Metastasised Sarcomatoid Carcinoma Component with a Rare BRAF K601E Point Mutation and High PD-L1 Expression

Yusuke Sugita, Noriaki Sakakura, Yasushi Yatabe and Hiroaki Kuroda

Department of Thoracic Surgery, Aichi Cancer Center Hospital, Japan
Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Japan

^*Correspondance to: Hiroaki Kuroda 

 PDF  Full Text DOI: 10.25107/2474-1647.2255

Abstract

We experienced the case of a 74-year-old male with difficulty in preoperative diagnosis, but the definitive diagnosis was explicitly obtained with genetic analyses and immuno staining of programmed death-ligand 1. Chest computed tomography revealed a tumour with a maximum diameter of 30 mm in the left upper lobe adjacent to the chest wall, with osteolytic changes of the second rib. The following two clinical possibilities were considered based on the chest wall biopsy: 1) Heterogeneous lung malignancy and its direct invasion and 2) Double primary lung cancer and the chest wall sarcoma. The patient underwent left upper division segmetectomy and combined costectomy of the second and third ribs. Contrary to our expectations, the histopathological diagnosis was metastasis of the sarcomatoid component in adenocarcinoma harbouring programmed deathligand 1expression positivity and an extremely rare BRAF K601E point mutation. Therefore, genetic analyses and immuno staining can be helpful in determining a definitive histopathological diagnosis.

Keywords

BRAF; K601E; NSCLC; PD-L1; Costectomy

Cite the article

Sugita Y, Sakakura N, Yatabe Y, Kuroda H. Metastasised Sarcomatoid Carcinoma Component with a Rare BRAF K601E Point Mutation and High PD-L1 Expression. Clin Surg. 2018; 3: 2255.