A case of undifferentiated pleomorphic sarcoma of the thoracic wall poorly differentiated from local recurrence of lung cancer

Abstract

We report a case of undifferentiated pleomorphic sarcoma of the thoracic wall that was diagnosed preoperatively as local recurrence of primary lung cancer. Based on pathological examination findings, the lesion was an undifferentiated pleomorphic sarcoma.

The patient was an 80-year-old man. Nine years previously, he had undergone thoracoscopic resection of the upper right lung lobe for lung adenocarcinoma. pT3N1M0 stage IIIA cancer was treated with postoperative adjuvant therapy, and the patient had no recurrence. Computed tomography obtained for another disease showed a nodule shadow on the pleural side of the right middle lung field. Local recurrence was suspected as the shadow was located proximal to the previous surgical wound. We initiated surgery following treatment of the intra-atrial thrombus identified preoperatively. Two months into the surgical standby period, the mass enlarged with no distant metastasis, and the patient underwent combined resection of the chest wall and part of the adherent lower right lung lobe. Undifferentiated pleomorphic sarcoma was diagnosed by postoperative pathology. Because of the patient's age and systemic complications, no adjuvant therapy was prescribed. Six months postoperatively, multiple bone metastases appeared, and the patient was transferred to a hospice after palliative irradiation.