ABSTRACT
Sarcomatoid carcinoma is a subtype of non-small cell lung cancer (NSCLC) characterized by mesenchymal - epithelial transition component and awful prognosis. In this report, based on a case of stage IV lung sarcomatoid carcinoma with an extraordinary evolution and survival over 4 years, we address unresolved questions about the treatment of this cancer. We also make a literature review about the key factors that characterize this histology and that should be considered when treating those patients. Sarcomatoid carcinoma presents with mutations as KRAS, EGFR, ALK or MET in up to 70% of cases, and an important expression of PD-L1 (also called B7-H1), which can influence treatment of those patients with new drugs as immune checkpoint inhibitors. Immunotherapy has changed the horizon of patients with stage IV lung cancers without driver mutations, as their survival has improved extraordinary. Moreover, radical treatments are being considered in long survivors with oligometastatic disease. In this report, we review targeted and radical therapy, treatment duration and the mechanisms responsible of disease evolution of sarcomatoid tumors.
Subject(s)
Amino Acyl-tRNA Synthetases/immunology , Azathioprine/administration & dosage , Calcinosis , Lung Diseases, Interstitial , Myositis , Paraspinal Muscles , Prednisone/administration & dosage , Tomography, X-Ray Computed/methods , Autoantibodies/blood , Calcinosis/diagnostic imaging , Calcinosis/etiology , Female , Humans , Immunosuppressive Agents/administration & dosage , Lung Diseases, Interstitial/diagnostic imaging , Lung Diseases, Interstitial/etiology , Lung Diseases, Interstitial/therapy , Middle Aged , Myositis/diagnosis , Myositis/immunology , Myositis/physiopathology , Myositis/therapy , Paraspinal Muscles/diagnostic imaging , Paraspinal Muscles/pathologySubject(s)
Biopsy, Large-Core Needle/methods , Heart Neoplasms/pathology , Hemangiosarcoma/pathology , Image-Guided Biopsy/methods , Adult , Heart Neoplasms/diagnostic imaging , Hemangiosarcoma/diagnostic imaging , Humans , Magnetic Resonance Imaging , Male , Myocardium/pathology , Tomography, X-Ray ComputedSubject(s)
Humans , Male , Adult , Biopsy, Large-Core Needle/methods , Image-Guided Biopsy/methods , Heart Neoplasms/pathology , Hemangiosarcoma/pathology , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Heart Neoplasms/diagnostic imaging , Hemangiosarcoma/diagnostic imaging , Myocardium/pathologyABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Varicose Veins/diagnosis , Pulmonary Veins/physiopathology , Solitary Pulmonary Nodule/diagnosis , Diagnosis, Differential , Mitral Valve Insufficiency/complications , Hypertension, Pulmonary/complicationsABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Lymphangioleiomyomatosis/complications , Lymphangioleiomyomatosis , Incidental Findings , Breast Neoplasms/diagnosis , Lung Neoplasms , Angiomyolipoma , Lung Neoplasms/complications , Tuberous Sclerosis/complications , Tuberous Sclerosis/pathology , Angiomyolipoma/pathologyABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Pulmonary Artery/physiopathology , Atherosclerosis/diagnosis , Alagille Syndrome/physiopathology , Pulmonary Subvalvular Stenosis/diagnosis , Dyspnea/etiology , Dilatation, Pathologic/diagnosisSubject(s)
Alagille Syndrome/complications , Atherosclerosis/diagnostic imaging , Calcinosis/diagnostic imaging , Dilatation, Pathologic/diagnostic imaging , Postoperative Complications/diagnostic imaging , Pulmonary Artery/diagnostic imaging , Pulmonary Valve Stenosis/diagnostic imaging , Alagille Syndrome/surgery , Atherosclerosis/etiology , Calcinosis/etiology , Dilatation, Pathologic/etiology , Humans , Kidney Transplantation , Liver Transplantation , Male , Middle Aged , Postoperative Complications/etiology , Pulmonary Artery/pathology , Pulmonary Valve Stenosis/etiologyABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Lung Diseases/diagnosis , Lung Diseases , Lung Diseases/therapy , Diaphragm/abnormalities , Diaphragm/growth & development , Diaphragm/surgeryABSTRACT
PURPOSE: Congenital cystic adenomatoid malformation (CCAM) of the lung in adults is very rare. We aimed to evaluate the clinicoradiological features of adult patients with CCAM. METHODS: Adult patients diagnosed with CCAM were evaluated for clinicoradiological presentation and management. METHODS: Nine patients were diagnosed with CCAM (four were incidentally diagnosed on chest imaging). Most cases appeared on computed tomography as thin-walled multiseptated cystic lesions. Two patients had another concurrent pulmonary developmental anomaly. Five patients were surgically treated and three conservatively. CONCLUSIONS: CCAMs might be incidentally diagnosed on routine chest imaging in adults and can be safely treated with minimally invasive techniques.
