Resected well-differentiated fetal pulmonary adenocarcinoma and summary of 25 cases reported in Japan

Abstract

We report a case of well-differentiated fetal adenocarcinoma (WDFA), which is a variant of pulmonary blastoma. A 36-year-old man was found to have a tumor shadow in the right middle field of a chest radiograph as part of a mass screening examination, and chest computed tomography (CT) showed a 4.5-cm pulmonary mass in the right lower lobe. A diagnosis of adenocarcinoma of the lung was made based on a CT-guided needle biopsy, and right middle and lower lobectomy and lymph node dissection were performed. The postoperative pathological diagnosis was well-differentiated fetal adenocarcinoma. WDFA has a better prognosis than conventional pulmonary blastoma (biphasic pulmonary blastoma). We summarize the cases of WDFA reported in Japan and review the literature.

Differences between low and high grade fetal adenocarcinoma of the lung: a clinicopathological and molecular study

“…Our results demonstrated that H-FLAC tended to occur more frequently in elderly men with a history of heavy smoking but that L-FLAC was typically found in younger patients; these findings are consistent with the results of prior reports (2,4,7,10). Additionally, H-FLAC was often at an advanced stage at presentation, with a poor prognosis; in contrast, L-FLAC, was predominantly at stage I, with favorable outcomes (2,4).…”

“…On the contrary, H-FLAC shows a membranous staining for β-catenin while lacking β-catenin gene mutations (11)(12)(13). FLAC is uncommon, and only a few studies with limited cases on L-FLAC and H-FLAC have been published) (2,4,(7)(8)(9)(10). In the present study, we retrospectively examined 3 L-FLAC cases and 5 H-FLAC cases to provide further information on the clinicopathological and molecular features of FLAC in Chinese patients.…”

“…The pattern resembles the morphology of a developing fetal lung. L-FLAC is characterized by complex glandular structures with low nuclear atypia and prominent morule formation, which resembles the developing fetal lung during the pseudoglandular phase (6)(7)(8)(9). In contrast, H-FLAC shows predominant nuclear atypia while morule formation is rarely observed (2,4,10).…”

Rare Case of Fetal Adenocarcinoma of Lung.

“…According to the previous study, the 10 year survival for WDFA is about 75% versus about 15% for BPB ( 12,13) . Based on current information about the disease, no additional treatment was recommended and the patient was discharged.…”

Fetal adenocarcinoma — a rare variant of lung adenocarcinoma with good prognosis

“…Nakatani et al also detected some incorrect nuclear-cytoplasmatic b-catenin expression, which led them to a hypothesis that b-catenin mutation is involved in the proliferation of epithelial cells and the creation of morules [8,10,11]. The observation of children suffering from fetal adenocarcinoma show that this can be the rare form of DICER1 syndrome connected with somatic mutation or the mutation from the line of germinal cells [12].…”