ABSTRACT
A 90-year-old female was admitted to our hospital with a history of a dry cough. Chest computed tomography (CT) scan showed a tumor shadow, and CT-guided lung biopsy revealed squamous cell carcinoma harboring an EGFR mutation. In addition, programmed death-ligand 1 (PD-L1) was highly expressed with a tumor proportion score (TPS) of >75%. Pembrolizumab therapy in the first-line setting was not effective, and the patient died at six months from the first visit. Squamous cell lung cancers (SCLCs) with both EGFR mutation and high expression of PD-L1 are very rare.
Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , B7-H1 Antigen/metabolism , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Squamous Cell/drug therapy , Lung Neoplasms/drug therapy , Mutation , Aged, 80 and over , Antineoplastic Agents, Immunological/therapeutic use , Carcinoma, Non-Small-Cell Lung/genetics , Carcinoma, Non-Small-Cell Lung/immunology , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Squamous Cell/genetics , Carcinoma, Squamous Cell/immunology , Carcinoma, Squamous Cell/secondary , ErbB Receptors/genetics , Fatal Outcome , Female , Humans , Lung Neoplasms/genetics , Lung Neoplasms/immunology , Lung Neoplasms/pathologyABSTRACT
A 61-year-old woman was referred to our hospital due to right chest pain. A huge, 13-cm-diameter tumor was detected in the right lower lobe. For diagnostic and treatment purposes, pneumonectomy was performed, and the tumor was diagnosed as advanced pulmonary synovial sarcoma (SS) with pleural metastasis, according to immunohistochemistry analysis. Due to recurrence with brain metastases, treatment sequence composed of radiosurgery, doxorubicin, eribulin, and pazopanib was selected. The patient died after a considerably long survival of 29 months after the first visit. This case suggests that multimodal treatment may provide prolonged survival even for patients with advanced SS.
