Clinical status and research progress of adenosquamous carcinoma of the lung / 中国综合临床

Adenosquamous carcinoma of the lung (ASC), a relatively rare subtype of non-small-cell lung cancer, is defined as a malignancy containing components of both lung adenocarcinoma (ADC) and lung squamous cell carcinoma (SCC), with each comprising at least 10% of the tumor. Comparing to pure ADC or SCC, ASC has stronger aggressiveness and poorer prognosis. Surgery and chemotherapy are the mainstay treatments for ASC currently. The great progress of targeted therapy and immunotherapy in non-small cell lung cancer (NSCLC) has given ASC patients new hope. The EGFR mutation frequency and PD-L1 expression rate are similar comparing ASC to ADC and SCC, which means the targeted therapy and immunotherapy could make promising benefits to ASC patients. How to make personal treatment strategy and conduct whole course management is the emphasis of future studies.

Coughing up: “Adenosquamous carcinoma lung with unusual initial presentation as an ulceroproliferative growth” - case report and review of literature

Lung carcinoma is the most common carcinoma seen in males with the skin being a rare metastatic site. Adenosquamous carcinoma as a rare histologic subtype, showing cutaneous metastasis is an unusual event with no reports in the literature till date. Skin metastasis is an alarming sign, carries poor prognosis, and is associated with shortened survival. Herein, we report a case of 60-year-old male who presented with isolated cutaneous metastasis as a chronic nonhealing ulcer over the sternal region for 3 years (unusual) in the first place, without any other associated symptoms and clinical evidence of the primary. Wide local excision of the lesion was performed after proper workup which revealed metastatic adenosquamous carcinoma. The patient was advised systemic chemotherapy. A high index of suspicion along with clinico-radio-pathological correlation in these cases is of utmost importance and forms the basis of accurate diagnosis

Changing Modalities in the Management of Lung Cancer after the Invention of Computed Tomography

Introduction: Lung cancer is the leading cause of cancer-related mortality in both men and women. The prevalence of lungcancer is second only to that of prostate cancer in men and breast cancer in women. Lung cancer recently surpassed heartdisease as the leading cause of smoking-related mortality. Most lung carcinomas are diagnosed at an advanced stage, conferringa poor prognosis. The need to diagnose lung cancer at an early and potentially curable stage is obvious. In addition, mostpatients who develop lung cancer smoke and have smoking-related damage to the heart and lungs, making aggressive surgicalor multimodality therapies less viable options.Aim: This study aims to access the role of computerized tomography in the surgical management of carcinoma of the lung.Materials and Methods: This is a prospective study from 2014 to 2019, a period of 5 years. Atotal of 22 cases entered in the study.In this study, we compare both pre-operative computed tomography (CT) image and intraoperative findings and level of operability.Results: CT imaging will continue to play a major role in the evaluation of lung cancer. With the advent of non-invasive imagingmodalities like multi-slice/spiral CT scan, the use of invasive screening and staging procedures including bronchography hasbeen pushed to the periphery of staging workup; a total of 35 patients with carcinoma lung were studied. Seven patients werewith carcinoma lung Stage II, one patient with carcinoma Stage III, and 27 were in Stage IV. Seven patients underwent primarysurgical treatment. Other patients were treated appropriately with chemotherapy or radiotherapy or a combination of both.Conclusion: CT is still the cornerstone of imaging studies in the pre-operative staging and post-therapeutic evaluation of lungcancer. Treatment of lung cancer depends on the cancers specific cell type, how far it has spread and the patient’s performancestatus. CT is very useful for this purpose.

