title: A case of rapidly growing pulmonary carcinosarcoma.
abstract: We report herein a case of rapidly growing pulmonary carcinosarcoma, a rare and highly malignant lung neoplasm characterized by a biphasic histopathological pattern consisting of both epithelial and sarcomatous components, and we also summarize the clinical features of this entity based on previously reported cases. A 65-year-old man was referred for further examination of a lung tumor after a routine chest X-ray (CXR) showed a tumor shadow in the right upper lung zone. Chest computed tomography (CT) found a 2.0 cm pulmonary mass with suspected chest wall invasion in the right upper lobe, although cytological evidence of malignancy could not be obtained despite repeated preoperative bronchoscopy. The tumor grew rapidly, indicating the possibility of lung cancer. A right upper lobectomy with chest wall excision was performed. The postoperative definitive diagnosis was carcinosarcoma consisting of adenocarcinoma and chondrosarcoma. The pathological stage was p-T3N0M0. The patient subsequently received adjuvant chemotherapy with cisplatin and vinorelbine. Routine follow-up chest CT 7 months after the surgery showed pleural dissemination. Consequently he underwent radiotherapy, but the disseminated tumors enlarged further while he received this treatment. The patient is receiving best supportive care at present. Findings based on previously reported cases and our case suggest that early surgical intervention and combined therapeutic strategy are the most important aspects of treatment for pulmonary carcinosarcoma.
authors.affiliation: Division of Chest Surgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Niigata, 951-8566, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Sato
authors.forename: Teruaki
authors.initials: T
authors.lastname: Koike
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yamato
authors.forename: Katsuo
authors.initials: K
authors.lastname: Yoshiya
authors.forename: Nozomu
authors.initials: N
authors.lastname: Motono
authors.forename: Mariko
authors.initials: M
authors.lastname: Takeshige
authors.forename: Keiichi
authors.initials: K
authors.lastname: Homma
authors.forename: Naoya
authors.initials: N
authors.lastname: Koizumi
authors.forename: Akira
authors.initials: A
authors.lastname: Yokoyama
authors.forename: Hiroko
authors.initials: H
authors.lastname: Tsukada
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001999:Bronchoscopy; D002296:Carcinosarcoma / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D002813:Chondrosarcoma / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D002945:Cisplatin / Q000008:administration & dosage; D018450:Disease Progression; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000628:therapy; D008297:Male; D009367:Neoplasm Staging; D010997:Pleural Neoplasms / Q000532:radiotherapy / Q000556:secondary; D011013:Pneumonectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
chemical_list: D014747:Vinblastine; D002945:Cisplatin; D000077235:Vinorelbine