Hepatoid adenocarcinoma of the lung and the review of the literature

Abstract

Introduction Hepatoid adenocarcinoma of the lung is an extremely rare type of the non-small cell lung cancer. Treatment principles and prognosis are similar to that of lung adenocarcinoma. Case report A 62-year-old female smoker presented with a huge mass in the left upper lobe. After diagnostic biopsy, she underwent left pneumonectomy and mediastinal lymph node dissection. A diagnosis of stage T4N1M0 hepatoid adenocarcinoma of the lung with positive surgical margins was made. Management and outcome After the operation, the level of serum alpha fetoprotein was 9010 ng/ml (N: <10). The level of serum alpha fetoprotein was decreased with concurrent chemoradiotherapy and chemotherapy. Disease progression was detected at 11 months after diagnosis. No response was obtained to other therapies. The patient died at 14 months from the time of diagnosis. Discussion Usually, patients with hepatoid adenocarcinoma of the lung are male smokers. Hepatoid adenocarcinoma tends to settle in the upper lobes of the lung. The most important prognostic factor of the hepatoid adenocarcinoma of the lung is the disease stage at the diagnosis and patients with metastatic disease have poor survival.

<p>Radiotherapy of Pulmonary Hepatoid Adenocarcinoma with Intrahepatic Hemangioma: A Case Report</p>

“…According to the reported cases, the clinical features, treatments and prognosis of the pulmonary HAC patients are shown in Table 1 (palliative radiotherapy to bone or other metastatic sites is not included in the table). 1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] The incidence of pulmonary HAC is higher in men, which is similar to the incidence of other pathological types of lung cancer. The age of the patients ranges from 47 to 71, with an average age of 58.91 years.…”

“…1,19 After surgery, radiotherapy and chemotherapy, and immunotherapy, the reported survival was 14 months. 21 And the survival period after radiotherapy and chemotherapy was 19 months. 7 Our case only received thoracic radiation therapy, and the survival period reached 12 months.…”

“…The survival benefit of immunotherapy was 3 months. 21 Basse et al reported a HAC case used durvalumab anti-PD-L1 therapy.…”

Hepatoid Adenocarcinoma of the Lung Responsive to Frontline Combination Chemotherapy With Immunotherapy: Case Report

“…2 Though there are IHC differences between HAC and HCC, such as a lack of CDX-2 staining in HCC, there are insufficient data to conclude that IHC can definitively segregate the two. 1,3 In addition, positive staining for AFP or elevated serum AFP is common but not required. 1 Most patients with advanced HAL receive first-line platinum-based chemotherapy, although a standard regimen is not established.…”

“…1,3 In addition, positive staining for AFP or elevated serum AFP is common but not required. 1 Most patients with advanced HAL receive first-line platinum-based chemotherapy, although a standard regimen is not established. The reported survival for patients with unresectable HAL has generally been 6 to 11 months.…”