Gefitinib in the Treatment of a Pulmonary Sequestration Patient Complicated by Large Cell Lung Carcinoma

Abstract

Pulmonary sequestration is a rare malformation in which nonfunctioning lung tissue is separated from the rest of the lung. 1 It is not attached to the pulmonary arterial blood supply and is supplied with blood from an unusual source, often from an artery of the systemic circulation. 2 Large cell lung carcinoma (LCLC) comprises a heterogeneous group of undifferentiated malignant neoplasms and accounts for 5% to 10% of all lung cancers. 3 Gefitinib is an EGFR inhibitor that interrupts signaling through the EGFR in target cells. Gefitinib has been widely used for EGFR-positive lung cancers, especially for NSCLC. 4 However, there have been few reports of LCLC being treated with gefitinib. Patients with LCLC combined with pulmonary sequestration are extremely rare. Here, we describe such a rare case of a 51-year-old Chinese woman with outcomes that were satisfactory after oral gefitinib. A 51-year-old Chinese woman was admitted to Tianjin Chest Hospital on June 9, 2014, after having suffered from intermittent fever for half a year and chest distress for 1 month. The patient initially received antiinflammatory treatment in other hospitals, but her symptoms were not significantly relieved. Chest computed tomography (CT) showed some shadow in the lobe of left lung; a hilar mass (Fig. 1A); and multiple lymph nodes in left supraclavicular, alar, pulmonary hilum and mediastinum, which showed partial enlargement. The left lower lobe of the lung was atrophied, and it closely adhered to the chest wall, diaphragm, pericardium, and posterior. The mass was hard and invaded the posterior chest wall, pericardium, and mediastinum. In addition, an