Clinical outcomes of epidermal growth factor receptor tyrosine kinase inhibitors in re-current adenosquamous carcinoma of the lung after resection / 中国肿瘤临床

Objective:To investigate the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in adenosqua-mous carcinoma (ASC) of the lung after resection. Methods:Clinical data of patients suffering from ASC and receiving EGFR-TKI treat-ment at one institution between January 2006 and December 2014 were retrospectively reviewed. Results:A total of 27 EGFR muta-tion-positive patients with ASC subjected to EGFR-TKI therapy were enrolled in this study. EGFR mutations included deletion in exon 19 in 15 cases and point mutation at codon 858 in exon 21 in 12 cases. Of the 27 ASC patients who received EGFR-TKI treatment, 9 exhibit-ed a partial response and 11 manifested a stable disease, and these patients accounted for a disease control rate of 74.1%(20/27). The median overall survival (OS), median progression-free survival, and median relapse OS of the EGFR mutation-positive patients who underwent TKI therapy were 39 months [95%confidence interval (CI)=25.6-52.4], 15 months (95%CI=12.9-17.1), and 19 months (95%CI=0.9-37.1), respectively. The 3-and 5-year survival rates of these patients after operation were 51.9%and 15.3%, respectively. Con-clusion:The survival of EGFR mutation-positive ASC patients treated with EGFR-TKIs was satisfactory. EGFR testing was recommended for ASCs and EGFR-TKI treatment was suitable for ASCs with EGFR-sensitizing mutation.

CT guided microwave ablation combined with gemcitabine and cisplatin regimen for the treatment of advanced squamous cell carcinoma of the lung / 中国生化药物杂志

Objective To investigate the clinical efficacy of gemcitabine and cisplatin chemotherapy combined with CT guided microwave ablation used in treatment of advanced squamous cell lung cancer. Methods 76 patients with lung squamous carcinoma in our hospital from April 2013 to July 2015 were selected,and randomly divided into treatment group and control group,38 cases in each groups. The control group were treated with gemcitabine and cisplatin chemotherapy. The patients in the treatment group in the control group based on the combined CT guided ablation under microwave, after the end of treatment to evaluate the efficacy of the two groups of patients, observe two groups of patients with adverse reactions, and were followed up for 1-2 years. Results The total effective rate of treatment group was significantly higher than the control group (P<0.05); pneumothorax treatment group after microwave ablation in patients with 2 cases, 3 cases of hemoptysis, 2 cases of fever, recovered after symptomatic treatment. The adverse reactions of the two groups due to chemotherapy caused by comparison of the rate of no significant difference; the treatment group of patients with PFS was significantly longer than the control group, the 1 year survival rate and 2 year survival rate was significantly higher than the control group(P<0.05). Conclusion Gemcitabine combined with cisplatin chemotherapy regimen combined with CT guided microwave ablation is effective in the treatment of advanced squamous cell lung cancer, and is worthy of clinical promotion.

CT diagnosis and differential diagnosis of mucoepidermoid carcinoma of the lung / 局解手术学杂志

Objective To improve the diagnostic accuracy by analyzing the computed tomography ( CT) characteristic performance of mucoepidermoid carcinoma of the lung. Methods CT findings 15 cases proved by pathology of mucoepidermoid carcinoma of the lung were retrospectively analyzed,and CT characteristic performance were studied by reviewing the literatures. Results The mucoepidermoid carcino-ma were located in right bronchial of 8 cases,left bronchial of 6 cases,peripheral part of the lung of 1 case. Calcification was seen in 7 mas-ses. Most masses density was not homogeneous at plain scanning. Venous phase have significantly enhanced compared with arterial phase. Ten cases showed obstructive pneumonia and atelectasis,3 cases with mediastinal lymph node metastases. Conclusion Multiple mucoepidermoid carcinoma of the lung grows extension of the long axis of bronchial,calcification be seen in most of patients. The enhanced mode of the lesions appeared as continuous progressive enhancement,some were illustrated with post obstructive pneumonia or atelectasis,CT have a certain value of diagnosis and diffenertial diagnosis.

