A case of two-year survival after the total resection of a giant pulmonary carcinosarcoma

Background. Pulmonary carcinosarcoma is a rare and aggressive malignant neoplasm which has been reported to have poor prognosis. Preoperative diagnosis is often difficult, and the optimal therapy has not been established. We report a patient with giant pulmonary carcinosarcoma with good survival after the total resection of the tumor. Case. A 64-year-old man presented to our hospital with a complaint of hemoptysis. A chest computed tomographic (CT) scan on admission demonstrated a 17-cm mass in the right lung. Lymphadenopathy was observed only in the hilar node. Bronchial biopsy and fiberscopy showed non-small cell lung cancer, and we initially diagnosed primary lung cancer, cT3N1M0 stage IIIA. Right pneumonectomy was performed through a median sternotomy with a right anterior thoracotomy, and the tumor was completely resected. The tumor was histologically diagnosed as pulmonary carcinosarcoma, pT3N0M0 stage IIB and was 17 cm in diameter. Although the patient received no adjuvant chemotherapy or radiotherapy, neither tumor recurrence nor systemic metastasis was observed on repeated CT scans during follow-up. He finally died of pneumonia at 24 months postoperatively. Conclusion. We report a rare case of giant pulmonary carcinosarcoma with a satisfactory postoperative course. Although poor prognosis is reported in the literatures, complete resection may provide a long survival period, even in patients with giant carcinosarcoma.