Durable Disease Control in Primary Pulmonary Sarcomatoid Carcinoma Following Pneumonectomy

TL;DR

A rare lung cancer case was successfully treated with surgery and embolization, showing no recurrence after two years.

Contribution

This case demonstrates effective long-term disease control in a rare aggressive lung cancer through timely multidisciplinary treatment.

Findings

A pneumonectomy with arterioplasty achieved durable disease control in a patient with sarcomatoid carcinoma.

Preoperative embolization and surgical intervention led to no recurrence after two years.

Timely imaging and multidisciplinary planning are crucial for managing aggressive lung cancers.

Abstract

We report a 26-year-old male presenting with a chronic cough and hemoptysis. Imaging revealed a large hypermetabolic mass in the left lower lung with the invasion of adjacent great vessels. A biopsy confirmed sarcomatoid carcinoma, a rare and aggressive form of primary pulmonary sarcoma. Due to vascular involvement, the patient underwent preoperative bronchial artery embolization followed by left pneumonectomy with pulmonary arterioplasty via median sternotomy. Postoperative recovery was uneventful. A two-year follow-up CT showed no recurrence. Primary pulmonary sarcomas are extremely rare, accounting for only 0.013–0.4% of lung malignancies, and are often diagnosed late due to nonspecific symptoms. This case highlights the importance of timely imaging, multidisciplinary planning, and aggressive surgical management in achieving long-term disease control, even in cases with extensive vascular invasion.

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