.

Fumihiro Shoji,Hiroshi Wataya,Yukito Ichinose,Tomomi Nakamura,Riichiroh Maruyama,Tatsuro Okamoto,Jiro Ikeda

doi:10.1186/1477-7819-3-32

Abstract

BackgroundPulmonary giant cell carcinoma is one of the rare histological subtypes with pleomorphic, sarcomatoid or sarcomatous elements. The prognosis of patients with this tumor tends to be poor, because surgery, irradiation and chemotherapy are not usually effective.Case presentationWe herein report a patient with pulmonary giant cell carcinoma with stage IV disease in whom aggressive multi-modality therapy resulted in a long-term survival. A 51-year-old male underwent an emergent operation with a partial resection of small intestinal metastases due to bleeding from the tumor. The patient also underwent a left pneumonectomy due to hemothorax as a result of the rapid growth of the primary tumor. Thereafter, two different regimens of chemotherapy and a partial resection for other site of small intestinal metastases and a splenectomy for splenic metastases were performed. The patient is presently doing well without any evidence of recurrence for 3 years after the initial operation.ConclusionThis is a first report of a rare case with stage IV pulmonary giant cell carcinoma who has survived long-term after undergoing aggressive surgical treatment and chemotherapy.

Highlights

Pulmonary giant cell carcinoma is one of the rare histological subtypes with pleomorphic, sarcomatoid or sarcomatous elements
The recent World Health Organization (WHO) classification of lung tumors has unified the heterogeneous group of non-small cell lung carcinomas that contains sarcoma or sarcoma-like components under the designation of "carcinomas with pleomorphic, sarcomatoid or sarcomatous elements" [1]
We experienced a pulmonary giant cell carcinoma patient with stage IV disease in whom aggressive multi-modality therapy consisting of surgical resections for the primary lesion and multi-organ metastases and chemotherapy which together resulted in a long-term survival

Summary

Background

The recent World Health Organization (WHO) classification of lung tumors has unified the heterogeneous group of non-small cell lung carcinomas that contains sarcoma or sarcoma-like components under the designation of "carcinomas with pleomorphic, sarcomatoid or sarcomatous elements" [1]. This group includes different entities, such as pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma and pulmonary blastoma. The patient's chest X-ray demonstrated a huge mass lesion in the left upper lung field (Figure 1). After receiving a total of 10 cycles of chemotherapy on an outpatient basis, abdominal CT showed the chemotherapeutic effect to be a complete response (Figure 3B), without any severe hematological or non-hematological adverse events. The patient has survived for about 3years since the first operation and a complete response has been maintained for 15 months

Discussion

Travis WD