Sarcomatoid carcinoma of the lung with brain metastases

Oliveira, Matheus Fernandes de; Watanabe, Sílvia Conde; Andrade, Mara Patrícia Guilhermina de; Rotta, José Marcus; Pinto, Fernando

doi:10.1590/s1806-37132013000600016

Cited by 6 publications

(6 citation statements)

References 9 publications

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“…Male gender, age > 65, smoking and asbestoses exposure are noted to be key risk factors for PSC; however, our patient was a female non‐smoker without asbestos exposure. Oliveira et al reported a case of PSC with brain metastasis . Our patient presented with an adrenal mass which was thought to be a metastasis from the primary lung tumor.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Sarcomatoid carcinoma in cytology: Report of a rare entity presenting in pleural and pericardial fluid preparations

Basu

Moreira

Simms

et al. 2019

Diagnostic Cytopathology

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Sarcomatoid carcinoma is rarely found in pleural or pericardial fluid, with very few cases published to date. Here, we describe a 59-year-old female who presented with cough persisting for 5 months.Chest CT scan revealed a 6.0 cm cavitary mass in the left lung base with bulky mediastinal and hilar lymphadenopathy. An additional 1.2 cm right adrenal mass was seen and was suspicious for metastatic disease. The patient developed dyspnea, tachycardia, pleuritic chest pain and generalized weakness and was admitted to the hospital. She was found to have pleural and pericardial effusions, which were drained and sent to cytology. The fluid revealed enlarged highly pleomorphic malignant cells, some displaying multinucleation with irregular nuclear borders, coarse chromatin and prominent nucleoli. Tumor cells were positive for CK7 and Vimentin and negative for MOC-31, Ber-EP4, B72.3, Sox10, Melan-A, TTF-1, Napsin-A and CK20. A concurrent surgical biopsy of the tumor mass displayed immunopositivity for AE1/AE3 and CAM5.2. The tumor was negative for p40, TTF-1, calretinin, D2-40 and STAT6. A diagnosis of sarcomatoid carcinoma with giant cells and spindle cells was rendered. Sarcomatoid carcinomas of the lung are very uncommon consisting of 1% of nonsmall-cell lung carcinomas and are even more unusual in cytology specimens. Despite its rarity, it is important to keep this entity in mind in the differential diagnosis of a fluid specimen with bizarre nuclear atypia and the above staining pattern. K E Y W O R D Scytology, pulmonary sarcomatoid carcinoma

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Section: Discussion/conclusionmentioning

confidence: 99%

Sarcomatoid carcinoma in cytology: Report of a rare entity presenting in pleural and pericardial fluid preparations

Basu

Moreira

Simms

et al. 2019

Diagnostic Cytopathology

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“…The likely pathogenesis of SC includes malignant transformation of cancer derived stroma, malignant transformation of hamartoma, simultaneous malignant transformation of epithelial elements and stroma, sarcomatous change in carcinoma, and carcinomatous change in sarcoma [ [5] , [6] , [7] ]. Some studies indicate a stem cell origin of SC from a single totipotent stem cell that has the capacity to pursue both mesenchymal and epithelial differentiation [ [8] , [9] , [10] , [11] ].…”

Section: Discussionmentioning

confidence: 99%

“…Paraneoplastic syndromes due to SC have not been reported so far, although they are seen in around 5–8% of NSCLC [ 11 ]. Metastasis to skin, stomach, pancreas, esophagus, jejunum, rectum, kidneys, bones, and adrenal glands and brain have been reported with SC of the lung [ 7 ]. Park et al reported an unusual case where a patient initially presented with gingival exophytic mass which was rapidly growing.…”

Section: Discussionmentioning

confidence: 99%

“…Radical surgical resection remains the mainstay of treatment, especially for localized tumors. Radiotherapy and chemotherapy are being used as adjuvant therapy or in cases where the patient is a poor surgical candidate because there seems to be a little benefit [ 7 ]. Chemotherapy used for the treatment of SC is the same as used for NSCLCs.…”

Section: Discussionmentioning

confidence: 99%

“…SC of the lung has a worse outcome than conventional NSCLC. The 5-year survival rate is approximately 20% for sarcomatoid carcinoma as compared with non-small cell lung cancer which has a 5-year survival of 50% [ 7 ]. The early identification of the tumor followed by surgical and adjuvant therapy might lead to prolonged survival in patients with SC of the lung.…”

Section: Discussionmentioning

confidence: 99%

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Sarcomatoid Carcinoma of the Lung Presenting as Localized Bronchiectasis: A Case Report and Review of Literature

Rajdev

Siddiqui

Ibrahim

et al. 2018

Respiratory Medicine Case Reports

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Sarcomatoid carcinoma (SC) of the lung is a rare and aggressive biphasic lung tumor with a 5-year survival of 20%. Early detection and treatment is the only way to improve outcomes in patients with SC of the lung. We present a case of primary SC identified early based on high suspicion. A 56-year-old female with a history of chronic obstructive pulmonary disease (COPD) presented with hemoptysis and exertional dyspnea. Chest X-ray revealed right upper lobe (RUL) opacity and patient was started on antibiotics for pneumonia. Due to the persistence of hemoptysis, a computed tomography scan was performed which showed RUL bronchiectasis with scattered nodular opacities suggestive of an infectious process. The patient underwent bronchoscopy which revealed a pedunculated mass in the RUL biopsy of which was consistent with poorly differentiated SC. Positron-emission tomography scan revealed Flourdeoxyglucose-avid right peri-hilar mass and another nodule in the RUL. The patient was not a surgical candidate because of severe COPD and was started on chemoradiation therapy. SC of the lung can have various presentations and is usually detected at a later stage and hence, difficult to treat. Our case highlights the importance of critical thinking and prompt diagnostic evaluation in high-risk patients with localized bronchiectasis even without an obvious lung mass on imaging.

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