Pulmonary pleomorphic carcinoma; an investigation of thirteen cases

Pleomorphic carcinoma is a rare pulmonary epithelial malignant tumor defined in the World Health Organization classification updated in 1999. We investigated the clinical findings and prognosis associated with this tumor since to our knowledge they have yet to be well-understood. Between 2000 and 2006, in our hospital 387 patients underwent surgical resection for primary nonsmall cell lung carcinoma (NSCLC). Of these, 13 (3.4%) were diagnosed as pleomorphic carcinoma. We compared the clinical and pathological data between the patients with pleomorphic carcinoma (n = 13) and patients with other NSCLC (n = 374). Twelve (92.3%) of our patients were men and 9 (69.2%) were symptomatic. These tumors were located predominantly in an upper lobe and were associated more often with adjacent bullae than were other NSCLC. Surgical resection in 4 of the cases was incomplete due to tumor invasion into mediastinum, aortic arch, pleurae and/or chest wall. None of the diagnoses could be confirmed preoperatively. Thus, invasion of surrounding tissue occurred frequently and early. Although there are no defined management strategies for pleomorphic carcinoma, it is important to make the diagnosis early and perform complete resection if possible.