Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10652
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
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.
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.
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.