Sarcomas of the lung

Of 18 patients with primary sarcoma of the lung, 10 were women and 8 were men whose ages ranged from 22 to 77 years; 6 patients were in the sixth decade of life. Nine patients had no symptoms referable to the tumor. When present, symptoms were cough, chest pain, or dyspnea. One patient had attacks of hypoglycemia. Radiographically, the tumors were generally large and well circumscribed. Grossly, three tumors were intrabronchial; one of these had invaded the lung. The remaining lesions were intrapulmonary. The sizes of the tumors ranged from 2 to 16 cm in greatest dimension. Histologically, there were nine fibrosarcomas, four leiomyosarcomas, three hemangiopericytomas, and two osteosarcomas. Most of the fibrosarcomas and leiomyosarcomas were poorly differentiated; all hemangiopericytomas were considered malignant, and both osteosarcomas were high grade. Treatment consisted of complete removal when feasible. At last follow-up, four patients were alive without disease from 3 to 18 years after surgery. The common factor in all four of these cases was the size of the tumor, 2 to 3 cm in greatest dimension. Hence, the size of the tumor is the most important prognostic indicator in sarcomas of the lung.