A case of true pulmonary carcinosarcoma

Abstract

Background. The incidence of true pulmonary carcinosarcoma is about 0.1% of all lung tumors, and it has a tendency to occur in heavy smokers and elderly men. The tumor sizes of true pulmonary carcinosarcoma are generally large and the prognosis is bad. Case. An abnormal shadow was pointed out on the chest X-ray film of a 74-year-old man in a clinic. The chest X-ray film and CT showed honeycomb lung, lung fibrosis, and pulmonary emphysema predominantly in the bilateral lower lung field and a mass 7.5 cm in diameter in the right lower lobe. The mass was diagnosed as adenocarcinoma accompanied by sarcomatous change by a CT-guided lung biopsy. A right lower lobectomy with ND2a lymph node dissection was performed. The post-operative diagnosis was T4N2M0, p-Stage IIIB, and the tumor sizes were 8.5 x 8.0 x 5.3 cm in the primary lesion and 4.0 x 2.6 cm in the metastatic lesion (right S6). The patient passed away 6 months after the operation due to renal failure and cardiopulmonary failure despite chemoradiotherapy. Conclusion. We treated and report a case of true pulmonary carcinosarcoma. © 2008 The Japan Lung Cancer Society.