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| __NOTOC__ | | __NOTOC__ |
| {{SI}} | | {{Sarcomatoid carcinoma of the lung}} |
| {{CMG}} {{AE}} {{MV}} | | {{CMG}}; {{AE}} {{Trusha}}, {{MV}} |
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| {{SK}} Primary sarcoma of the lung; Lung sarcoma; Sarcomatoid tumor of the lung | | {{SK}} Primary sarcoma of the lung; Lung sarcoma; Sarcomatoid tumor of the lung; Pulmonary sarcomatoid carcinoma |
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| ==Overview== | | ==[[Sarcomatoid carcinoma of the lung overview|Overview]]== |
| Sarcomatoid carcinoma of the lung is a rare histologic subtype of non-small cell lung cancer. Sarcomatoid carcinoma of the lung is a "sarcoma-like" carcinoma neoplasm. The overall prevalence of sarcomatoid carcinoma of the lung is 0.1% to 0.4% of all lung malignancies.<ref name="pmid20073605">{{cite journal |vauthors=Franks TJ, Galvin JR |title=Sarcomatoid carcinoma of the lung: histologic criteria and common lesions in the differential diagnosis |journal=Arch. Pathol. Lab. Med. |volume=134 |issue=1 |pages=49–54 |year=2010 |pmid=20073605 |doi=10.1043/2008-0547-RAR.1 |url=}}</ref> | |
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| ==Historical Perspective== | | ==[[Sarcomatoid carcinoma of the lung historical perspective|Historical Perspective]]== |
| *In 1988, EGFR gene mutations were first identified in the pathogenesis of sarcomatoid carcinoma of the lung.
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| ==Classification==
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| *Sarcomatoid carcinoma of the lung may be classified according to WHO classification into 5 subtypes:
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| :*Pleomorphic carcinoma
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| :*Spindle cell carcinoma
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| :*Giant cell carcinoma
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| :*Carcinosarcoma
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| :*Pulmonary blastoma
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| ==Pathophysiology==
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| *The pathogenesis of sarcomatoid carcinoma of the lung is characterized by a rare epithelial origin, and morphologic features suggestive of a malignant mesenchymal tumour.
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| *Sarcomatoid carcinoma of the lung arises from epithelial cells but has morphologic features suggestive of a malignant mesenchymal tumor.
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| *The EGFR gene and K-ras mutations mutation has been associated with the development of sarcomatoid carcinoma of the lung.
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| *On gross pathology, a large sized mass lesion, with upper lobe and peripheral location are characteristic findings of sarcomatoid carcinoma of the lung.
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| *On microscopic histopathological analysis, sarcomatous components are characteristic findings of sarcomatoid carcinoma of the lung.
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| ==Causes== | | ==[[Sarcomatoid carcinoma of the lung classification|Classification]]== |
| * Sarcomatoid carcinoma of the lung may be caused by a mutation in the EGFR and K-ras genes.
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| | ==[[Sarcomatoid carcinoma of the lung pathophysiology|Pathophysiology]]== |
| ==Differentiating sarcomatoid carcinoma of the lung from other Diseases== | | |
| *Sarcomatoid carcinoma of the lung must be differentiated from other diseases that cause cough, weight loss, hemoptysis, and dyspnea among adults, such as:
| | ==[[Sarcomatoid carcinoma of the lung causes|Causes]]== |
| :*Tuberculosis
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| :*Adenocarcinoma of the lung
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| :*Pulmonary fungal disease
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| :*Lung abscess
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| ==Epidemiology and Demographics==
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| * The prevalence of sarcomatoid carcinoma of the lung is approximately 0.4 cases per 100,000 individuals worldwide.
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| *The overall prevalence of sarcomatoid carcinoma of the lung is 0.1% to 0.4% of all lung malignancies.<ref name="pmid20073605">{{cite journal |vauthors=Franks TJ, Galvin JR |title=Sarcomatoid carcinoma of the lung: histologic criteria and common lesions in the differential diagnosis |journal=Arch. Pathol. Lab. Med. |volume=134 |issue=1 |pages=49–54 |year=2010 |pmid=20073605 |doi=10.1043/2008-0547-RAR.1 |url=}}</ref>
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| ===Age=== | | ==[[Sarcomatoid carcinoma of the lung differential diagnosis|Differentiating Sarcomatoid carcinoma of the lung from other Diseases]]== |
| * Sarcomatoid carcinoma of the lung is more commonly observed among patients aged 50 to 75 years old.
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| * Sarcomatoid carcinoma of the lung is more commonly observed among elderly patients and adults
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| ===Gender===
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| *Males are more commonly affected with sarcomatoid carcinoma of the lung than females.
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| ===Race=== | | ==[[Sarcomatoid carcinoma of the lung epidemiology and demographics|Epidemiology and Demographics]]== |
| *There is no racial predilection for sarcomatoid carcinoma of the lung.
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| ==Risk Factors==
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| *Common risk factors in the development of sarcomatoid carcinoma of the lung are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
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| == Natural History, Complications and Prognosis==
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| *The majority of patients with sarcomatoid carcinoma of the lung remain asymptomatic for [duration/years].
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| *Early clinical features include chronic coughing, chest pain, and fatigue.
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| *If left untreated, the majority of patients with sarcomatoid carcinoma of the lung may progress to develop lymphatic invasion, distant metastasis, and
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| *Common complications of sarcomatoid carcinoma of the lung include respiratory failure, pneumonia, and distant metastasis.
