A Two-year Surviving Case of Primary Spindle Cell Carcinoma of the Lung after Adjuvant Chemotherapy

Abstract

A man in his sixties who was a heavy smoker but had no remarkable histories presented to a neighboring hospital because of an about one-month history of right back pain. He was referred to our hospital because a chest X-ray film revealed an 8-cm tumor in the right upper lung field. Percutaneous needle biopsy suggested a diagnosis of poorly differentiated non-small-cell lung cancer. Imaging findings did not reveal lymph node nor distant metastases so that radical resection appeared to be possible. We performed right upper lobectomy + associated resection of chest wall, where the mediastinal lymph nodes were dissected up to ND2a-2. Histopathology showed that the tumor was composed of large spindle cells ; and the tumor cells were positive for CK AE1/3 and negative for TTF1, p63, synaptophysin, chromogranin A and calretinin D2-40 on immunostaining. The final diagnosis was spindle cell carcinoma, pT4N0M0. After the operation, we conducted 4 courses of adjuvant chemotherapy with carboplatin + paclitaxel. The patient has been free from recurrence, as of 2 years after the operation. Since there have been few cases of spindle cell carcinoma undergone surgical resection and treatment with adjuvant chemotherapy, we present our case together with some bibliographical comments.