Management strategies for primary lung carcinosarcoma: a case study and comprehensive literature review

Primary lung carcinosarcoma, characterized by the presence of both carcinoma and sarcoma components, is a rare soft tissue malignancy. Its pathogenesis remains incompletely elucidated, and it exhibits significant resistance to conventional therapeutic interventions, resulting in a dismal prognosis. Consequently, there is currently no established standard treatment protocol for lung carcinosarcoma, leading most clinicians to draw upon their experiences with other tumor types when formulating treatment strategies.

A 56-year-old non-smoking male presented with a progressively enlarging mass in the right cervical region, The diagnosis of lung carcinosarcoma was definitively confirmed through CT-guided biopsy. First-line immunotherapy combined with targeted therapy was ineffective; second-line chemotherapy was effective, chest CT revealed the disappearance of enlarged lymph nodes in the retrosternal area and a significant reduction of pulmonary lesions, but showed signs of brain metastasis. the patient passed away at home on June 27th, 2023 due to sudden onset dyspnea accompanied by loss of consciousness.

A comprehensive literature search for lung carcinosarcoma was conducted across four databases, including PubMed/MEDLINE, Web of Science, Cochrane Library, and Embase, covering the period from 1968 to 2023. A total of 48 patients were included for analysis. Further survival analysis revealed a median survival time of 18 months; adjuvant therapy following surgery significantly improved survival compared to surgery alone and other treatment modalities.

Lung carcinosarcoma is an exceptionally rare malignant neoplasm of the lung, and definitive treatment protocols remain elusive. The most effective strategy to enhance prognosis may still entail complete surgical resection of the lesions in conjunction with adjuvant therapy.