Division of Respirology, NTT Medical Center Tokyo, Tokyo, Japan.
Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
Medicine (Baltimore). 2022 Oct 21;101(42):e31220. doi: 10.1097/MD.0000000000031220.
Pulmonary pleomorphic carcinoma is a rare tumor with a poor prognosis and has no standard chemotherapy. We herein report a case of small intestinal metastasis of pulmonary pleomorphic carcinoma that resulted in intestinal bleeding and was successfully treated with pembrolizumab monotherapy.
A 54-year-old man with a history of pulmonary pleomorphic carcinoma resection was referred to our hospital due to a 1-month history of a fever and general fatigue.
Laboratory investigation revealed microcytic anemia. Hematochezia was also noted after admission. Computed tomography (CT) and positron emission tomography (PET)/CT at the time of this admission revealed intraperitoneal masses alongside the small intestine with no significant ascites.
Pembrolizumab (400 mg/body) was introduced as the first-line chemotherapy.
By the 15th day after the initial pembrolizumab administration, the fever had disappeared, and the intraperitoneal masses were markedly reduced. Hematochezia had also disappeared, and he no longer needed to receive blood transfusions.
To our knowledge, this is the first report in which small intestinal metastasis of pulmonary pleomorphic carcinoma was successfully controlled by pembrolizumab monotherapy. Immune checkpoint inhibitors may be promising therapeutic agents against pulmonary pleomorphic carcinoma.
肺多形性癌是一种罕见的肿瘤，预后较差，且没有标准的化疗方案。本文报告了一例肺多形性癌小肠转移导致肠道出血的病例，该病例经帕博利珠单抗单药治疗取得了成功。
一名 54 岁男性，有肺多形性癌切除术病史，因发热和全身乏力 1 个月就诊于我院。
实验室检查发现小细胞性贫血。入院后出现血便。入院时的计算机断层扫描（CT）和正电子发射断层扫描（PET）/CT 显示，小肠旁有腹腔肿块，无明显腹水。
帕博利珠单抗（400mg/体）作为一线化疗药物引入。
在首次使用帕博利珠单抗后的第 15 天，发热已消失，腹腔肿块明显缩小。血便也消失了，他不再需要输血。
据我们所知，这是首例肺多形性癌小肠转移经帕博利珠单抗单药治疗成功控制的报告。免疫检查点抑制剂可能是治疗肺多形性癌有前途的治疗药物。
