Hu Chun-Hong, Shi Shenghao, Dong Wen, Xiao Lizhi, Zang Hongjing, Wu Fang
Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China.
Department of Oncology, The Changde First People's Hospital, Changde, China.
Front Oncol. 2022 Mar 7;12:799549. doi: 10.3389/fonc.2022.799549. eCollection 2022.
Primary pulmonary enteric adenocarcinoma (PEAC) is a rare invasive adenocarcinoma clinically similar to metastatic colorectal adenocarcinoma (MCRC). Although many studies have addressed the differential diagnosis of PEAC, few have described the treatment of PEAC, especially using immunotherapy. This report describes a 61-year-old man who presented initially with pain in the ribs. Pathological analysis of biopsy samples shows malignant tumors of the right pleura, and next-generation sequencing of 26 genes showed a gene mutation. Positron emission tomography-computed tomography (PET-CT) found no evidence of gastrointestinal malignancy. Due to multiple metastases, the patient could not undergo radical surgery. The patient was treated with a combination chemotherapy regimen of paclitaxel plus carboplatin, along with sindilizumab immunotherapy, but, after one cycle of treatment, the tumor showed a hyperprogressive state. The patient is still being monitored regularly. These findings indicate that chemotherapy combined with immunotherapy may be ineffective in the treatment of primary PEAC with positive driver genes.
原发性肺肠型腺癌（PEAC）是一种罕见的浸润性腺癌，临床上与转移性结直肠癌（MCRC）相似。尽管许多研究探讨了PEAC的鉴别诊断，但很少有研究描述PEAC的治疗方法，尤其是免疫治疗。本报告描述了一名61岁男性，最初表现为肋骨疼痛。活检样本的病理分析显示右胸膜有恶性肿瘤，26基因的二代测序显示有基因突变。正电子发射断层扫描-计算机断层扫描（PET-CT）未发现胃肠道恶性肿瘤的证据。由于多处转移，患者无法接受根治性手术。患者接受了紫杉醇加卡铂的联合化疗方案以及信迪利单抗免疫治疗，但在一个疗程的治疗后，肿瘤呈现超进展状态。该患者仍在定期监测中。这些发现表明，化疗联合免疫治疗可能对驱动基因阳性的原发性PEAC治疗无效。
