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. 2024 May 2;150(5):225.
doi: 10.1007/s00432-024-05750-1.

Primary lung cancer in children and adolescents

Qiuming Chen  1 , Jun Cheng  2 , Luming Wang  2 , Xiayi Lv  2 , Jian Hu  2
Affiliations

Primary lung cancer in children and adolescents

Qiuming Chen et al. J Cancer Res Clin Oncol. .

Abstract

Purpose: Primary lung cancer is extremely rare in children and adolescents. The aim of this study is to clarify clinical features and outcomes of primary lung cancer in children and adolescents.

Methods: Young patients (aged ≤ 20 years) diagnosed as primary lung cancer between 2012 and 2023 were retrospective reviewed. According to radiological appearance of the nodules, they were divided into solid nodule (SN) group and ground glass opacity (GGO) group.

Results: A total of 74 patients were identified, with a median age at diagnosis of 18 years old (range: 11-20), including 7 patients in SN group and 67 patients in GGO group. In the GGO group, none of the nodules enlarged or changed during an average surveillance period of 10.8 months before surgery, except one. Wedge resection was the most common procedure (82.1%), followed by segmentectomy (16.4%) and lobectomy (1.5%). Histopathological analysis revealed that 64.2% of GGO nodules were adenocarcinoma in situ and minimally invasive adenocarcinomas, while the remaining 35.8% were invasive adenocarcinomas. Mutational analysis was performed in nine patients, with mutations identified in all cases. After a mean follow-up period of 1.73 ± 1.62 years, two patients in the SN group died due to multiple distant metastases, while all patients in the GGO group survived without recurrence. The overall survival (100%) of the GGO group was significantly higher than SN group (66.7%).

Conclusions: Primary lung cancer in children and adolescents are rare and histopathological heterogeneous. Persistent GGO nodules may indicate early-stage lung adenocarcinoma in children and adolescents.

Keywords: Adolescents; Children; Ground glass opacity; Primary lung cancer; Solid nodule.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Flow chart for patient selection in this study
Fig. 2
Fig. 2
A The time distribution of the number of patients enrolled in the study. B The age distribution of the number of patients enrolled in the study
Fig. 3
Fig. 3
Examples of pulmonary nodules. Examples of pure ground glass opacity nodules that remained unchanged after 7 months and pathological diagnosis was invasive adenocarcinoma (IAC) (A, B). Examples of mixed ground glass opacity nodules that remained unchanged after 2 months (C, D, invasive adenocarcinoma) and 3 months (E, F, invasive adenocarcinoma) of follow-up. Examples of solid nodule that remained unchanged after 12 months and pathological diagnosis was minimally invasive adenocarcinoma (MIA) (G, H). I, J, A ground glass opacity nodule that enlarged from 0.6 cm (I) to 0.9 cm (J) after 14 months of follow-up. The final pathology was acinar predominant adenocarcinoma, pT1aN0M0. K A 20- year-old woman with a solid nodule was diagnosed pulmonary lymphoepithelioma like carcinoma, pT2aN2M0 and died due to multiple distant metastases 1.5 years after surgery. L A 14- year-old woman with a solid nodule is diagnosed mucoepidermoid carcinoma, pT2aN2M0 and stays alive
Fig. 4
Fig. 4
Overall survival rates of patients between GGO group and SN group. OS overall survival, GGO: ground glass opacity, SN solid nodule
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