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

Abstract

Fetal adenocarcinoma (FA) is a rare variant of lung adenocarcinoma with a good prognosis which represents approximately 0.5% of all primary lung neoplasms. The tumour has nonciliated tubules with morules in the lumen resembling fetal lung at 10 to 16 weeks of gestation. FA typically occurs in young patients 75-80% of whom are tobacco smokers. FA occurs in low-and high-grade forms. Surgical procedure is usually necessary to obtain final diagnosis and a complete surgical resection is the standard treatment. The 5-year survival rate for FA is about 75-80%. We report a case of 32-year-old male, a smoker, who had an incomplete regression of parenchymal consolidations after antibiotic treatment, which led to further diagnostics. An intravenous tumour in one of the pulmonary veins with concomitant development of collateral circulation and pulmonary venous infarction were additional diagnostic problems. Based on the intraoperative microscopic examination, fetal adenocarcinoma was diagnosed. An upper right bilobectomy with intrapericardial ligation of the right superior pulmonary vein was performed as radical treatment. At the 9-month follow-up stage, there has been no evidence of disease recurrence.