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Histologic transformation of non-small-cell lung cancer in brain metastases

Meng Jiang1, Xiaolong Zhu2, Xiao Han3

  • 1Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China.

International Journal of Clinical Oncology
|November 17, 2018
PubMed
Abstract

Insights

Histologic transformation in brain metastases (BM) of non-small-cell lung cancer (NSCLC) occurs at a notable frequency. This finding suggests BM may evolve, impacting treatment strategies and the need for repeated pathologic evaluation.

Area of Science:

  • Oncology
  • Pathology
  • Cancer Metastasis

Background:

  • Treatment for lung cancer varies by histology (SCLC, adenocarcinoma, SCC).
  • Histologic transformation in brain metastases (BM) of lung cancer has not been previously reported.
  • Identifying histologic changes in BM is significant for treatment planning.

Purpose of the Study:

  • To investigate and report on the phenomenon of histologic transformation in brain metastases (BM) from non-small-cell lung cancer (NSCLC) for the first time.
  • To analyze the characteristics of histologic transformation in NSCLC BM.

Main Methods:

  • Retrospective review of medical records for patients with resected primary tumors and BM.
  • Histologic diagnosis confirmed by H&E staining and immunohistochemistry.
  • Analysis of characteristics of histologic transformation in BM.

Main Results:

  • Histologic transformation was observed in 3 of 24 patients (12.5%) with NSCLC and resected BM.
  • Transformations included squamous-cell cancer (SCC) to adenocarcinoma, adenocarcinoma to small-cell lung cancer (SCLC), and adenocarcinoma to SCC.
  • All observed transformations were spontaneous, with no prior genetic testing data.

Conclusions:

  • Histologic transformation in NSCLC BM occurs more frequently than previously assumed.
  • This transformation may represent an evolutionary process driven by intratumor heterogeneity.
  • Findings support surgical intervention for resectable metastatic lesions and repeated pathologic evaluation for personalized treatment.
Keywords:
Brain metastasesHistologic transformationNon-small-cell lung cancerSmall-cell lung cancerSurgery

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