A Single-center Surgical Case Series of Pulmonary Pleomorphic Carcinoma

Abstract

Objectives. To examine the clinical profiles of pulmonary pleomorphic carcinoma and its treatment in surgical cases. Materials and Methods. We retrospectively reviewed the clinical profiles of seven patients with pulmonary pleomorphic carcinoma who underwent surgery at our hospital between January 2016 and June 2021. Results. The seven patients were five males and two females, aged 64-81 years. The clinical stage was IA (three cases), IB (one case), IIA (one case), IIB (one case), and IIIA (one case). Pneumonectomy (one case), lobectomy (five cases), and segmentectomy (one case) were performed in the patients. Two patients who underwent surgery alone lived without recurrence until 31 and 28 months, respectively, after the lung surgery. Post-surgical recurrences were detected in five cases, two of which died of early and aggressive cancer progression after discharge. Adrenal metastasis was detected in the remaining three cases, and one patient with bilateral adrenal metastases received systemic chemotherapy and immune checkpoint inhibitors and lived without recurrence until 32 months after the lung surgery; the two cases with unilateral metastasis, one of which underwent laparoscopic adrenalectomy alone, and another of which underwent chemotherapy following laparoscopic adrenalectomy, lived without recurrence for 66 and 52 months, respectively. Conclusion. Patients with a single unilateral adrenal metastasis after surgery for pulmonary pleomorphic carcinoma had a good prognosis after metastasectomy and administration of immune checkpoint inhibitors. In some cases, aggressive surgical intervention including metastases might contribute to a long-term survival.