A Resected Case of Pulmonary Carcinosarcoma

Taichiro Goto, MD,1 Arafumi Maeshima, MD,2 Atsushi Tajima, MD,3 and Ryoichi Kato, MD1

The patient was a 78-year-old man with a history of smoking 5 or 6 cigarettes per day for 40 years. A chest X-ray taken during a medical checkup demonstrated a mass shadow in the right lower lung field. The patient was diagnosed with squamous cell carcinoma by bronchoscopic brushing cytology. A right lower lobectomy and a lymph node dissection were performed under a diagnosis of squamous cell carcinoma of the lung (cT2N0M0, stage IB). Gross examination of the resected specimen demonstrated an ovoid, irregularly bordered, yellowish-white tumor, 8 cm in diameter, containing a necrotic cavity. Histopathological examination showed diffuse proliferation of spindle-shaped tumor cells intermingled with areas of well-differentiated squamous cell carcinoma with definite keratinization. Areas of cartilage and bone were observed in the spindle-cell components of the tumor. These findings led to a diagnosis of carcinosarcoma (pT2N0M0, stage IB). The patient developed multiple intrapulmonary metastases 5 months after surgery and died of respiratory failure 10 months later. Herein we report a rare surgical case of lung carcinosarcoma. (Ann Thorac Cardiovasc Surg 2010; 16: 190-193)

Key words: pulmonary carcinosarcoma, surgery

1Department of General Thoracic Surgery, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan; 2Department of Pathology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan; and 3Department of General Thoracic Surgery, Saiseikai-Utsunomiya Hospital, Tochigi, Japan

Received December 4, 2008; accepted for publication April 2, 2009
Address reprint requests to Taichiro Goto, MD: Department of General Thoracic Surgery, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo 152–8902, Japan.