Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10236
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
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.
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.
This is the first report to document successful treatment of unresectable AFP-related HAL with single-agent sorafenib after multiline therapy.
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.