Ju Q, Wu YT, Zhang Y, Yang WH, Zhao CL, Zhang J. Histology transformation-mediated pathological atypism in small-cell lung cancer within the presence of chemotherapy: A case report. World J Clin Cases 2021; 9(34): 10652-10658 [PMID: 35004997 DOI: 10.12998/wjcc.v9.i34.10652]
Corresponding Author of This Article
Jian Zhang, PhD, Doctor, Professor, Department of Pulmonary and Critical Care Medicine, Xijing Hospital, No. 127 Changle West Road, Xi'an 710000, Shaanxi Province, China. zhangjian_1970@126.com
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/
Qing Ju, Ying-Tong Wu, Yong Zhang, Wen-Hui Yang, Jian Zhang, Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Xi'an 710000, Shaanxi Province, China
Cheng-Lei Zhao, Department of Dermatology, Southwest Hospital, Chongqing 404100, China
Author contributions: Ju Q, Zhang Y and Zhang J contributed to the conceptualization; Ju Q, Wu YT and Zhao CL collected the information; Ju Q, Zhang Y, Wu YT and Yang WH wrote the original draft; Wu YT, Zhang Y and Zhang J reviewed and edited the manuscript.
Informed consent statement: Informed written consent was obtained from the patient to publish this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Zhang, PhD, Doctor, Professor, Department of Pulmonary and Critical Care Medicine, Xijing Hospital, No. 127 Changle West Road, Xi'an 710000, Shaanxi Province, China. zhangjian_1970@126.com
Received: February 9, 2021 Peer-review started: February 9, 2021 First decision: April 25, 2021 Revised: May 27, 2021 Accepted: October 20, 2021 Article in press: October 20, 2021 Published online: December 6, 2021 Processing time: 293 Days and 18.1 Hours
Abstract
BACKGROUND
The treatment of small-cell lung cancer (SCLC) has progressed little in recent years because of its unique biological activities and complex genomic alterations. Chemotherapy combined with radiotherapy has been widely accepted as the first-line treatment for SCLC.
CASE SUMMARY
Here, we present a 68-year-old male smoker who was diagnosed with SCLC of the right lung. After several cycles of concurrent chemoradiotherapy, the tumor progressed with broad metastasis to liver and bone. Histopathological examination showed an obvious transformation to adenocarcinoma, probably a partial recurrence mediated by the chemotherapy-based regimen. A mixed tumor as the primary lesion and transformation from SCLC or/and tumor stem cells may have accounted for the pathology conversion. We adjusted the treatment schedule in accord with the change in phenotype.
CONCLUSION
Although diffuse skeletal and hepatic metastases were seen on a recent computed tomography scan, the patient is alive, with intervals of progression and shrinkage of his cancer.
Core Tip: In this report, we present a male patient with a diagnosis of small-cell lung cancer (SCLC) who developed metastatic adenocarcinoma, a subtype of non-SCLC, after standard chemotherapy regimens. He has survived for 90 mo since the first diagnosis, which is longer than expected.