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| *Prognosis is generally poor, and the average 5- survival rate of patients with sarcomatoid carcinoma of the lung is approximately 12%.
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| == Diagnosis ==
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| ===Diagnostic Criteria===
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| *The diagnosis of sarcomatoid carcinoma of the lung is made by lung biopsy.
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| *Biopsy findings associated with sarcomatoid carcinoma of the lung will depend on the subtype of tumor histology, common findings include:
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| :*Pleomorphic carcinoma subtype
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| :*Spindle cell carcinoma subtype
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| :*Giant cell carcinoma subtype
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| :*Carcinosarcoma subtype
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| === Symptoms === | | ==[[Sarcomatoid carcinoma of the lung risk factors|Risk Factors]]== |
| *Common symptoms of sarcomatoid carcinoma of the lung may include the following:
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| :*Shortness of breath
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| :*Fatigue
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| :*Chest pain
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| === Physical Examination === | | ==[[Sarcomatoid carcinoma of the lung screening|Screening]]== |
| *Patients with sarcomatoid carcinoma of the lung usually appear older in age in relation to their chronological age.
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| *Physical examination may be remarkable for:
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| '''Inspection'''
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| *Performed in the anterior chest/posterior chest
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| *Hoarseness
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| *Rapid rate of breathing
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| '''Auscultation'''
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| *Present [[pleural friction rub]]
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| *Present [[egophony]]
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| *Crackling or bubbling noises
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| *Present whispered pectoriloquy
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| *Decreased/absent [[breath sounds]]
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| '''Percussion'''
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| *Hyporesonance
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| *Dull percussion
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| *[[Tactile fremitus]]
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| *Reduced chest expansion
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| === Laboratory Findings === | |
| *There are no specific laboratory findings associated with sarcomatoid carcinoma of the lung.
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| ===Imaging Findings===
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| *CT scan is the imaging modality of choice for sarcomatoid carcinoma of the lung.
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| *On CT, sarcomatoid carcinoma of the lung is characterized by the following findings:
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| === Other Diagnostic Studies === | | ==[[Sarcomatoid carcinoma of the lung natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| *Sarcomatoid carcinoma of the lung may also be diagnosed using bronchoscopy, mediastinoscopy, transthoracic percutaneous fine needle aspiration.
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| == Treatment == | | ==Diagnosis== |
| === Medical Therapy ===
| | [[Sarcomatoid carcinoma of the lung diagnostic study of choice|Diagnostic study of choice]] | [[Sarcomatoid carcinoma of the lung history and symptoms|History and Symptoms]] | [[Sarcomatoid carcinoma of the lung physical examination|Physical Examination]] | [[Sarcomatoid carcinoma of the lung laboratory findings|Laboratory Findings]] | [[Sarcomatoid carcinoma of the lung electrocardiogram|Electrocardiogram]] | [[Sarcomatoid carcinoma of the lung x ray|X-Ray Findings]] | [[Sarcomatoid carcinoma of the lung echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[Sarcomatoid carcinoma of the lung CT scan|CT-Scan Findings]] | [[Sarcomatoid carcinoma of the lung MRI|MRI Findings]] | [[Sarcomatoid carcinoma of the lung other imaging findings|Other Imaging Findings]] | [[Sarcomatoid carcinoma of the lung other diagnostic studies|Other Diagnostic Studies]] |
| *There is no treatment for sarcomatoid carcinoma of the lung; the mainstay of therapy is supportive care.
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| *The mainstay of therapy for sarcomatoid carcinoma of the lung is [medical therapy 1] and [medical therapy 2].
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| *[Medical therapy 1] acts by [mechanism of action1].
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| *Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
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| === Surgery ===
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| *Surgery is the mainstay of therapy for sarcomatoid carcinoma of the lung.
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| *[Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of sarcomatoid carcinoma of the lung.
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| *[Surgical procedure] can only be performed for patients with [disease stage] sarcomatoid carcinoma of the lung.
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| === Prevention ===
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| *Effective measures for the primary prevention of sarcomatoid carcinoma of the lung include CT screening.
| | ==Treatment== |
| *According to the U.S. Preventive Services Task Force (USPSTF), screening for lung cancer by low-dose computed tomography is recommended every year among smokers who are between 55 to 80 years old and who have history of smoke 30 pack-years or more and either continue to smoke or have quit within the past 15 years (grade B recommendation)
| | [[Sarcomatoid carcinoma of the lung medical therapy|Medical Therapy]] | [[Sarcomatoid carcinoma of the lung surgery|Surgery]] | [[Sarcomatoid carcinoma of the lung primary prevention|Primary Prevention]] | [[Sarcomatoid carcinoma of the lung secondary prevention|Secondary Prevention]] | [[Sarcomatoid carcinoma of the lung cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Sarcomatoid carcinoma of the lung future or investigational therapies|Future or Investigational Therapies]] |
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| *Once diagnosed and successfully treated, patients with sarcomatoid carcinoma of the lung are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
| | ==Case Studies== |
| ==References==
| | [[Sarcomatoid carcinoma of the lung medical case study one|Case #1]] |
| {{Reflist|2}}
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| [[Category:Pick One of 28 Approved]] | | [[Category: Oncology]] |
| | [[Category:Up-To-Date]] |
| | [[Category:Oncology]] |
| | [[Category:Medicine]] |
| | [[Category:Pulmonology]] |
| | [[Category:Surgery]] |