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Revue de Pneumologie Clinique
Volume 67, n° 3
pages 163-166 (juin 2011)
Doi : 10.1016/j.pneumo.2010.04.002
Le carcinome pléomorphe du poumon. À propos d’un cas
Pleomorphic carcinoma of the lung: A case report

E.M. Tazi a, , I. Essadi b, S. Arifi a, M. Ichou b, H. Errihani a
a Service d’oncologie médicale, institut national d’oncologie, PB 6213, Rabat, Maroc 
b Service d’oncologie médicale, hôpital militaire d’instruction Mohamed V, Rabat, Maroc 

Auteur correspondant.

Le carcinome pléomorphe du poumon est une tumeur primitive rare appartenant au groupe des cancers non à petites cellules du poumon. Nous présentons le cas d’un homme âgé de 40ans, tabagique, admis pour douleurs thoraciques associées à une toux sèche évoluant dans un contexte d’altération de l’état général. L’imagerie objectivait un aspect en « lâcher de ballons » pulmonaire bilatéral. La preuve anatomopathologique était obtenue par biopsie pulmonaire scanoguidée. La tumeur était classée stade IV du fait de son extension montrant la présence d’adénopathies sus-claviculaires et abdominales profondes. Le patient recevait six cycles de chimiothérapie de première ligne associant vinorelbine et cisplatine, le patient décédait six mois après le diagnostic dans un tableau de métastases cérébrales. Le diagnostic de carcinome pléomorphe est histologique, reposant sur l’association d’un contingent mésenchymateux malin homologue et d’un contingent épithélial carcinomateux. Son traitement curatif est similaire aux autres cancers non à petites cellules du poumon, basé essentiellement sur la chirurgie. Son pronostic est plus sombre que celui des autres cancers non à petites cellules, malgré une prise en charge pluridisciplinaire associant chirurgie, radiothérapie et chimiothérapie.

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Pleomorphic carcinoma is a rare malignancy belonging to the family of nonsmall cell lung cancers. A 40-year-old man, a smoker, was hospitalized for thoracic pain and dry cough with a deteriorating general condition. The imaging showed a “drop ball” of both lungs. The pathological evidence was obtained by lung biopsy under scanographic control. The presence of supraclavicular and abdominal nodes classified the tumour as stage IV. The patient received six cycles of first-line chemotherapy associating cisplatin and vinorelbine. However, the disease continued to progress and distant metastases were observed. The patient died 6 months after the diagnosis. Pleomorphic carcinoma is identified by purely histological criteria: the concomitant presence of malignant epithelial and homologous sarcomatoid spindle-cell components. Like the other nonsmall cell lung cancers, the treatment is primarily surgical, and the invasive nature of this tumour makes it very difficult. Pleomorphic carcinoma has a poorer prognosis than conventional nonsmall cell lung cancers despite surgery, irradiation and chemotherapy, because relapse occurs early.

The full text of this article is available in PDF format.

Mots clés : Carcinome pléomorphe, Poumon, Carcinome non à petites cellules, Chimiothérapie

Keywords : Pleomorphic carcinoma, Lung, Nonsmall cell lung cancer, Chemotherapy

© 2010  Elsevier Masson SAS. All Rights Reserved.
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