Primary dedifferentiated chondrosarcoma of the lung with a 4-year history of breast cancer:A case report

BACKGROUND Primary dedifferentiated chondrosarcoma(DDCS)of the lung is extremely rare and has a poor prognosis,especially in patients with a history of carcinomas and related treatment.Herein,we report a case of primary DDCS of the lung in a patient with a 4-year history of breast cancer and related treatment.CASE SUMMARY A 49-year-old woman was admitted to our hospital with complaints of headache,dizziness,slurred speech,and dyskinesia in May 2021.Computed tomography(CT)examinations showed multiple nodules in the brain,vertebral body,and both lungs with multiple enlarged lymph nodes in the right hilum and mediastinum,which were considered metastases of breast cancer.No obvious mass was discovered in the right hilum.After several months of related administration,the patient's headache disappeared,and her condition improved.However,new problems of asthma,dyspnea,cough,and restricted activity appeared in late November 2021.Although the CT scan indicated that the lesions in the brain,lung,and vertebral body had shrunk or disappeared,a soft tissue density lesion appeared in her right hilum and blocked the bronchial lumen.To relieve her dyspnea,part of the mass was resected,and a stent was placed via fiberoptic bronchoscopy.Following a complete pathological examination of the tumor,it was confirmed to be a primary DDCS of the lung.The patient then received two rounds of systemic chemotherapy with a regimen of cisplatin+ifosfamide+doxorubicin hydrochloride liposome,palliative radiotherapy for the tumor in her right lung,and four cycles of systemic chemotherapy and targeted therapy with a regimen of temozolomide combined with bevacizumab successively.She was in stable condition after the completion of the systemic chemotherapy and targeted therapy but underwent rapid progression after lung radiotherapy.The CT examinations showed multiple nodules in the brain and in both lungs,and the tumor in the right hilum was increased in size.CONCLUSION This case revealed a rare primary DDCS of the lung with a medical history of breast cancer,meaning a worse prognosis and making it more difficult to treat.

Primary pulmonary malignant melanoma diagnosed with percutaneous biopsy tissue:A case report

BACKGROUND Primary malignant melanoma of the lung (PMML) is a rare and highly malignanttumor with a poor prognosis. Here, we report a PMML case diagnosed bycomputed tomography (CT)-guided percutaneous biopsy, describe itspathological features and review relevant literature to improve our understandingof this tumor.CASE SUMMARY A 64-year-old Chinese female presented with productive cough for 7 mo. A chestCT scan showed a large and space-occupying lesion in Lingual lobe. Positronemission tomography-CT revealed multiple nodules located in the superior lobeapicoposterior segment of her left lung. Brain magnetic resonance imagingshowed numerous enhancing nodules, suggesting brain metastasis. AbdominalCT scan did not show any abnormalities. By CT-guided percutaneous biopsy, fourpieces of gray and taupe tissues (1 cm length and 0.1 mm in diameter) wereobtained. After pathologic examination, the tumor was found to consist ofepidermal and nested small round cells, fibrosis and thin-walled blood vessels.The finding was suggestive of malignant melanoma. To confirm the diagnosis,pathological morphology and immunophenotypic features of the biopsyspecimens were observed. The patient denied any history of skin tumors. Noabnormal lesions were detected in other sites of the body. Molecular testing waspositive for wild-type EGFR and KIT gene mutations. Finally, the clinical andpathological findings suggested PMML.CONCLUSION PMML is very rare, and the percutaneous biopsy tissue is limited. Therefore,comprehensive consideration of histology, immunohistochemistry, imaging, andclinical information is important for the diagnosis of PMML.