Pulmonary Pleomorphic Carcinoma Mimicking Primary Sarcoma of the Neck: A Case Report and Literature Review

Daishi Ogawa,1,2 Masahisa Arahata,2 Masato Kuriyama,3 Shunji Shinagawa,3 Gakuto Tomizawa,4 Yukihiro Shimizu3 1Nanto Community Medical Support Unit, Toyama University Hospital, Toyama, Toyama, Japan; 2Department of General Medicine, Nanto Municipal Hospital, Toyama, Toyama, Japan; 3Department of Inte...

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Autores principales:	Ogawa D, Arahata M, Kuriyama M, Shinagawa S, Tomizawa G, Shimizu Y
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	pleomorphic carcinoma of the lung non-small-cell lung cancer metastases to soft tissues mesentery poor prognosis. Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/60a7f59babac4644b15e9322e316b555
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spelling	oai:doaj.org-article:60a7f59babac4644b15e9322e316b5552021-12-02T10:34:37ZPulmonary Pleomorphic Carcinoma Mimicking Primary Sarcoma of the Neck: A Case Report and Literature Review1178-1998https://doaj.org/article/60a7f59babac4644b15e9322e316b5552021-02-01T00:00:00Zhttps://www.dovepress.com/pulmonary-pleomorphic-carcinoma-mimicking-primary-sarcoma-of-the-neck--peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Daishi Ogawa,1,2 Masahisa Arahata,2 Masato Kuriyama,3 Shunji Shinagawa,3 Gakuto Tomizawa,4 Yukihiro Shimizu3 1Nanto Community Medical Support Unit, Toyama University Hospital, Toyama, Toyama, Japan; 2Department of General Medicine, Nanto Municipal Hospital, Toyama, Toyama, Japan; 3Department of Internal Medicine, Nanto Municipal Hospital, Nanto, Toyama, Japan; 4Department of Radiology, Nanto Municipal Hospital, Nanto, Toyama, JapanCorrespondence: Masahisa ArahataDepartment of General Medicine, Nanto Municipal Hospital, 938 Inami, Nanto, Toyama, 932-0211, JapanTel +81-763-82-1475Fax +81-763-82-1853Email rqxhf297@yahoo.co.jpAbstract: We describe our challenge in diagnosing an unusual and rapidly progressing case of pulmonary pleomorphic carcinoma (PPC)—a rare, poorly differentiated, or undifferentiated non-small-cell carcinoma that can metastasize locally or distantly and has a poor prognosis. Our patient was an elderly man with a one-month history of abdominal pain, anorexia, and weight loss, diagnosed with atrophic gastritis via endoscopy, and treated medically without improvement. A week later, this patient developed pain in the head, neck, and shoulder area, and further examination revealed a thickening of his left neck and shoulder, with no palpable lymph nodes. Computed tomography (CT) of the neck, chest, and abdomen led us to believe that we might be dealing with primary sarcoma of the neck since no lung mass was evident. Further investigation could not be performed because the patient’s status deteriorated rapidly. An autopsy revealed that soft tissue in the left neck and the mesentery was invaded by poorly differentiated polymorphic malignant cells, which were also seen in the lung lesion. Immunohistochemically, these malignant cells were all positive for AE1/AE3, CAM5.2, TTF-1, Napsin-A, and Vimentin. The cells were also positive for programmed death-ligand 1 staining with a low level of tumor proportion score (over 1%). The final diagnosis was PPC with metastases to soft tissues in the left neck and the mesentery. A review of previous case reports of PPC revealed that soft tissue is an uncommon site for metastasis, and that our CT findings were rather unusual. We hereby present our case and review of published case reports, with the hope that an awareness of the heterogeneous features of PPC could prompt timely biopsy and histological diagnosis.Keywords: pleomorphic carcinoma of the lung, non-small-cell lung cancer, metastases to soft tissues, mesentery, poor prognosisOgawa DArahata MKuriyama MShinagawa STomizawa GShimizu YDove Medical Pressarticlepleomorphic carcinoma of the lungnon-small-cell lung cancermetastases to soft tissuesmesenterypoor prognosis.GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 16, Pp 325-333 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pleomorphic carcinoma of the lung non-small-cell lung cancer metastases to soft tissues mesentery poor prognosis. Geriatrics RC952-954.6
