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Case Report Open Access

Pulmonary pleomorphic carcinoma associated with cystic airspace and recurrent spontaneous pneumothorax: A case report

  • Authors:
    • Qiangsheng Li
    • Jing Zhang
    • Youjie Gong
    • Xudong Wan
    • Song Zhang
    • Zhongwang Li
    • Jun Liu
  • View Affiliations / Copyright

    Affiliations: Department of Cardiothoracic Surgery, Bengbu Third People's Hospital Affiliated to Bengbu Medical University, Bengbu, Anhui 233000, P.R. China, Department of Pathology, Bengbu Third People's Hospital Affiliated to Bengbu Medical University, Bengbu, Anhui 233000, P.R. China
    Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 321
    |
    Published online on: May 2, 2025
       https://doi.org/10.3892/ol.2025.15067
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Abstract

Pulmonary pleomorphic carcinoma (PPC), classified as the predominant subtype of pulmonary sarcomatoid carcinoma under the current World Health Organization (WHO) criteria, accounts for 0.1‑0.4% of all non‑small cell lung carcinoma cases and typically manifests radiologically as solid masses with peripheral infiltration. In the present report, a novel clinicopathological manifestation of PPC presenting as a primary solitary cystic airspace with recurrent spontaneous pneumothorax (SP), challenging conventional diagnostic paradigms, is described. A 66‑year‑old man with recurrent SP was initially misdiagnosed with pulmonary bullae based on the peripheral cystic airspaces observed on computed tomography. Persistent air leakage prompted video‑assisted thoracoscopic wedge resection, which revealed biphasic histology: Malignant spindle cell proliferations (vimentin‑positive) mixed with conventional adenocarcinoma components (transcription termination factor 1‑positive/napsin A‑positive), consistent with the WHO 2021 diagnostic criteria for PPC. The patient reached sustained remission without adjuvant therapy, and disease‑free survival was maintained for 29 months. The present case highlights three critical implications: First, primary cystic airspaces represent a rare but clinically significant radiological phenotype of PPC that mimic benign bullous lesions, particularly when obscured by pneumothorax; second, recurrent SP may serve as the initial manifestation of occult pulmonary malignancy, necessitating rigorous evaluation of cystic lung lesions; third, early surgical intervention offers dual diagnostic and therapeutic value, even in patients with compromised pulmonary function. These findings expand the recognized spectrum of the imaging heterogeneity of PPC and underscore the need for heightened clinical suspicion of cystic lung cancer in high‑risk populations.
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Copy and paste a formatted citation
Spandidos Publications style
Li Q, Zhang J, Gong Y, Wan X, Zhang S, Li Z and Liu J: Pulmonary pleomorphic carcinoma associated with cystic airspace and recurrent spontaneous pneumothorax: A case report. Oncol Lett 30: 321, 2025.
APA
Li, Q., Zhang, J., Gong, Y., Wan, X., Zhang, S., Li, Z., & Liu, J. (2025). Pulmonary pleomorphic carcinoma associated with cystic airspace and recurrent spontaneous pneumothorax: A case report. Oncology Letters, 30, 321. https://doi.org/10.3892/ol.2025.15067
MLA
Li, Q., Zhang, J., Gong, Y., Wan, X., Zhang, S., Li, Z., Liu, J."Pulmonary pleomorphic carcinoma associated with cystic airspace and recurrent spontaneous pneumothorax: A case report". Oncology Letters 30.1 (2025): 321.
Chicago
Li, Q., Zhang, J., Gong, Y., Wan, X., Zhang, S., Li, Z., Liu, J."Pulmonary pleomorphic carcinoma associated with cystic airspace and recurrent spontaneous pneumothorax: A case report". Oncology Letters 30, no. 1 (2025): 321. https://doi.org/10.3892/ol.2025.15067
Copy and paste a formatted citation
x
Spandidos Publications style
Li Q, Zhang J, Gong Y, Wan X, Zhang S, Li Z and Liu J: Pulmonary pleomorphic carcinoma associated with cystic airspace and recurrent spontaneous pneumothorax: A case report. Oncol Lett 30: 321, 2025.
APA
Li, Q., Zhang, J., Gong, Y., Wan, X., Zhang, S., Li, Z., & Liu, J. (2025). Pulmonary pleomorphic carcinoma associated with cystic airspace and recurrent spontaneous pneumothorax: A case report. Oncology Letters, 30, 321. https://doi.org/10.3892/ol.2025.15067
MLA
Li, Q., Zhang, J., Gong, Y., Wan, X., Zhang, S., Li, Z., Liu, J."Pulmonary pleomorphic carcinoma associated with cystic airspace and recurrent spontaneous pneumothorax: A case report". Oncology Letters 30.1 (2025): 321.
Chicago
Li, Q., Zhang, J., Gong, Y., Wan, X., Zhang, S., Li, Z., Liu, J."Pulmonary pleomorphic carcinoma associated with cystic airspace and recurrent spontaneous pneumothorax: A case report". Oncology Letters 30, no. 1 (2025): 321. https://doi.org/10.3892/ol.2025.15067
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