The importance of medical treatment before surgery in pleomorphic carcinoma of the lung: A case series study

Francesco Tormen; Federico Banchelli; Valentina Masciale; Antonino Maiorana; Uliano Morandi; Beatrice Aramini

doi:10.1016/j.ijscr.2021.106275

The importance of medical treatment before surgery in pleomorphic carcinoma of the lung: A case series study

Int J Surg Case Rep. 2021 Sep:86:106275. doi: 10.1016/j.ijscr.2021.106275. Epub 2021 Aug 4.

Authors

Francesco Tormen¹, Federico Banchelli², Valentina Masciale³, Antonino Maiorana⁴, Uliano Morandi⁵, Beatrice Aramini⁶

Affiliations

¹ Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.
² Center of Statistic, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Italy.
³ Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy. Electronic address: valentina.masciale@unimore.it.
⁴ Institute of Pathology, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Italy. Electronic address: antonino.maiorana@unimore.it.
⁵ Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy. Electronic address: uliano.morandi@unimore.it.
⁶ Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy. Electronic address: beatrice.aramini@auslromagna.it.

Abstract

Introduction and importance: Pleomorphic carcinoma of the lung is a rare malignant epithelial tumor. Due to its rarity, its clinicopathological characteristics are not clear, and there is no defined therapeutic path for this type of tumor.

Case presentation: We retrospectively analyzed the medical and pathological reports of 8 patients who underwent surgical resection for pleomorphic carcinoma between 2007 and 2010.

Clinical discussion: Eight patients were analyzed (7 males and 1 female, mean age 60). All patients underwent CT scans, and the average diameter of the nodules was 56 mm. Four patients were also investigated with FDG-PET with hypermetabolic activity in all four cases. In four patients, the carcinomatous component was adenocarcinoma (all with sarcomatoid component of spindle cell and giant cell carcinoma), although in two patients, it was squamous cell carcinoma (one with spindle cell and one with giant cell). In the two remaining patients, one showed a non-small cell carcinoma with giant cell carcinoma, and the other was a non-small cell carcinoma and squamous cell carcinoma with spindle and giant cell carcinoma. All cases were treated with surgical resection. Only two patients underwent neoadjuvant chemotherapy. At the time of data analysis, only one patient treated with neoadjuvant chemotherapy was alive.

Conclusion: The prognosis for these patients with a diagnosis of pleomorphic carcinoma undergoing surgery is generally better than those not treated with surgical resection, however the survival remains poor. Although with low number of patients, our research would suggest to consider neoadjuvant chemotherapy an appropriate approach for improving the outcomes before surgery.

Keywords: Carcinoma; Lung cancer; NSCLC; Pleomorphic; Rare tumor.