A 49-year-old woman with well-differentiated fetal adenocarcinoma

Politiek, Mathijs J; Vrugt, Bart; Aalbers, Rick

doi:10.1016/s0300-2977(01)00092-4

Cited by 10 publications

(5 citation statements)

References 3 publications

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“… 23 , 27 On the other hand, L-FLAC tends to occur in young females at the third to fourth decade of life. 1 , 2 , 18 , 23 , 44 , 49 , 50 Patients with L-FLAC usually present with stage I–II disease, while patients with H-FLAC usually present with a more advanced-stage disease (stage III–IV) ( Table 2 ). 21 , 23 , 31 …”

Section: Diagnosis and Clinical Characteristicsmentioning

confidence: 99%

Comprehensive review of fetal adenocarcinoma of the lung

Ricaurte

Arrieta

Zatarain-Barrón

et al. 2018

LCTT

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Fetal adenocarcinoma of the lung (FLAC) is a rare tumor. It accounts for ~0.1%–0.5% of all pulmonary neoplasms. Due to its rarity, much of the world literature regarding FLAC comes from case reports and case series. FLAC is an adenocarcinoma resembling developing fetal lung in its pseudoglandular stage (8–16 weeks of gestation). It is distinguishable from pulmonary blastoma (PB) because it lacks the mesenchymal component which is a hallmark finding in PB. Due to differences in histopathology and clinical course, FLAC has been further categorized into low-grade (L-FLAC) and high-grade (H-FLAC) forms. L-FLAC displays low nuclear atypia and prominent morule formation and has a pure pattern. H-FLAC typically presents with at least 50% fetal morphology, and is often associated with other conventional types of lung adenocarcinoma. FLAC expresses neuroendocrine markers and thyroid transcription factor 1 in most cases. L-FLAC has an aberrant nuclear/cytoplasmic expression of β-catenin and presents mutations in this gene. H-FLAC overexpresses p53. These tumors have a very low frequency of mutations in KRAS and EGFR; it is thought that they are different from a molecular point of view to conventional lung adenocarcinomas. Approximately 25%–40% of patients are asymptomatic at presentation; most of them are incidental findings on chest radiographs. H-FLAC is more common in elderly male patients, with a heavy smoking history. L-FLAC tends to occur in young females. Patients with L-FLAC are usually diagnosed with stage I–II disease, while patients with H-FLAC usually present with a more advanced-stage disease. Poor prognostic factors for FLAC are thoracic lymphadenopathy, metastases at diagnosis, and tumor recurrence; however, the 10-year survival for FLAC is estimated at 75%.

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Section: Diagnosis and Clinical Characteristicsmentioning

confidence: 99%

Comprehensive review of fetal adenocarcinoma of the lung

Ricaurte

Arrieta

Zatarain-Barrón

et al. 2018

LCTT

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“…However, if patients are young females of approximately 30 years of age showing a high accumulation of FDG on a well-defined solid lung nodule, WDFA should be listed as one of the differential diseases and the necessity of anatomical lung resection and lymph node dissection should be considered. Local recurrence of WDFA following limited resection and lymph node metastasis has been reported [13]. Adjuvant chemotherapy and radiation are unlikely to provide substantial benefit and are thus not recommended [14].…”

Section: Discussionmentioning

confidence: 99%

Well-differentiated fetal adenocarcinoma of the lung: positron emission tomography features and diagnostic difficulties in frozen section analysis—a case report

et al. 2020

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Background: Well-differentiated fetal adenocarcinoma (WDFA) of the lung is a rare disease that resembles fetal lung tubules. Most of previous reports concerning WDFA have focused on histological features, while there are few reports describing radiological features. In addition, there are no reports evaluating the difficulty of intraoperative diagnosis of WDFA with frozen section. We report a case of WDFA and review the radiological features of WDFA including the findings of F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and assess the difficulty of intraoperative diagnosis with frozen section. Case presentation: A chest radiography performed in a 20-year-old female revealed a mass in the hilum of the right lung. Computed tomography revealed a well-defined mass measuring 3.5 × 3.0 cm in diameter in the right upper lobe, whereas PET showed a high accumulation of FDG. The most likely diagnosis was clinical T2aN0M0 stage 1B non-small cell lung cancer. A right S 3 segmentectomy was performed via thoracotomy, and a benign tumor that was possibly an adenoma was intraoperatively diagnosed based on frozen section analysis. The mass was a solid tumor measuring 2.9 × 2.5 cm in diameter. Microscopically, the tumor comprised abundant glands with single or double layers of nonciliated cells and bronchial structures resembling a fetal lung. Rounded morules of polygonal cells were frequently observed. Immunohistochemistry revealed that nuclei and cytoplasm of the tumor cell were positive for β-catenin. Finally, the postoperative pathological diagnosis was well-differentiated fetal adenocarcinoma of the lung, and completion right upper lobectomy and mediastinal lymph node dissection were conducted 1 month after the initial segmentectomy. No residual tumor or lymph node metastasis was identified, and the final pathological stage was pT1cN0M0 stage 1A3. The patient did not wish to receive any adjuvant therapy. At the 1-year follow-up, no evidence of recurrence was noted. Conclusions: Here, we report a rare case of well-differentiated fetal adenocarcinoma of the lung that was difficult to diagnose based on radiological evaluations including FDG-PET and intraoperative diagnosis using frozen section analysis.

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“…At the histological level, the element of WDFA characteristically shows glandular elements with tubules composed of glycogen-rich, non ciliated cells that resemble fetal lung, tubuless and squamoid morules may be seen with clear nuclei within lumens. The immature mesenchyme and epithelium mimic the embryonic lung at 10-16 weeks gestation [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant chemotherapy in well-differentiated fetal adenocarcinoma: a case report

et al. 2014

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BackgroundFetal adenocarcinoma of the lung is a rare subtype of pulmonary adenocarcinoma with a relative estimated incidence of 0.5% or fewer of all lung cancers. Because of its extreme rarity, there have been no controlled clinical trials investigating treatment regimens for fetal adenocarcinoma and, as a result, there are no guidelines for management.Case presentationWe report a case of a well-differentiated fetal adenocarcinoma, which is a variant of pulmonary blastoma, that is a low-grade malignancy and associated with a good prognosis. A 29-year-old Moroccan man presented with a well-differentiated fetal adenocarcinoma staged T3N0M0, who received 3 cycles of neoadjuvant chemotherapy followed by surgery, with no recurrence at 2 years follow-up.ConclusionFetal adenocarcinoma is a rare suptype of adenocarcinoma. Surgical resection is the treatment of choice for resectable disease. The role of chemotherapy in the neoadjuvant setting or adjuvant setting is not well defined.

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A 49-year-old woman with well-differentiated fetal adenocarcinoma

Cited by 10 publications

References 3 publications

Comprehensive review of fetal adenocarcinoma of the lung

Comprehensive review of fetal adenocarcinoma of the lung

Well-differentiated fetal adenocarcinoma of the lung: positron emission tomography features and diagnostic difficulties in frozen section analysis—a case report

Neoadjuvant chemotherapy in well-differentiated fetal adenocarcinoma: a case report

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