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Vol. 52. Issue 6.
Pages 331 (June 2016)
Vol. 52. Issue 6.
Pages 331 (June 2016)
Clinical Image
DOI: 10.1016/j.arbr.2016.03.025
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An Example of Difficulty in Diagnosing and Treating Lung Sarcoma
Ilustramos la dificultad en el diagnóstico y tratamiento del sarcoma pulmonar
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Laura Quintana Cortésa,
Corresponding author
, Patricia Cruz Castellanosb, Javier de Castro Carpeñob
a Servicio de Oncología Médica, Hospital San Pedro de Alcántara, Cáceres, Spain
b Servicio de Oncología Médica, Hospital Universitario La Paz, Madrid, Spain
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A 59-year-old woman with a significant smoking history presented with cough. Chest X-ray revealed a 4cm pulmonary mass in the left hemithorax. The examination was completed with a positron emission tomography, which confirmed uptake in this region and ruled out secondary involvement (cT2cN0) (Fig. 1); bronchoscopy, which was normal; and computed tomography (CT)-guided fine needle aspiration. Pathology results were indicative of non-small cell lung cancer. In view of these findings, surgery involving left pneumonectomy and hilar-mediastinal lymphadenectomy was planned. Definitive histology results showed a pleomorphic sarcomatoid carcinoma with areas of squamous differentiation.

Fig. 1.

(A) Chest X-ray: left paracardiac mass. (B) Positron emission tomography; left lower mass with marked increase in glucidic metabolism, in contact with the posterior pleura, paravertebral space and oblique fissure.

(0.09MB).

Sarcoma of the lung is an uncommon neoplasm (0.5%–1%). It can be difficult to diagnose since it presents certain similarities to lung cancer, although it progresses more slowly.1 An additional problem is the difficulty in reaching a diagnosis from a biopsy specimen, since the heterogeneous nature of these tumors means that they are often incorrectly diagnosed as squamous cell carcinoma, resulting in the application of an inappropriate treatment plan.2

References
[1]
A.J. Spillane, R. A’Hern, I.R. Judson, C. Fisher, J.M. Thomas.
Synovial sarcoma: a clinicopathologic, staging, and prognostic assessment.
J Clin Oncol, 18 (2000), pp. 3794-3803
[2]
A. Italiano, N. Penel, Y.M. Robin, B. Bui, A. Le Cesne, S. Piperno-Neumann.
Neo/adjuvant chemotherapy does not improve outcome in resected primary synovial sarcoma: a study of the French Sarcoma Group.
Ann Oncol, 20 (2009), pp. 425-430

Please cite this article as: Quintana Cortés L, Cruz Castellanos P, de Castro Carpeño J. Ilustramos la dificultad en el diagnóstico y tratamiento del sarcoma pulmonar. Arch Bronconeumol. 2016;52:331.

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