Clinical Characteristics of Malignant Pulmonary Sclerosing Pneumocytoma Based on a Study of 46 Cases Worldwide

Weidong Zhang,1 Dong Cui,1 Yaqian Liu,2 Kefeng Shi,1 Xia Gao,3 Rulin Qian1 1Department of Thoracic Surgery, Henan Provincial Chest Hospital, Zhengzhou City, Henan Province, People’s Republic of China; 2Medical Records and Statistics Room, Henan Provincial Chest Hospital, Zhengzhou City, Henan Province, People’s Republic of China; 3Department of Cardiovascular Surgery, Henan Provincial Chest Hospital, Zhengzhou City, Henan Province, People’s Republic of ChinaCorrespondence: Rulin Qian; Xia Gao, Henan Provincial Chest Hospital, Room 1, Weiwu Road, Zhengzhou City, Henan Province, 450003, People’s Republic of China, Email qianrulin0371@163.com; gaoxia03712022@163.comObjective: To analyze the clinical characteristics of patients with malignant pulmonary sclerosing pneumocytoma (PSP) with metastasis, recurrence, and growth and to improve clinicians’ understanding of PSP in patients with malignant tumor characteristics.Methods: A total of 46 PSP patients with malignant tumor characteristics were identified in the literature search and compared with 38 patients with benign PSP diagnosed and treated in our hospital in the past 5 years. We explored the pathogenesis, clinical symptoms, diagnostic methods, treatment strategies and prognosis of PSP patients with malignant tumor.Results: The characteristics of young age (≤ 41 years old), larger tumor (≥ 36mm), lymph node metastasis and distribution in East Asians are indicative of PSP with malignant potential. Such patients should undergo segmental resection or lobectomy, combined with necessary lymph node dissection or biopsy. All patients with PSP should have an entire course of follow-up management, because they may have an adverse prognosis such as recurrence, growth, metastasis, and even death.Conclusion: PSP has the potential for malignancy. Anatomical lobectomy or segmental resection combined with lymph node dissection should be performed in PSP with some specific characteristics. Inappropriate diagnosis and treatment may lead to poor prognosis in PSP patients.Keywords: pulmonary sclerosing pneumocytoma, malignant tumor, metastasis, recurrence, growth, treatment and diagnosis