A case of pulmonary carcinosarcoma (squamous cell carcinoma and osteosarcoma) treated with cisplatin and doxorubicin

Pulmonary carcinosarcoma is a rare malignancy composed of epithelial and mesenchymal elements. Little information is available on systemic treatment options for this tumor entity.

A 65-year-old man with severe chronic obstructive pulmonary disease (COPD) was diagnosed with primary pulmonary carcinosarcoma after percutaneous fine-needle biopsy of a right-sided calcified mass. The tumor was composed of squamous cell carcinoma and true osteosarcoma. A second, non-calcified mass was present in the left lung. The patient received six cycles of chemotherapy with cisplatin and doxorubicin, resulting in partial remission of both tumor manifestations. However, a few months thereafter, the patient died from spinal and cerebral metastases, the former of which was of adenocarcinomatous differentiation.

Cisplatin and doxorubicin may be effective in pulmonary carcinosarcoma. Nevertheless, the aggressiveness of this rare tumor entity, its histological heterogeneity, and its potential coexistence with non-small cell lung cancer (NSCLC) make the management of patients with pulmonary carcinosarcoma a diagnostic and therapeutic challenge.