Case Report: Controversies in managing pulmonary enteric adenocarcinoma: reflections from an early-stage case
Pulmonary enteric adenocarcinoma (PEAC) is a rare non-small cell lung cancer subtype characterized by predominant intestinal differentiation (≥50%) and histological resemblance to colorectal adenocarcinoma. We report a 70-year-old male ex-smoker with an incidentally detected 18×11 mm spiculated lung...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1603084/full |
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| author | Yuchen Bao Dongdong Liu Yanzhe Wang Zhigang Wu Haitao Wang |
| author_facet | Yuchen Bao Dongdong Liu Yanzhe Wang Zhigang Wu Haitao Wang |
| author_sort | Yuchen Bao |
| collection | DOAJ |
| description | Pulmonary enteric adenocarcinoma (PEAC) is a rare non-small cell lung cancer subtype characterized by predominant intestinal differentiation (≥50%) and histological resemblance to colorectal adenocarcinoma. We report a 70-year-old male ex-smoker with an incidentally detected 18×11 mm spiculated lung nodule on chest CT, which subsequently demonstrated intense FDG uptake (SUVmax 14.0) on PET-CT. Histopathological evaluation confirmed PEAC. Immunohistochemistry revealed HER2 overexpression (3+) and intestinal differentiation markers (CK7+, CK20+, CDX2+, Villin+), while molecular testing showed wild-type ERBB2 and no actionable mutations. The patient underwent successful R0 resection with no recurrence at 8-month follow-up. This case underscores the critical importance of a multimodal diagnostic approach integrating immunohistochemical markers (notably CK7’s superior specificity), PET-CT imaging, and endoscopic evaluation to reliably differentiate PEAC from metastatic gastrointestinal malignancies. Furthermore, the patient’s favorable outcome following R0 resection without adjuvant therapy reinforces surgical intervention as the cornerstone of treatment for localized PEAC, particularly in early-stage disease. Advanced cases require early multidisciplinary collaboration to develop individualized treatment. |
| format | Article |
| id | doaj-art-690605ae2a654792ad94b5fe53e4674d |
| institution | DOAJ |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-690605ae2a654792ad94b5fe53e4674d2025-08-20T03:21:32ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-06-011510.3389/fonc.2025.16030841603084Case Report: Controversies in managing pulmonary enteric adenocarcinoma: reflections from an early-stage caseYuchen Bao0Dongdong Liu1Yanzhe Wang2Zhigang Wu3Haitao Wang4Hangzhou Normal University, Hangzhou, Zhejiang, ChinaCancer Center, Department of Thoracic Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, ChinaZhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaCancer Center, Department of Thoracic Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, ChinaCancer Center, Department of Thoracic Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, ChinaPulmonary enteric adenocarcinoma (PEAC) is a rare non-small cell lung cancer subtype characterized by predominant intestinal differentiation (≥50%) and histological resemblance to colorectal adenocarcinoma. We report a 70-year-old male ex-smoker with an incidentally detected 18×11 mm spiculated lung nodule on chest CT, which subsequently demonstrated intense FDG uptake (SUVmax 14.0) on PET-CT. Histopathological evaluation confirmed PEAC. Immunohistochemistry revealed HER2 overexpression (3+) and intestinal differentiation markers (CK7+, CK20+, CDX2+, Villin+), while molecular testing showed wild-type ERBB2 and no actionable mutations. The patient underwent successful R0 resection with no recurrence at 8-month follow-up. This case underscores the critical importance of a multimodal diagnostic approach integrating immunohistochemical markers (notably CK7’s superior specificity), PET-CT imaging, and endoscopic evaluation to reliably differentiate PEAC from metastatic gastrointestinal malignancies. Furthermore, the patient’s favorable outcome following R0 resection without adjuvant therapy reinforces surgical intervention as the cornerstone of treatment for localized PEAC, particularly in early-stage disease. Advanced cases require early multidisciplinary collaboration to develop individualized treatment.https://www.frontiersin.org/articles/10.3389/fonc.2025.1603084/fullpulmonary enteric adenocarcinoma (PEAC)PET-CTmultidisciplinary diagnosissurgical resectioncase report |
| spellingShingle | Yuchen Bao Dongdong Liu Yanzhe Wang Zhigang Wu Haitao Wang Case Report: Controversies in managing pulmonary enteric adenocarcinoma: reflections from an early-stage case Frontiers in Oncology pulmonary enteric adenocarcinoma (PEAC) PET-CT multidisciplinary diagnosis surgical resection case report |
| title | Case Report: Controversies in managing pulmonary enteric adenocarcinoma: reflections from an early-stage case |
| title_full | Case Report: Controversies in managing pulmonary enteric adenocarcinoma: reflections from an early-stage case |
| title_fullStr | Case Report: Controversies in managing pulmonary enteric adenocarcinoma: reflections from an early-stage case |
| title_full_unstemmed | Case Report: Controversies in managing pulmonary enteric adenocarcinoma: reflections from an early-stage case |
| title_short | Case Report: Controversies in managing pulmonary enteric adenocarcinoma: reflections from an early-stage case |
| title_sort | case report controversies in managing pulmonary enteric adenocarcinoma reflections from an early stage case |
| topic | pulmonary enteric adenocarcinoma (PEAC) PET-CT multidisciplinary diagnosis surgical resection case report |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1603084/full |
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