Extended radical resection and chest wall reconstruction for a pulmonary sarcomatoid carcinoma: a case report

Abstract Background Pulmonary sarcomatoid carcinoma (PSC) is a rare and highly malignant type of non-small cell lung cancer (NSCLC), for which the treatment of choice is surgery. For peripheral PSC growing outward and invading the chest wall, a complete resection of the affected lung lobes and the i...

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Main Authors: Yingzhi Zhao, Shaohua Xie, Haoqian Zheng, Kaixin Zhang, Xin Gao, Wenwu Liu, Wei Dai, Hongfan Yu, Qiuling Shi, Bin Hu, Qiang Li, Tianpeng Xie, Xing Wei
Format: Article
Language:English
Published: Japan Surgical Society 2024-03-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-024-01866-1
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author Yingzhi Zhao
Shaohua Xie
Haoqian Zheng
Kaixin Zhang
Xin Gao
Wenwu Liu
Wei Dai
Hongfan Yu
Qiuling Shi
Bin Hu
Qiang Li
Tianpeng Xie
Xing Wei
author_facet Yingzhi Zhao
Shaohua Xie
Haoqian Zheng
Kaixin Zhang
Xin Gao
Wenwu Liu
Wei Dai
Hongfan Yu
Qiuling Shi
Bin Hu
Qiang Li
Tianpeng Xie
Xing Wei
author_sort Yingzhi Zhao
collection DOAJ
description Abstract Background Pulmonary sarcomatoid carcinoma (PSC) is a rare and highly malignant type of non-small cell lung cancer (NSCLC), for which the treatment of choice is surgery. For peripheral PSC growing outward and invading the chest wall, a complete resection of the affected lung lobes and the invaded chest wall can improve long-term prognosis. However, when the extent of the resected chest wall is large, reconstruction is often required to reduce the risk of postoperative complications. Here, we present a case of PSC invading the chest wall treated with successful extended radical resection for lung cancer and chest wall reconstruction. Case presentation A 58-year-old male patient with a nodule in the right upper lobe that had been identified on physical examination 2 years before presentation presented to our hospital with a recent cough, expectoration, and chest pain. Imaging revealed a mass in the right upper lobe that had invaded the chest wall. Preoperative puncture pathology revealed poorly differentiated NSCLC. We performed extended radical resection for lung cancer under open surgery and reconstructed the chest wall using stainless steel wire and polypropylene meshes. The procedure was uneventful, and the patient was discharged 7 days postoperatively. Furthermore, the final pathology revealed PSC. Conclusions This case underscores the feasibility of surgical R0 resection in patients with PSC with chest wall invasion and no lymph node metastasis, potentially enhancing long-term outcomes. The novel aspect of this case lies in the individualized chest wall reconstruction for a large defect, using cost-effective materials that offered satisfactory structural support and postoperative recovery, thereby providing a valuable reference for similar future surgical interventions.
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spelling doaj-art-6136fd28126644c0a0b6fef9cd3ba2302025-08-20T03:33:11ZengJapan Surgical SocietySurgical Case Reports2198-77932024-03-011011610.1186/s40792-024-01866-1Extended radical resection and chest wall reconstruction for a pulmonary sarcomatoid carcinoma: a case reportYingzhi Zhao0Shaohua Xie1Haoqian Zheng2Kaixin Zhang3Xin Gao4Wenwu Liu5Wei Dai6Hongfan Yu7Qiuling Shi8Bin Hu9Qiang Li10Tianpeng Xie11Xing Wei12Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaGraduate School, Chengdu Medical CollegeDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaSchool of Public Health, Chongqing Medical UniversityDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of the University of Electronic Science and Technology of ChinaAbstract Background Pulmonary sarcomatoid carcinoma (PSC) is a rare and highly malignant type of non-small cell lung cancer (NSCLC), for which the treatment of choice is surgery. For peripheral PSC growing outward and invading the chest wall, a complete resection of the affected lung lobes and the invaded chest wall can improve long-term prognosis. However, when the extent of the resected chest wall is large, reconstruction is often required to reduce the risk of postoperative complications. Here, we present a case of PSC invading the chest wall treated with successful extended radical resection for lung cancer and chest wall reconstruction. Case presentation A 58-year-old male patient with a nodule in the right upper lobe that had been identified on physical examination 2 years before presentation presented to our hospital with a recent cough, expectoration, and chest pain. Imaging revealed a mass in the right upper lobe that had invaded the chest wall. Preoperative puncture pathology revealed poorly differentiated NSCLC. We performed extended radical resection for lung cancer under open surgery and reconstructed the chest wall using stainless steel wire and polypropylene meshes. The procedure was uneventful, and the patient was discharged 7 days postoperatively. Furthermore, the final pathology revealed PSC. Conclusions This case underscores the feasibility of surgical R0 resection in patients with PSC with chest wall invasion and no lymph node metastasis, potentially enhancing long-term outcomes. The novel aspect of this case lies in the individualized chest wall reconstruction for a large defect, using cost-effective materials that offered satisfactory structural support and postoperative recovery, thereby providing a valuable reference for similar future surgical interventions.https://doi.org/10.1186/s40792-024-01866-1Pulmonary sarcomatoid carcinomaChest wall invasionExtended radical resection for lung cancerChest wall reconstruction
spellingShingle Yingzhi Zhao
Shaohua Xie
Haoqian Zheng
Kaixin Zhang
Xin Gao
Wenwu Liu
Wei Dai
Hongfan Yu
Qiuling Shi
Bin Hu
Qiang Li
Tianpeng Xie
Xing Wei
Extended radical resection and chest wall reconstruction for a pulmonary sarcomatoid carcinoma: a case report
Surgical Case Reports
Pulmonary sarcomatoid carcinoma
Chest wall invasion
Extended radical resection for lung cancer
Chest wall reconstruction
title Extended radical resection and chest wall reconstruction for a pulmonary sarcomatoid carcinoma: a case report
title_full Extended radical resection and chest wall reconstruction for a pulmonary sarcomatoid carcinoma: a case report
title_fullStr Extended radical resection and chest wall reconstruction for a pulmonary sarcomatoid carcinoma: a case report
title_full_unstemmed Extended radical resection and chest wall reconstruction for a pulmonary sarcomatoid carcinoma: a case report
title_short Extended radical resection and chest wall reconstruction for a pulmonary sarcomatoid carcinoma: a case report
title_sort extended radical resection and chest wall reconstruction for a pulmonary sarcomatoid carcinoma a case report
topic Pulmonary sarcomatoid carcinoma
Chest wall invasion
Extended radical resection for lung cancer
Chest wall reconstruction
url https://doi.org/10.1186/s40792-024-01866-1
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