spellingShingle	pleomorphic carcinoma of the lung non-small-cell lung cancer metastases to soft tissues mesentery poor prognosis. Geriatrics RC952-954.6 Ogawa D Arahata M Kuriyama M Shinagawa S Tomizawa G Shimizu Y Pulmonary Pleomorphic Carcinoma Mimicking Primary Sarcoma of the Neck: A Case Report and Literature Review
description	Daishi Ogawa,1,2 Masahisa Arahata,2 Masato Kuriyama,3 Shunji Shinagawa,3 Gakuto Tomizawa,4 Yukihiro Shimizu3 1Nanto Community Medical Support Unit, Toyama University Hospital, Toyama, Toyama, Japan; 2Department of General Medicine, Nanto Municipal Hospital, Toyama, Toyama, Japan; 3Department of Internal Medicine, Nanto Municipal Hospital, Nanto, Toyama, Japan; 4Department of Radiology, Nanto Municipal Hospital, Nanto, Toyama, JapanCorrespondence: Masahisa ArahataDepartment of General Medicine, Nanto Municipal Hospital, 938 Inami, Nanto, Toyama, 932-0211, JapanTel +81-763-82-1475Fax +81-763-82-1853Email rqxhf297@yahoo.co.jpAbstract: We describe our challenge in diagnosing an unusual and rapidly progressing case of pulmonary pleomorphic carcinoma (PPC)—a rare, poorly differentiated, or undifferentiated non-small-cell carcinoma that can metastasize locally or distantly and has a poor prognosis. Our patient was an elderly man with a one-month history of abdominal pain, anorexia, and weight loss, diagnosed with atrophic gastritis via endoscopy, and treated medically without improvement. A week later, this patient developed pain in the head, neck, and shoulder area, and further examination revealed a thickening of his left neck and shoulder, with no palpable lymph nodes. Computed tomography (CT) of the neck, chest, and abdomen led us to believe that we might be dealing with primary sarcoma of the neck since no lung mass was evident. Further investigation could not be performed because the patient’s status deteriorated rapidly. An autopsy revealed that soft tissue in the left neck and the mesentery was invaded by poorly differentiated polymorphic malignant cells, which were also seen in the lung lesion. Immunohistochemically, these malignant cells were all positive for AE1/AE3, CAM5.2, TTF-1, Napsin-A, and Vimentin. The cells were also positive for programmed death-ligand 1 staining with a low level of tumor proportion score (over 1%). The final diagnosis was PPC with metastases to soft tissues in the left neck and the mesentery. A review of previous case reports of PPC revealed that soft tissue is an uncommon site for metastasis, and that our CT findings were rather unusual. We hereby present our case and review of published case reports, with the hope that an awareness of the heterogeneous features of PPC could prompt timely biopsy and histological diagnosis.Keywords: pleomorphic carcinoma of the lung, non-small-cell lung cancer, metastases to soft tissues, mesentery, poor prognosis
format	article
author	Ogawa D Arahata M Kuriyama M Shinagawa S Tomizawa G Shimizu Y
author_facet	Ogawa D Arahata M Kuriyama M Shinagawa S Tomizawa G Shimizu Y
author_sort	Ogawa D
title	Pulmonary Pleomorphic Carcinoma Mimicking Primary Sarcoma of the Neck: A Case Report and Literature Review
title_short	Pulmonary Pleomorphic Carcinoma Mimicking Primary Sarcoma of the Neck: A Case Report and Literature Review
title_full	Pulmonary Pleomorphic Carcinoma Mimicking Primary Sarcoma of the Neck: A Case Report and Literature Review
title_fullStr	Pulmonary Pleomorphic Carcinoma Mimicking Primary Sarcoma of the Neck: A Case Report and Literature Review
title_full_unstemmed	Pulmonary Pleomorphic Carcinoma Mimicking Primary Sarcoma of the Neck: A Case Report and Literature Review
title_sort	pulmonary pleomorphic carcinoma mimicking primary sarcoma of the neck: a case report and literature review
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/60a7f59babac4644b15e9322e316b555
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Pulmonary Pleomorphic Carcinoma Mimicking Primary Sarcoma of the Neck: A Case Report and Literature Review

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