Clinical characteristics of pleomorphic carcinoma of the lung

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• 作者：Kenichiro Ito ; Satoshi Oizumi ; Shinichi Fukumoto ; Masao Harada ; Takashi Ishida ; Yuka Fujita ; Toshiyuki Harada ; Tetsuya Kojima ; Hiroshi Yokouchi ; Masaharu Nishimura ; Hokkaido Lung Cancer Clinical Stud
• 关键词：Pleomorphic carcinoma ; FDG-PET ; Surgery ; Chemotherapy ; Gefitinib ; Prognosis
• 刊名：Lung Cancer
• 出版年：2010
• 出版时间：May 2010
• 年：2010
• 卷：68
• 期：2
• 页码：204-210
• 全文大小：537 K

文摘

Background

Pleomorphic carcinoma of the lung is a malignant epithelial tumor that contains carcinomatous and sarcomatoid components. Due to its rarity, few studies have been reported, and its clinical and pathological characteristics remain unclear.

Method

We retrospectively investigated 22 cases of pleomorphic carcinoma of the lung.

Results

Fifteen cases were diagnosed by surgical resection, 4 by autopsy, and 3 by transbronchial biopsy. Nineteen patients were male and 3 were female, and their mean age at diagnosis was 68.3 years (±10.1). Eighteen were current- or ex-smokers with substantial smoking histories (mean 46.4 pack-years). Sixteen patients had symptoms: hemoptysis and cough were commonly seen. Chest computed tomography (CT) findings revealed that the tumors were quite large (mean diameter 45.3 ± 21.9 mm; range 14–110 mm), and 21 tumors were peripherally located. Positron emission tomography with 18-fluorodeoxy-glucose (FDG-PET) was performed in 12 patients, and the Standardized Uptake Value (SUV) tended to be high (9.44 ± 4.98). In the 15 patients who underwent surgical resection, recurrence was common; systemic metastases were also frequently found. Patients who had received surgical treatment with proper follow-up care survived longer than those who did not undergo surgery. Responses to chemotherapy were generally poor, although 1 patient exhibited partial response to gefitinib.

Conclusions

Pulmonary pleomorphic carcinoma has strong malignant potential with frequent distant metastases, as has already been reported. However, this study demonstrated that surgical treatment and appropriate follow-up therapy might result in better prognoses.