Vol 66, No 5 (2016)
Case report
Published online: 2017-03-29

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Fetal adenocarcinoma — a rare variant of lung adenocarcinoma with good prognosis

Jolanta Winek, Paweł Caban, Jacek Zych, Renata Langfort, Barbara Burakowska, Kazimierz Roszkowski-Śliż
Nowotwory. Journal of Oncology 2016;66(5):381-385.

Abstract

Fetal adenocarcinoma (FA) is a rare variant of lung adenocarcinoma with a good prognosis which represents approximately 0.5% of all primary lung neoplasms. The tumour has nonciliated tubules with morules in the lumen resembling fetal lung at 10 to 16 weeks of gestation. FA typically occurs in young patients 75–80% of whom are tobacco smokers. FA occurs in low- and high-grade forms. Surgical procedure is usually necessary to obtain final diagnosis and a complete surgical resection is the standard treatment. The 5-year survival rate for FA is about 75–80%. We report a case of 32-year-old male, a smoker, who had an incomplete regression of parenchymal consolidations after antibiotic treatment, which led to further diagnostics. An intravenous tumour in one of the pulmonary veins with concomitant development of collateral circulation and pulmonary venous infarction were additional diagnostic problems. Based on the intraoperative microscopic examination, fetal adenocarcinoma was diagnosed. An upper right bilobectomy with intrapericardial ligation of the right superior pulmonary vein was performed as radical treatment. At the 9-month follow-up stage, there has been no evidence of disease recurrence.

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References

  1. Osakwe NC, Tong J, Rodgers WH, et al. A rare case of fetal adenocarcinoma of the lung. Ann Thorac Surg. 2014; 98(6): 2217–2218.
  2. Furuya K, Yasumori K, Takeo S, et al. Well-differentiated fetal adenocarcinoma of the lung: early-phase sequential high-resolution computed tomographic findings. J Comput Assist Tomogr. 2008; 32(5): 806–809.
  3. Sheehan KM, Curran J, Kay EW, et al. Well differentiated fetal adenocarcinoma of the lung in a 29 year old woman. J Clin Pathol. 2003; 56(6): 478–479.
  4. Tanoue LT. International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society International Multidisciplinary Classification of Lung Adenocarcinoma. Yearbook of Pulmonary Disease. 2012; 2012: 94–96.
  5. Mardini G, Pai U, Chavez AM, et al. Endobronchial adenocarcinoma with endometrioid features and prominent neuroendocrine differentiation. A variant of fetal adenocarcinoma. Cancer. 1994; 73(5): 1383–1389.
  6. Fujino S, Asada Y, Konishi T, et al. Well-differentiated fetal adenocarcinoma of lung. Lung Cancer. 1995; 13(3): 311–316.
  7. Longo M, Levra MG, Capelletto E, et al. Fetal adenocarcinoma of the lung in a 25-year-old woman. J Thorac Oncol. 2008; 3(4): 441–443.
  8. Suzuki M, Yazawa T, Ota S, et al. High-grade fetal adenocarcinoma of the lung is a tumour with a fetal phenotype that shows diverse differentiation, including high-grade neuroendocrine carcinoma: a clinicopathological, immunohistochemical and mutational study of 20 cases. Histopathology. 2015; 67(6): 806–816.
  9. Geisinger KR, Travis WD, Perkins LA, et al. Aspiration cytomorphology of fetal adenocarcinoma of the lung. Am J Clin Pathol. 2010; 134(6): 894–902.
  10. Sato S, Koike T, Yamato Y, et al. Resected well-differentiated fetal pulmonary adenocarcinoma and summary of 25 cases reported in Japan. Jpn J Thorac Cardiovasc Surg. 2006; 54(12): 539–542.
  11. Nakatani Y, Masudo K, Miyagi Y, et al. Aberrant nuclear localization and gene mutation of beta-catenin in low-grade adenocarcinoma of fetal lung type: up-regulation of the Wnt signaling pathway may be a common denominator for the development of tumors that form morules. Mod Pathol. 2002; 15(6): 617–624.
  12. de Kock L, Bah I, Wu Y, et al. Germline and Somatic DICER1 Mutations in a Well-Differentiated Fetal Adenocarcinoma of the Lung. J Thorac Oncol. 2016; 11(3): e31–e33.
  13. Patnayak R, Jena A, Rukmangadha N, et al. Well-differentiated fetal adenocarcinoma of the lung in an adult male: report of an unusual tumor with a brief review of literature. J Cancer Res Ther. 2014; 10(2): 419–421.
  14. Kadota K, Haba R, Katsuki N, et al. Bronchial brushing cytology of a pulmonary fetal adenocarcinoma with a poorly differentiated component. Cytopathology. 2010; 21(5): 349–351.
  15. Thompson RJ, Hasleton PS, Taylor PM, et al. Haemoptysis in pregnancy caused by a well-differentiated fetal adenocarcinoma: a case report. J Med Case Rep. 2010; 4: 17.
  16. Giusti R, Iacono D, Ida P, et al. Multidisciplinary approach to fetal adenocarcinoma of the lung: A case report. Thorac Cancer. 2014; 5(1): 97–100.
  17. Lkhoyaali S, Boutayeb S, Ismaili N, et al. Neoadjuvant chemotherapy in well-differentiated fetal adenocarcinoma: a case report. BMC Res Notes. 2014; 7: 283.
  18. Kneafsey P, Duggan MA, McFadden S. Fine needle aspiration cytology of pulmonary, well-differentiated fetal adenocarcinoma prepared by the ThinPrep method. Cytopathology. 2003; 14(2): 87–90.