Pulmonary spindle cell carcinoma with hemothorax: A rare case report

BACKGROUND: Pulmonary spindle cell carcinoma is a type of variant sarcomatoid carcinoma, which is a very rare case. CASE PRESENTATION: A 53-year-old male presented with weakness, 95% oxygen saturation with nasal cannula 3 L/min, asymmetric chest movement, and problem in the right lung (dull to percussion, and low vesicular auscultation). X-ray and CT-Scan supported hemothorax and lung malignancies in the right lung. The patient had a chest drain inserted which confirmed the hemothorax and was transferred to the operating room for emergency thoracotomy to stop the bleeding. Bleeding was still massive so re-thoracotomy and lobectomy were performed. The lung tissue was examined for anatomical pathology, and the results showed spindle cell carcinoma. The patient was given pemetrexed and carboplatin chemotherapy. The patient refused to continue therapy and died 3 months after the first chemotherapy. DISCUSSION: Immunohistochemistry markers are the parameter for diagnosis of pulmonary spindle cell carcinoma that is highly positive for pan-cytokeratin, vimentin, and Ki67. The treatment is similar to other NSCLC, depending on the staging, and may include surgical resection, chemotherapy, and radiotherapy. CONCLUSION: Pulmonary spindle cell carcinoma is very rare and has a poor prognosis, especially in the presence of hemothorax.