Subject(s)
Cystic Adenomatoid Malformation of Lung, Congenital/diagnostic imaging , Lung/diagnostic imaging , Tomography, X-Ray Computed , Adult , Aged , Cystic Adenomatoid Malformation of Lung, Congenital/diagnosis , Cystic Adenomatoid Malformation of Lung, Congenital/therapy , Female , Follow-Up Studies , Humans , Incidental Findings , Male , Middle Aged , Retrospective Studies , Treatment OutcomeABSTRACT
BACKGROUND: An extrapleural hematoma (EH) is an uncommon and potentially life-threatening condition defined as the accumulation of blood in the extrapleural space between the parietal pleura and the endothoracic fascia. EH usually occurs after blunt thoracic trauma causing fractures of the sternum and ribs, which can tear the intercostal or internal mammary vessels. Typical radiological findings of EH are a biconvex opacity on the involved hemithorax and the so-called displaced "extrapleural fat sign." CASE REPORT: We present a case of a 36-year-old man with an isolated scapular fracture after a high-energy blunt chest trauma complicated with a large contralateral EH that was successfully managed nonoperatively with transcatheter arterial embolization (TAE) and image-guided drainage with a pig-tail catheter. To the best of our knowledge there is only one previous report describing a large EH after blunt thoracic trauma without rib fractures. Only two previous cases of large EHs have been treated initially with TAE, but both patients ultimately required open surgery. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Patients with EH can present with respiratory distress and hypotension, so early identification is important to facilitate proper treatment. EH has characteristic radiological findings, and contrast-enhanced computed tomography is not only the best imaging tool for confirming an EH, but also the best technique for detecting the source of the bleeding and other serious thoracic complications that may not be evident on chest x-ray studies.
Subject(s)
Catheter Ablation/methods , Embolization, Therapeutic/methods , Hematoma/therapy , Thoracic Diseases/therapy , Thoracic Injuries/complications , Wounds, Nonpenetrating/complications , Adult , Hematoma/etiology , Humans , Male , Thoracic Diseases/etiology , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Humans , Female , Aged, 80 and over , Cholangitis/complications , Cholecystitis/diagnosis , Choledocholithiasis/diagnosis , Liver Abscess/physiopathology , Pleural Effusion , Cholecystectomy, Laparoscopic , Drainage/methods , Sphincterotomy, EndoscopicSubject(s)
Arterio-Arterial Fistula/congenital , Brachial Artery/abnormalities , Carcinoma, Squamous Cell/complications , Lung Neoplasms/complications , Pulmonary Artery/abnormalities , Aged , Angiography , Arterio-Arterial Fistula/complications , Arterio-Arterial Fistula/diagnosis , Biopsy , Brachial Artery/diagnostic imaging , Carcinoma, Squamous Cell/diagnosis , Humans , Lung Neoplasms/diagnosis , Male , Pulmonary Artery/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
No disponible