Clinical characteristics of pleomorphic carcinoma of the lung.
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.


METHODS
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+/-21.9mm; range 14-110mm), 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.
Ito
Kenichiro
K
First Department of Medicine, Hokkaido University School of Medicine, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan.
Oizumi
Satoshi
S
Fukumoto
Shinichi
S
Harada
Masao
M
Ishida
Takashi
T
Fujita
Yuka
Y
Harada
Toshiyuki
T
Kojima
Tetsuya
T
Yokouchi
Hiroshi
H
Nishimura
Masaharu
M
D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm; D005260:Female; D006469:Hemoptysis; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed