Pulmonary Adenocarcinoma with Heterotopic Ossification
Suzuki, J.; Kanauchi, N.; Endo, M.; Hamada, A.; Watanabe, H.
Kyobu Geka. Japanese Journal of Thoracic Surgery 72(5): 363-366
2019
ISSN/ISBN: 0021-5252 PMID: 31268034 Document Number: 699897
Although malignant tumor with heterotopic ossification have often been reported, it is very rare in lung cancer. We report a case of primary lung adenocarcinoma with heterotopic ossification. A 43-year-old woman undergoing a health check was found an abnormal nodular lesion on chest X-ray. Chest computed tomography (CT) showed a calcified tumor, which was diagnosed adenocarcinoma by transbronchial biopsy. Right lower lobectomy and ND2a-2 lymph node dissection was done. Postoperative pathological examination identified the tumor as a bronchioloalveolar adenocarcinoma with other mixed subtypes, associated with ossification containing bone marrow tissue in the tumor. An immunohistochemical examination showed that cancer cells around the ossification expressed bone morphogenetic protein-2 and osteopontin, which generally induce and stimulate bone formation. This finding may serve to elucidate a probable mechanism for the heterotopic ossification observed in cancer lesions.