Molecular features of giant-cell carcinoma of the lung: a case report and literature review

Abstract

Giant-cell carcinoma of the lung (GCCL) is a rare histological form of poorly differentiated non-small-cell lung cancer, which is classified as a subtype of pulmonary sarcomatoid carcinomas. In this case report, we describe the case of a 50-year-old Chinese male who presented with a pulmonary nodule in the right upper lobe of his lung. After thoracoscopic lobectomy, a histopathologic diagnosis of GCCL was made. He did well postoperatively, showing no local recurrence or distal disease in a 7-year follow-up period. Furthermore, for this case, we also analyzed 295 tumor-related driver genes with high-throughput sequencing technology. We found that treatment using MEK inhibitor, CDK 4/6 inhibitor, and TP53 inhibitor may provide a new therapeutic direction for GCCL. Therefore, complete tumor excision is the best choice of treatment strategy at the early stage of GCCL and gene target therapy may be a new therapeutic option for this disease.

Keywords: gene mutation; giant-cell carcinoma of the lung; high-throughput sequencing.

Figure 1

Computed tomography (CT) scans of the chest. (A) CT scan before surgery: tumor-like mass in the right upper lobe with blurred contour and irregular margin shown in the lung and mediastinal windows. (B) The 7-year follow-up CT scan after surgery.

Figure 2

Pathological characteristics demonstrated by H&E staining and immunohistochemistry. CK and vimentin immunostaining was positive, while CgA and Syn immunostaining was negative. Abbreviations: CgA, chromogranin A; CK, cytokeratin; H&E, hemotoxylin and eosin; Syn, synaptophysin.