Abstract
BackgroundPulmonary spindle cell carcinoma (PSCC) is an extremely rare tumor that is highly malignant and fast-growing. As chemotherapy and radiation therapy are ineffective, early surgical resection is effective for PSCC.Case presentationA 70-year-old woman with rheumatoid arthritis was referred to our hospital with an abnormal shadow. Chest computed tomography revealed a 33-mm-wide lobular mass in the right upper lobe. She was diagnosed with non-small cell lung cancer by bronchoscopic smear cytology. Although staging evaluation indicated stage IIIB (T3N2M0) disease, she required continued administration of immunosuppressants and prednisolone for rheumatoid arthritis. Therefore, robot-assisted thoracoscopic surgery (RATS) right upper lobectomy followed by lymph node dissection was performed without preoperative chemotherapy and radiotherapy. Pathological findings revealed PSCC.ConclusionsWe report a very rare case of pulmonary spindle cell carcinoma, successfully resected with RATS.
Highlights
Pulmonary spindle cell carcinoma (PSCC) is an extremely rare tumor that is highly malignant and fastgrowing
Pulmonary spindle cell carcinoma (PSCC) is a sarcomalike carcinoma consisting of only spindle-shaped tumor cells according to the 2015 World Health Organization (WHO) histological classification of lung cancer [1]
We report a case of rapidly growing PSCC that was resected by robot-assisted thoracoscopic surgery (RATS)
Summary
Pulmonary spindle cell carcinoma (PSCC) is a sarcomalike carcinoma consisting of only spindle-shaped tumor cells according to the 2015 World Health Organization (WHO) histological classification of lung cancer [1]. Chest computed tomography (CT) revealed a lobular mass of 33 mm in maximum diameter at the apex of the right upper lobe (Fig. 1A). 18F-fluorodeoxyglucose (FDG) positron emission tomography revealed FDG accumulation with maximum standardized uptake values of 11.78 in the mass and 3.48 in the right lower paratracheal lymph node (#4R) (Fig. 2A, B). Magnetic resonance imaging of the head did not reveal any findings suggestive of brain metastases She was diagnosed with non-small cell lung. Except for cytokeratin (AE1/AE3) (Fig. 4B), negative staining for leukocyte-common antigen, α-smooth muscle actin, S-100 protein, thyroid transcription factor-1 (Fig. 4C), and napsin A were shown. Based on these findings, the final diagnosis was PSCC.
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