Spindle Cell Sarcomatoid Carcinoma of the Lungs in a Nigerian Woman: A Case Report


  • OT Ojo




Giant cell cancer, Lung cancer, Non-small cell cancer, Sarcomastoid cancer, Spindle cell cancer


Spindle cell sarcomatoid carcinoma of the lung is a very rare but highly aggressive tumour. The presentation is usually non-specific and can be confused with bronchogenic carcinoma, even on imaging. Tissue biopsy, with histology and immunohistochemistry, is very helpful in diagnosing and differentiating sarcomatoid cell cancer from bronchogenic carcinoma. Surgical resection is the treatment of choice, and if it is not possible, palliative chemotherapy may be an option. This report is about a rare case of spindle cell sarcomatoid sarcoma of the left lung in a flight attendant who presented with left-sided, dull aching chest pain, associated shortness of breath, and cough that was occasionally productive, haemoptysis and weight loss of one-month duration. The tissue biopsy with histology and immunohistochemistry supported the clinical diagnosis of the tumour. Although rare, spindle cell sarcomas may occur in very few patients. The clinical history, imaging and pathologic findings are essential in preventing misdiagnosis of these patients.


Fishback NF, Travis WD, Moran CA, Guinee Jr D, McCarthy WF, Koss MN. Pleomorphic (spindle/giant cell) carcinoma of the lung. A clinicopathologic correlation of 78 cases. Cancer 1994; 73(12):2936-2945. https://doi.org/10.1002/1097-0142(19940615)73:12<2936::AID-CNCR2820731210>3.0.CO;2-U

Nakajima M, Kasai T, Hashimoto H, Iwata Y, Manabe H. Sarcomatoid carcinoma of the lung: a clinicopathologic study of 37 cases. Cancer 1999; 86: 608-616. https://doi.org/10.1002/(SICI)1097-0142(19990815)86:4<608::AID-CNCR9>3.0.CO;2-1

Gbolahan OO, Fasina O, Adisa AO, Fasola OA. Spindle cell hemangioma: Unusual presentation of an uncommon tumor. J Oral Maxillofac Pathol 2015; 19: 406. https://doi.org/10.4103/0973-029X.174634

Seleye-Fubara D, Nwosu S, Bob-Yellowe E. Soft tissue sarcomas in the Niger Delta region of Nigeria (A Referal hospital's study). Niger J Med 2005; 14: 188-194. https://doi.org/10.4314/njm.v14i2.37179

Terada T. Spindle cell carcinoma of the lung: frequency, clinical features, and immunohistochemical studies of three cases. Respir Med CME 2010; 3: 241-245. https://doi.org/10.1016/j.rmedc.2009.10.003

Sardar M, Azharuddin M, Khan WJ, Noory MA, Shaikh N, Malik SU, et al. Spindle Cell Carcinoma of the Lung/Pleura: An Incidental Finding. Cureus 2018; 10: e2848-e. https://doi.org/10.7759/cureus.2848

Mochizuki T, Ishii G, Nagai K, Yoshida J, Nishimura M, Mizuno T, et al. Pleomorphic carcinoma of the lung: clinicopathologic characteristics of 70 cases. Am J Surg Pathol 2008; 32: 1727-1735. https://doi.org/10.1097/PAS.0b013e3181804302

Khan S, Dahal B, Siddiqui F, Norville KJ, Karki A. Pulmonary Spindle Cell Carcinoma: A Rare Case Report. Cureus 2019; 11: e4737-e. https://doi.org/10.7759/cureus.4737

Rossi G, Cavazza A, Sturm N, Migaldi M, Facciolongo N, Longo L, et al. Pulmonary carcinomas with pleomorphic, sarcomatoid, or sarcomatous elements: a clinicopathologic and immunohistochemical study of 75 cases. Am J Surg Pathol 2003; 27: 311-324. https://doi.org/10.1097/00000478-200303000-00004

Chang Y-L, Lee Y-C, Shih J-Y, Wu C-T. Pulmonary pleomorphic (spindle) cell carcinoma: peculiar clinicopathologic manifestations different from ordinary non-small cell carcinoma. Lung Cancer 2001; 34: 91-97. https://doi.org/10.1016/S0169-5002(01)00224-0

Rajdev K, Siddiqui AH, Ibrahim U, Agarwal S, Ding J, Chalhoub M. Sarcomatoid carcinoma of the lung presenting as localized bronchiectasis: a case report and review of literature. Respir Med Case Reports 2018; 24: 143-146. https://doi.org/10.1016/j.rmcr.2018.05.016

Karmakar S, Ansari MHG, Thakur S, Rai DK. Sarcomatoid carcinoma of the lung. Lung India 2021; 38: 266. https://doi: 10.4103/lungindia.lungindia_67_20

Ouziane I, Boutayeb S, Mrabti H, Lalya I, Rimani M, Errihani H. Sarcomatoid carcinoma of the lung: a model of resistance of chemotherapy. North Am J Med Sci 2014; 6: 342. https://doi.org/10.4103/1947-2714.136920

Brambilla E, Travis WD, Colby T, Corrin B, Shimosato Y. The new World Health Organization classification of lung tumours. Eur Respir J 2001; 18: 1059-1068. https://doi.org/10.1183/09031936.01.00275301

Wick MR, Ritter JH, Humphrey PA. Sarcomatoid carcinomas of the lung: a clinicopathologic review. Am J Clin Pathol 1997; 108: 40-53. https://doi.org/10.1093/ajcp/108.1.40

Karim NA, Schuster J, Eldessouki I, Gaber O, Namad T, Wang J, et al. Pulmonary sarcomatoid carcinoma: University of Cincinnati experience. Oncotarget 2018; 9: 4102. https://doi.org/10.18632/oncotarget.23468

Raveglia F, Mezzetti M, Panigalli T, Furia S, Giuliani L, Conforti S, et al. Personal experience in surgical management of pulmonary pleomorphic carcinoma. Ann Thoracic Surg 2004; 78: 1742-1747. https://doi.org/10.1016/j.athoracsur.2004.04.084






Case Report