Pulmonary pleomorphic
carcinomas are rare malignant
tumors, and no standard treatments have been established. We herein report the successful treatment of a patient with pulmonary pleomorphic
carcinoma with
pembrolizumab. A 51-year-old man who was a current smoker presented to our hospital due to
dyspnea and hemosputum. Chest X-ray showed right-sided
pneumothorax with
pleural effusion;
chest tube drainage was therefore performed. Computed tomography after
chest tube drainage showed a cavitary nodule in the right upper lobe and right hilar and bilateral mediastinal
lymphadenopathy. Surgery was performed for the diagnosis and treatment. He was eventually diagnosed with pulmonary pleomorphic
carcinoma corresponding to clinical stage IVB (cT2aN2M1c [PLE, ADR, HEP]). The giant cells strongly expressed programmed death ligand-1, and the
tumor proportion score was more than 50%. Therefore,
pembrolizumab was introduced as the first-line
therapy. After 3 cycles of
pembrolizumab, his right hilar and bilateral mediastinal
lymphadenopathy and pleural dissemination notably decreased.
Pembrolizumab might be an effective
therapy for pulmonary pleomorphic
carcinoma.