ArticleFrontiers in oncology2026
Case Report: Synchronous SCLC and minimally invasive adenocarcinoma in the same lobe: NGS-confirmed cross-histological molecular heterogeneity in an ultra-rare case.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
A 73-year-old male was diagnosed with synchronous multiple primary lung cancer (sMPLC) involving small cell lung cancer (SCLC) and minimally invasive adenocarcinoma in the right upper lobe-an ultra-rare entity accounting for only 2.0% of all lung cancers, with cross-histological (SCLC + adenocarcinoma) same-lobe presentation reported in fewer than 10 cases globally to date. Notably, the SCLC component exhibited striking aggressiveness and diagnostic mimicry: it initially presented as a 0.3cm tiny nodule with benign imaging features (clear borders, no lobulation), which was consistent with "low-risk nodule" criteria per clinical guidelines, yet rapidly progressed to 1.8cm×1.5cm×1cm within 1 year (a 31-fold volume increase). The patient underwent single-port video-assisted thoracoscopic right upper lobectomy combined with mediastinal lymph node dissection. Pathological examination confirmed: Nodule 1 (the progressed lesion) was peripheral SCLC with airway spread (Syn, CgA, CD56 positive); Nodule 2 (0.8cm×0.4cm×0.3cm) was peripheral minimally invasive adenocarcinoma with predominant lepidic growth pattern (TTF-1, Napsin A positive). No mediastinal lymph node metastasis was detected (Groups 2 + 4/7/10-14, 0/15). Next-generation sequencing (NGS) of mixed tissue from both lesions revealed an EGFR exon21 c.2573T>G mutation (p.L858R, 0.46%, OncoKB Level 1 sensitivity) and a TP53 exon8 c.820G>T mutation (p.V274F, 79.5%), with no RB1 mutation detected; although this is consistent with
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