Open AccessStereotactic body radiation therapy (SBRT) in the management of pulmonary spindle cell carcinoma
Author(s) -
Moyosore Awobajo,
Ara A. Vaporciyan,
Charles Lu,
Saumil Gandhi
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-234779
Subject(s) - medicine , radiology , spindle cell carcinoma , positron emission tomography , radiation therapy , biopsy , solitary pulmonary nodule , stage (stratigraphy) , lung , carcinoma , pathology , computed tomography , paleontology , biology
A 69-year-old woman underwent routine screening with CT scan of the chest, which showed a new right upper lobe lesion. Interval increase in size of the right upper lobe nodule over 3 months, prompted a CT-guided biopsy of the lung that confirmed a diagnosis of malignant pulmonary spindle cell carcinoma (PSCC) with 90% programmed death ligand 1 expression. Positron emission tomography CT demonstrated localised stage IIA disease. Given histologically proven PSCC and the rapid growth of her tumour, curative radiation with stereotactic body radiation therapy (SBRT) to the right upper lobe primary tumour was planned as patient was deemed not to be a surgical candidate. Repeat imaging with a CT chest 2 months after SBRT demonstrated good local control of the primary disease in the right upper lobe despite rapidly advancing distant metastasis. The patient continues systemic therapy with pembrolizumab, to which she has shown good response.