Imaging, Histopathologic, and Treatment Nuances of Pulmonary Carcinosarcoma

Gleason, Tyler J; Haas, Michael L.; Le, Brian

doi:10.1155/2017/8135957

Cited by 3 publications

(5 citation statements)

References 10 publications

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“…The most frequent epitheliel component is squamous carcinoma and sarcomatous compenent is rhabdomyosarcoma. Our two patients also had the two components just like the literature [8,10]. In the literature, fewer than 20 cases are reported until 1995 [11][12][13][14].…”

Section: Discussionsupporting

confidence: 71%

“…Xu et al [17] reported 48 cases and this is one of the largest series of the literature. They usually seen an average age of 60-year-old males of heavy smokers [8]. We have two male patients of 58 and 70 year ages and both of them were heavy smokers.…”

Section: Discussionmentioning

confidence: 94%

“…Carcinosarcoma of lung is a rare tumor and its incidence is 0.1 to 0.4% of all lung malignancies [7]. In the literature, pulmonary carcinosarcoma was first described in 1908, that a complex tumor for diagnosis [8]. The World Health Organization (WHO) classification of 2015 identified carcinosarcoma as a subtype of sarcomatoid carcinoma and defined as malignant neoplasm composed of both malignant epithelial and mesenchymal elements [1,9].…”

Section: Discussionmentioning

confidence: 99%

“…Liang et al [18] and Raveglia et al [19] both reported failures of patients' survival. [7] The five year survival rate varies between 6-49.4% [1,8]. According to Xu et al [17] the 1-3 and 5-year survival rate was 77.1%, 49.5% and 22.7%.…”

Section: Discussionmentioning

confidence: 99%

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Primary sarcomas of the lung: report of five cases and review of the literature

Ergin¹,

Keskin²,

Erdoğan³

2019

Curr Thorac Surg

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Primary pulmonary sarcomas of the lung are rare tumors with a low incidence. We reviewed the literature and analyzed 5 patients retrospectively. All clinical datas and therapeutic protocols were recorded. The required surgical procedure was lobectomy in 4 patients and diagnostic broncoscopy and mediastinoscopy in one patient. At histological examination; 2 carcinosarcoma, 1 undifferentiated pleomorphic sarcoma, 1 leiomyosarcoma and 1 synovial sarcoma diagnosed. Primary sarcomas of the lung cannot be differentieted from more common tumors of the lung tumors clinically. Early diagnosis and complete surgical resection is critical for prognosis.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Primary sarcomas of the lung: report of five cases and review of the literature

Ergin¹,

Keskin²,

Erdoğan³

2019

Curr Thorac Surg

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“…PSC is an exceedingly rare entity, representing less than 0.5% of all lung cancers [ 2 ]. Gender and heavy smoking are considered risk factors for the development of PSC with a male-to-female ratio of approximately 7:1 and occurring at a median age of 65 years [ 9 ]. The existing literature primarily relies on a limited number of case series and retrospective studies [ 10 ] hence, making it challenging to establish definitive clinical characteristics, diagnosis, treatment strategies, and survival outcomes [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Unusual Presentation of Primary Pulmonary Sarcomatous Cancer With Brain Metastasis: A Case Report

Alhusari,

Tahboub,

Masoudi

et al. 2023

Cureus

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Pulmonary sarcomatous carcinoma is a rare subtype of non-small cell lung cancer (NSCLC). This cancer has very low survival rates primarily due to its aggressive nature and propensity for early spread to abdominal organs and the skeletal system. Remarkably, brain metastasis is observed at later stages of the disease, likely attributing to the high fatality rate after the disease progresses to the brain tissue. In our case, a 79-year-old female with a 45-pack-year smoking history sought medical attention at a primary care clinic due to a 3month history of recurrent right-sided chest pain. Notably, she denied cough, sputum production, palpitations, or syncope. CT chest revealed a 6.8 x 3.5 cm mass in the right upper lobe (RUL) of the lung, with evidence of obstruction and infiltration of the adjacent chest wall. A PET scan indicated increased uptake in the mass and the presence of smaller pulmonary nodules in both lungs, and multiple nodules in the upper left arm, abdomen, right inguinal region, left thigh, and cecum. Importantly, no intracranial lesions were detected. A subsequent colonoscopy yielded normal findings. Histopathologic examination of the lung mass and cell markers was consistent with a diagnosis of sarcomatous carcinoma of the lung. Only three days after the initial clinic visit, the patient presented with numbness and tingling in her lower extremities. Brain MRI revealed multiple bilateral brain metastases accompanied by significant vasogenic edema, prompting treatment with steroid therapy and brain radiation therapy. Subsequent chemotherapy/immunotherapy with Nab-paclitaxel /carboplatin/atezolizumab was initiated but led to significant treatment-related toxicities. Consequently, the treatment plan was adjusted to a single dose of single-agent immunotherapy using pembrolizumab. Unfortunately, the patient chose to discontinue treatment and eventually passed away after 13 days of palliative care. Compared to other lung cancer subtypes, brain metastasis in sarcomatous lung cancer is infrequent due to its lower prevalence among all lung cancer cases. Furthermore, sarcomatous lung cancer has a reduced propensity for developing brain metastasis when compared to other forms of non-small cell lung cancer (NSCLC). Regrettably, the prognosis for sarcomatous lung cancer with brain metastasis remains generally unfavorable, signaling an advanced stage of the disease with limited treatment options.

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Diffuse pulmonary meningotheliomatosis: a rare cause of multiple pulmonary nodules

Healy,

O'Callaghan,

Deegan

et al. 2023

BMJ Case Rep

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This case describes a woman in her 50s who presented with recurrent lower respiratory tract infections. She was an ex-smoker and had worked on a livestock farm for many years. Chest radiograph and CT of the chest revealed multiple bilateral pulmonary nodules. Bronchoalveolar lavage and transbronchial biopsy did not confirm a unifying diagnosis and thus, surgical biopsy was pursued. Video-assisted thoracoscopic surgical guided biopsy of the right upper, middle and lower lobes demonstrated intraparenchymal minute nodules, consisting of bland epithelioid cells without any evidence of malignancy. The nodules stained positive for neural cell adhesion molecule (CD56) and progesterone receptor with weakly positive epithelial membrane antigen and smooth muscle actin. The combination of this characteristic staining pattern, the diffuse subcentimetre nature of the nodules and this clinical presentation fit with a diagnosis of the ultra-rare pulmonary disease, diffuse pulmonary meningotheliomatosis (DPM). This case highlights a rare cause of bilateral diffuse pulmonary nodules and thus, the breadth of differential diagnoses that need to be considered when approaching such a finding. Careful history-taking and thorough workup is often needed, typically requiring input from multiple specialties. DPM, while rare, should not be overlooked when considering the underlying cause of this presentation, especially in female patients. This case reiterates how common clinical presentations can unveil rare conditions and the contributions of physicians, pathologists and radiologists in the diagnosis and management of these complex diseases.

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Imaging, Histopathologic, and Treatment Nuances of Pulmonary Carcinosarcoma

Cited by 3 publications

References 10 publications

Primary sarcomas of the lung: report of five cases and review of the literature

Primary sarcomas of the lung: report of five cases and review of the literature

Unusual Presentation of Primary Pulmonary Sarcomatous Cancer With Brain Metastasis: A Case Report

Diffuse pulmonary meningotheliomatosis: a rare cause of multiple pulmonary nodules

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