Bullous Dermatomyositis Associated with Squamous Cell Carcinoma of the Lung / 대한피부과학회지

Dermatomyositis (DM) is a rare progressive autoimmune disease characterized by inflammatory myopathy, which classically manifests as several characteristic cutaneous features, including Gottron's papules, periorbital heliotrope rashes, poikiloderma, and reticular telangiectasis. Vesicle or bulla formation in dermatomyositis was first reported in 1903, and a few similar cases have been reported since then. Bullous DM has been associated with internal malignancies. We herein describe a case of bullous DM with squamous cell carcinoma of the lung in a 69-year old man.

A Case of Metastatic Neuroendocrine Carcinoma of the Lung Concomitant with Adenocarcinoma of the Stomach / 대한피부과학회지

Neuroendocrine tumors derive from the diffuse neuroendocrine system producing hormonal peptides and/or biogenic amines. Histologically neuroendocrine differentiation includes ultrastructural demonstration of neurosecretory granules and staining with immunhistochemical markers such as neuron-specific enolase, chromogranin, synaptophysin, and cytokeratin. Neuroendocrine carcinoma of the skin is rare but can be shown as an initial manifestation of metastatic neuroendocrine carcinoma as well as primary cutaneous neuroendocrine carcinoma. Histological differentiation between primary cutaneous Merkel cell carcinoma and metastatic neuroendocrine carcinoma of the skin is difficult and clinical correlation is important. We report a case of metastatic neuroendocrine carcinoma of the lung occurring on the scalp as a single nodule in a 65-year-old female who previously diagnosed with adenocarcinoma of the stomach.

A Case of Synchronous Double Primary Cancer with Esophageal Small Cell Carcinoma and Lung Squamous Cell Carcinoma / 대한소화기내시경학회지

Double primary cancer means that more than two cancers with different origin exist independently in an individual. The diagnosis of double primary cancer was determined by following criteria. Each of the tumors must present a definite picture of malignancy, each must be distance, and the probability of one being a metastasis of the other must be excluded. Primary small cell carcinoma in the esophagus is relatively rare, and rarer when it is combined with other malignant disease. A review of the Korean medical literature failed to reveal any previously described the case of syn-chronous double primary cancer of primary esophageal small cell carcinoma and squamous cell carcinoma of lung. Recently, we have experienced a case of double primary cancer, a 65-year-old man with primary esophageal small cell carcinoma and squamous cell carcinoma of lung, which were diagnosed by endoscopic biopsy and bronchoscopic biopsy.

Inappropriate Secretion of Antidiuretic Hormone in a Patient with Squamous Cell Carcinoma of the Lung mimicking Pulmonary Tuberculosis

A 71-year-old man with squamous cell carcinoma of lung mimicking pulmonary tuberculosis associated with the syndrome of inappropriate secretion of ADH(SIADH). Laboratory examination showed serum sodium concentration of 108 mEq/l. serum osmolality 247 mEg/l urine sodium concentration of 141 mEq/l urine osmolality 547 mEq/l. normal levels (<0.56 pg/ml) of serum antidiuretic hormone (ADH). ADH release was regulated normally with changes in serum osmolality. SIADH was diagnosed on the basis of hyponatremia with corresponding serum hypoosmolality and a high urine osmolality due to continuous sodium excretion. In this case, SIADH was probably induced by increased renal sensitivity to ADH and suspected high serum ANP level of unknown origin.

A Case of Paraneoplastic Acrokeratosis (Bazex' Syndrome) / 대한피부과학회지

We report a case of paraneoplastic acrokeratosis(Bazex syndrome) occurring in a 70 year old man with small cell carcinoma of the lung. The skin lesions showed violaceous erythema and psoriasiform scaling of the face, aural helices, scalp, and palmoplantar regions with severe nail dystrophy, Histcipathological findings revealed hyperkeratosis, acanthosis and spongiosis in the epiderrnis, and lyrnphocytic infiltration in the upper dermis. He was treated with cis-diamine dichloroplanum(Cisplan), 4 o-demethy-l-o-epipodo- phyllotoxin (Etoposide ) and steroid onitrnent. But eight months later, he died of lung carcinoma.