Primary Lung Adenocarcinoma With Trophoblastic Differentiation and Usage of Gefitinib for Postoperative Recurrence: Report of a Case With a Review of the Literature

Abstract

We report a rare and very aggressive case of lung carcinoma showing trophoblastic differentiation, so-called choriocarcinoma, for which postoperative recurrence was treated using gefitinib. A 51-year-old woman with pathological stage IIA adenocarcinoma with trophoblastic differentiation underwent left lower lobectomy with lymph node dissection and postoperative adjuvant chemotherapy, remaining tumor-free for 10 months until the detection of the brain metastasis. Gefitinib was administered, as the tumor was positive for epidermal growth factor receptor mutation, and this resulted in a 12-month progression-free period. The patient died 37 months after surgery due to multiple metastases in the brain, ovary and uterus. This is the first case report using gefitinib to the lung carcinoma showing trophoblastic differentiation. A review of the literature on lung cancer with trophoblastic differentiation suggested that a chemotherapeutic regimen for primary lung cancer other than germ cell tumor might be suitable for the lung carcinoma with trophoblastic differentiation.