Xu SZ, Zhang XC, Jiang Q, Chen M, He MY, Shen P. Alpha-fetoprotein-producing hepatoid adenocarcinoma of the lung responsive to sorafenib after multiline treatment: A case report. World J Clin Cases 2022; 10(28): 10236-10243 [PMID: 36246828 DOI: 10.12998/wjcc.v10.i28.10236]
Corresponding Author of This Article
Peng Shen, PhD, Chief Doctor, Department of Medical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. shenp@zju.edu.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Su-Zhen Xu, Xiao-Chen Zhang, Qi Jiang, Ming Chen, Meng-Ye He, Peng Shen, Department of Medical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Xu SZ and Zhang XC contributed equally to the drafting of manuscript and reviewed literature; Jiang Q was involved in planning and supervised the study; Chen M and He MY contributed to clinical data collection and follow-up of the patient; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng Shen, PhD, Chief Doctor, Department of Medical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. shenp@zju.edu.cn
Received: May 3, 2022 Peer-review started: May 3, 2022 First decision: June 16, 2022 Revised: June 29, 2022 Accepted: August 24, 2022 Article in press: August 24, 2022 Published online: October 6, 2022 Processing time: 146 Days and 23.4 Hours
Abstract
BACKGROUND
Hepatoid adenocarcinoma of the lung (HAL) is an extremely rare malignant tumor, and many patients with HAL exhibit high levels of alpha-fetoprotein (AFP) expression. Currently, there is no standardized treatment strategy for advanced HAL and its prognosis is poor.
CASE SUMMARY
We report a 55-year-old man with unresectable AFP-related HAL. The largest cross-sectional area of the mass in the upper lobe of the left lung at the beginning of treatment was 8.46 cm × 6.53 cm. The patient’s serum AFP level was 9283 ng/mL. The mass increased in size to 8.86 cm × 8.21 cm after two courses of platinum-based combination chemotherapy and immunotherapy, and serum AFP reached its highest level (71232.2 ng/mL). The patient was treated with sorafenib (400 mg twice daily, per os). Forty days later, the mass was reduced to 5.63 cm × 5.29 cm and serum AFP level dropped to 786.8 ng/mL. The patient achieved partial remission for > 9 mo with sorafenib and an excellent biomarker response, as well as survival > 13 mo, which is among the longest reported for unresectable stage IV HAL.
CONCLUSION
This is the first report to document successful treatment of unresectable AFP-related HAL with single-agent sorafenib after multiline therapy.
Core Tip: Hepatoid adenocarcinoma of the lung (HAL) is an extremely rare malignant tumor with poor prognosis and no standardized treatment strategy. To our knowledge, this is the first report to document a patient with unresectable alpha-fetoprotein-related HAL who benefited from single-agent sorafenib after multiline treatment. Sorafenib may be a viable option for inoperable, previously treated, advanced HAL.
