Background: Pulmonary carcinosarcoma is a rare malignancy composed of epithelial and mesenchymal elements. Little information is available on systemic treatment options for this tumor entity.
Case report: A 65-year-old man with severe chronic obstructive pulmonary disease (COPD) was diagnosed with primary pulmonary carcinosarcoma after percutaneous fine-needle biopsy of a right-sided calcified mass. The tumor was composed of squamous cell carcinoma and true osteosarcoma. A second, non-calcified mass was present in the left lung. The patient received six cycles of chemotherapy with cisplatin and doxorubicin, resulting in partial remission of both tumor manifestations. However, a few months thereafter, the patient died from spinal and cerebral metastases, the former of which was of adenocarcinomatous differentiation.
Conclusion: Cisplatin and doxorubicin may be effective in pulmonary carcinosarcoma. Nevertheless, the aggressiveness of this rare tumor entity, its histological heterogeneity, and its potential coexistence with non-small cell lung cancer (NSCLC) make the management of patients with pulmonary carcinosarcoma a diagnostic and therapeutic challenge.