A case of large cell lung carcinoma with rhabdoid phenotype metastasized solitarily to the duodenum.

症例は40歳代の男性で,検診の胸部X線写真にて肺野の異常陰影を指摘された.原発性肺癌の疑いで右上葉切除術が行われ,pT2aN0M0と診断された.原発巣には大細胞癌と腺癌が同程度に混在し,一部にラブドイド形質が認められた.補助化学療法施行にも関わらず,術後7ヵ月目に腹痛を契機に十二指腸転移を指摘された.化学療法と膵頭十二指腸切除術が行われたが状態は改善せず,初回術後11ヵ月目に永眠された.再発巣は,ほとんどがラブドイド形質を伴う大細胞癌で占められていた.本腫瘍は治療抵抗性で,予後が不良である.完全切除後であっても厳重な経過観察が必要であると同時に,本腫瘍に対する標準的治療法の確立が望まれる.

We report a case of non-small cell lung cancer with rhabdoid phenotype that was completely resected by right upper lobectomy and lymphadenectomy. Pathological examination revealed that the tumor was mainly consisted of adenocarcinoma and large cell carcinoma, combined, with scanty of rhabdoid phenotype. Regardless of postoperative chemotherapy, the patient developed duodenal metastasis 7 month postoperatively. According to the pathological examination of resected metastatic lesion, most of the tumor cells represented rhabdoid phenotype. Unfortunately, the patients died of the subsequent liver metastasis 11 month after initial operation. A close follow-up is needed for such non-small cell lung cancer with variety of pathological phenotype.

ラブドイド形質

大細胞肺癌

十二指腸転移