2016 Volume 30 Issue 2 Pages 153-158
In pulmonary pleomorphic carcinomas, some cases with an extremely poor prognosis have been reported with early relapses and metastases even after radical surgery. A 63-year-old man was admitted to our hospital for cardiac failure and renal dysfunction due to diabetic neuropathy. Computed tomography (CT) demonstrated a mass, 33 mm in the longest diameter, in lower lobe S9 of the right lung, suspected of being lung cancer. Two months later, right lower lobectomy plus mediastinal lymph node dissection was performed, and the tumor was diagnosed as pulmonary pleomorphic carcinoma with a pathological stage of IIA (T2bN0M0). He received adjuvant chemotherapy of tegafur-uracil from 31 days after the surgery, but developed anorexia and severe back pain from 46 and 49 days after the surgery, respectively. CT revealed fluid and multiple nodules in the peritoneal space, and multiple gastric tumors were detected on upper gastrointestinal endoscopy. Based on pathological examinations, he was diagnosed with malignant peritonitis due to multiple gastric metastases from pulmonary pleomorphic carcinoma. Thereafter, he died at 63 days after the surgery. In cases of pulmonary pleomorphic carcinoma with an extremely short tumor-doubling time, the prognosis may be poor even after complete surgical resection.
