Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2022; 10(28): 10236-10243
Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10236
Alpha-fetoprotein-producing hepatoid adenocarcinoma of the lung responsive to sorafenib after multiline treatment: A case report
Su-Zhen Xu, Xiao-Chen Zhang, Qi Jiang, Ming Chen, Meng-Ye He, Peng Shen
Su-Zhen Xu, Xiao-Chen Zhang, Qi Jiang, Ming Chen, Meng-Ye He, Peng Shen, Department of Medical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Xu SZ and Zhang XC contributed equally to the drafting of manuscript and reviewed literature; Jiang Q was involved in planning and supervised the study; Chen M and He MY contributed to clinical data collection and follow-up of the patient; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng Shen, PhD, Chief Doctor, Department of Medical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. shenp@zju.edu.cn
Received: May 3, 2022
Peer-review started: May 3, 2022
First decision: June 16, 2022
Revised: June 29, 2022
Accepted: August 24, 2022
Article in press: August 24, 2022
Published online: October 6, 2022
Processing time: 146 Days and 23.4 Hours
Abstract
BACKGROUND

Hepatoid adenocarcinoma of the lung (HAL) is an extremely rare malignant tumor, and many patients with HAL exhibit high levels of alpha-fetoprotein (AFP) expression. Currently, there is no standardized treatment strategy for advanced HAL and its prognosis is poor.

CASE SUMMARY

We report a 55-year-old man with unresectable AFP-related HAL. The largest cross-sectional area of the mass in the upper lobe of the left lung at the beginning of treatment was 8.46 cm × 6.53 cm. The patient’s serum AFP level was 9283 ng/mL. The mass increased in size to 8.86 cm × 8.21 cm after two courses of platinum-based combination chemotherapy and immunotherapy, and serum AFP reached its highest level (71232.2 ng/mL). The patient was treated with sorafenib (400 mg twice daily, per os). Forty days later, the mass was reduced to 5.63 cm × 5.29 cm and serum AFP level dropped to 786.8 ng/mL. The patient achieved partial remission for > 9 mo with sorafenib and an excellent biomarker response, as well as survival > 13 mo, which is among the longest reported for unresectable stage IV HAL.

CONCLUSION

This is the first report to document successful treatment of unresectable AFP-related HAL with single-agent sorafenib after multiline therapy.

Keywords: Hepatoid adenocarcinoma; Lung cancer; Alpha-fetoprotein; Sorafenib; Case report

Core Tip: Hepatoid adenocarcinoma of the lung (HAL) is an extremely rare malignant tumor with poor prognosis and no standardized treatment strategy. To our knowledge, this is the first report to document a patient with unresectable alpha-fetoprotein-related HAL who benefited from single-agent sorafenib after multiline treatment. Sorafenib may be a viable option for inoperable, previously treated, advanced HAL.