Pulmonary Enteric Adenocarcinoma in a Super-Elderly Patient: A Case Report and Literature Review.

IF 0.8 Q4 RESPIRATORY SYSTEM Respirology Case Reports Pub Date : 2025-02-19 eCollection Date: 2025-02-01 DOI:10.1002/rcr2.70127

Akira Shimamoto, Natsumi Kojo, Haruko Saiki, Akinobu Hayashi, Motoshi Takao

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Abstract

Pulmonary enteric adenocarcinoma (PEAC) is an extremely rare subtype of non-small cell lung cancer, characterised by histopathological features that resemble colorectal adenocarcinoma. Here, we report a case of PEAC in an 85-year-old male who presented with a pulmonary nodule initially identified at the age of 76. Initial PET-CT (maximum standardised uptake value [SUVmax] = 2.8) was inconclusive, leading to strict follow-up. Over 9 years, the nodule enlarged significantly (3.2 cm, SUVmax = 8.4). A transbronchial biopsy confirmed adenocarcinoma, and the patient underwent successfully video-assisted thoracoscopic surgery with lymph node dissection. The histopathological analysis revealed CK7 and CK20 positivity, focal CDX2 positivity, and TTF-1 negativity, confirming PEAC. Despite advanced age, the patient tolerated surgery well without adjuvant therapy. At the one-year postoperative follow-up, he remained disease-free. This case emphasises the diagnostic utility of immunohistochemistry and the feasibility of surgical management, even in super-elderly patients with PEAC.

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超高龄患者的肺肠腺癌1例报告及文献复习。

肺肠腺癌（PEAC）是一种非常罕见的非小细胞肺癌亚型，其组织病理特征与结直肠腺癌相似。在此，我们报告一例85岁男性PEAC，他在76岁时首次发现肺结节。初始PET-CT（最大标准化摄取值[SUVmax] = 2.8）无结论，需严格随访。9年后，结节明显增大（3.2 cm, SUVmax = 8.4）。经支气管活检证实为腺癌，患者成功接受了电视胸腔镜手术并进行了淋巴结清扫。组织病理学分析显示CK7和CK20阳性，局灶性CDX2阳性，TTF-1阴性，证实PEAC。尽管年事已高，患者在没有辅助治疗的情况下对手术耐受良好。在术后一年的随访中，他仍然无病。本病例强调了免疫组织化学诊断的实用性和手术治疗的可行性，即使在高龄PEAC患者中也是如此。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respirology Case Reports RESPIRATORY SYSTEM-

CiteScore

1.40

自引率

0.00%

发文量

178

审稿时长

8 weeks

期刊介绍： Respirology Case Reports is an open-access online journal dedicated to the publication of original clinical case reports, case series, clinical images and clinical videos in all fields of respiratory medicine. The Journal encourages the international exchange between clinicians and researchers of experiences in diagnosing and treating uncommon diseases or diseases with unusual presentations. All manuscripts are peer-reviewed through a streamlined process that aims at providing a rapid turnaround time from submission to publication.