CASE REPORT article
Front. Oncol.
Sec. Thoracic Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1603084
Controversies in Managing Pulmonary Enteric Adenocarcinoma: Reflections from an Early-Stage Case
Provisionally accepted
- 1Hangzhou Normal University, Hangzhou, China
- 2Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang Province, China
- 3Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
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Pulmonary enteric adenocarcinoma (PEAC) is a rare non-small cell lung cancer subtype characterized by predominant intestinal differentiation (≥50%) and histological resemblance to colorectal adenocarcinoma. We report a 70-year-old male ex-smoker with an incidentally detected 18×11 mm spiculated lung nodule on chest CT, which subsequently demonstrated intense FDG uptake (SUVmax 14.0) on PET-CT. Histopathological evaluation confirmed PEAC. Immunohistochemistry revealed HER2 overexpression (3+) and intestinal differentiation markers (CK7+, CK20+, CDX2+, Villin+), while molecular testing showed wild-type ERBB2 and no actionable mutations. The patient underwent successful R0 resection with no recurrence at 8-month follow-up. This case underscores the critical importance of a multimodal diagnostic approach integrating immunohistochemical markers (notably CK7's superior specificity), PET-CT imaging, and endoscopic evaluation to reliably differentiate PEAC from metastatic gastrointestinal malignancies. Furthermore, the patient's favorable outcome following R0 resection without adjuvant therapy reinforces surgical intervention as the cornerstone of treatment for localized PEAC, particularly in early-stage disease.Advanced cases require early multidisciplinary collaboration to develop individualized treatment.
Keywords: Pulmonary enteric adenocarcinoma (PEAC), PET-CT, Multidisciplinary diagnosis, surgical resection, case report
Received: 31 Mar 2025; Accepted: 27 May 2025.
Copyright: © 2025 Bao, Liu, Wang, Wu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Haitao Wang, Zhejiang Provincial People's Hospital, Hangzhou, 310014, Zhejiang Province, China
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