Pulmonary Giant Cell Carcinoma

Abstract

Pulmonary giant cell carcinoma is one of the most highly malignant neoplasms of the lung. Eighteen patients with this tumor are presented. Histologically the neoplasm is composed of a preponderance of multinucleated giant cells, round cells, and spindle cells. Some of the most differentiated tumors show adenocarcinomatous foci and ultrastructural features of secretory epithelium, favoring its classification as a variant of pulmonary adenocarcinoma. The giant cells of this neoplasm can be differentiated from those encountered in undifferentiated large cell carcinoma and epidermoid carcinoma by the abundant cytoplasm, the presence of more nuclei and nucleoli, and the significant degree of phagocytosis. The clinical picture and roentgenographic findings present no pathognomonic features. Complete pretreatment assessment and staging by means of mediastinoscopy should be done as in any case of bronchogenic carcinoma, and therapy should be based on the extent and stage of the disease. The results of treatment for this tumor, regardless of the form of therapy, remain unfavorable because of the high incidence of local recurrence and early metastasis. The average survival following treatment is about 5.5 months. In this series there were only 2 patients who survived beyond 5 years.