"Rare Primary Pulmonary Sarcomatoid Carcinoma with Isolated Pancreas Metastasis: Case Report and Literature Review"

Longzhen Zhang

doi:10.26717/bjstr.2022.40.006511

Abstract

"Rare Primary Pulmonary Sarcomatoid Carcinoma with Isolated Pancreas Metastasis: Case Report and Literature Review"

Highlights

Sarcomatoid change is an uncommon phenomenon in non-small cell lung cancer (NSCLC) which is characterized by poorly differentiated neoplasm containing sarcoma or sarcomatoid components [1,2,3], its pathological diagnosis include five subtypes and require high-quality sampling of the tumor [4]
Pancreatic metastasis of lung cancer is rare, its frequency was mainly related to the histological types and small cell lung carcinoma has the highest incidence which was followed by lung adenocarcinoma [6], while the morbidity of pulmonary sarcomatoid carcinoma (PSC) with pancreatic metastasis was extremely low
We reported a patient who suffered from PSC with isolated pancreas metastasis, after simultaneous resection of the pulmonary and pancreatic masses by state-of-the-art Da Vinci robotic surgery, the patient underwent multiple cycles of chemotherapy, immunotherapy and antiangiogenesis therapy, and he has survived for more than 11 months

Summary

Introduction

Sarcomatoid change is an uncommon phenomenon (accounts for approximately 0.4%) in non-small cell lung cancer (NSCLC) which is characterized by poorly differentiated neoplasm containing sarcoma or sarcomatoid components [1,2,3], its pathological diagnosis include five subtypes (pleomorphic carcinoma, spindle cell carcinoma, carcinosarcoma, giant cell carcinoma and pulmonary blastom) and require high-quality sampling of the tumor [4]. Considering that the lesions on the lung and pancreas were isolated and the patient was in good general condition with acceptable examination results of blood routine, liver and kidney function, serum electrolytes and coagulation function, the patient underwent the state-of-the-art Da Vinci robotic assisted laparoscopic resection of pancreatic lesions, thoracoscopic lobectomy and intrathoracic lymph node dissection on December. The postoperative pathological results demonstrated that the two lesions in the inferior lobe of right lung and the body of pancreas were malignant with extensive necrosis, and the tumor sizes were 1.5cm × 1.5cm × 0.5 cm (pulmonary lesion) and 1.3cm × 1.1cm × 1cm (pancreatic lesion), respectively, no definite vascular and nerve invasion, no cancer cell involvement at the bronchial cut-off, vascular cut-off and the cross-section of pancreas, no tumor metastasis was detected in the group 7 and 11 lymph nodes. The patient’s therapeutic process has been summarized as shown in Figure 4B, and we estimate that the patient’s subsequent survival time is relatively short

Discussion

Conclusion

Findings

Conflict of Interest