高悪性度胎児型肺腺癌の1例

Surgical Resection of High-grade Fetal Adenocarcinoma of the Lung：Report of a Case

はじめに　肺の胎児型腺癌は，胎児期の気道上皮に類似した腺管構造を特徴とした腫瘍で，原発性肺癌の約0.1％と報告されており非常にまれな疾患である1）．本稿では，高悪性度胎児型肺腺癌の1切除例を経験したので，文献的考察を加えて報告する．

A 79-year-old woman was revealed to have an abnormal shadow in the right upper lung field by a chest radiography at the time of medical examination. Contrast-enhanced chest computed tomography （CT） revealed a solid, irregularly-shaped nodule with pleural indentation and total/solid diameter of 26 mm in the S3 segment of the right upper lobe. A diagnosis could not be made with bronchoscopy, although positron emission tomography （PET）-CT showed accumulation of 18F-fluoro-2-deoxy-D-glucose （FDG） in the same area. The lung cancer in the right upper lobe was considered to be cT1cN0M0 stage ⅠA3, and surgery （thoracoscopic right upper lobectomy ND2a-1） was performed for diagnostic and therapeutic purposes. The histopathological diagnosis was high-grade fetal adenocarcinoma of the lung with metastasis to the #12 lymph node, pT1cN1M0 stage ⅡB. Currently, 3.5 years postoperatively, the patient has shown no apparent metastasis or recurrence. In future, the epidemiology and treatment methods of high-grade fetal adenocarcinoma of the lung should be established by accumulating more cases.