Fetal adenocarcinoma of the lung
Citation, DOI, disclosures and article data
At the time the article was created Yuranga Weerakkody had no recorded disclosures.View Yuranga Weerakkody's current disclosures
Fetal adenocarcinoma of the lung (FLAC) is a rare form of invasive adenocarcinoma of the lung.
Some reports suggest its occurrence at ~0.1-0.5% of all pulmonary neoplasms 1. Despite its "fetal" tissue morphology it typically presents in middle-aged to elderly patients (60 to 70 years old 2).
It is an adenocarcinoma resembling developing fetal lung in its pseudoglandular stage (i.e. that seen at 8-16 weeks of gestation). It is considered different from a pulmonary blastoma due to a lack of a mesenchymal component
Fetal adenocarcinoma of the lung can be divided into two forms according to severity.
low-grade fetal adenocarcinoma (L-FLAC): low nuclear atypia and prominent morule formation and has a pure pattern
high-grade fetal adenocarcinoma (H-FLAC): often over 50% fetal morphology, and often associated with other conventional types of lung adenocarcinoma
alpha-fetoprotein (AFP): thought to be elevated in most cases 3
History and etymology
It is thought to have been first described by W G Barnard in 1945 and 1952, as a biphasic tumor comprising an epithelial component surrounded by mesenchymal stroma resembling fetal lung, hence initially named “embryoma of the lung".
- 1. Ricaurte LM, Arrieta O, Zatarain-Barrón ZL, Cardona AF. Comprehensive review of fetal adenocarcinoma of the lung. (2018) Lung Cancer (Auckland, N.Z.). 9: 57-63. doi:10.2147/LCTT.S137410 - Pubmed
- 2. Nakatani Y, Kitamura H, Inayama Y, Kamijo S, Nagashima Y, Shimoyama K, Nakamura N, Sano J, Ogawa N, Shibagaki T, Resl M, Mark EJ. Pulmonary adenocarcinomas of the fetal lung type: a clinicopathologic study indicating differences in histology, epidemiology, and natural history of low-grade and high-grade forms. (1998) The American journal of surgical pathology. 22 (4): 399-411. Pubmed
- 3. Morita S, Yoshida A, Goto A, Ota S, Tsuta K, Yokozawa K, Asamura H, Nakajima J, Takai D, Mori M, Oka T, Tamaru J, Itoyama S, Furuta K, Fukayama M, Tsuda H. High-grade lung adenocarcinoma with fetal lung-like morphology: clinicopathologic, immunohistochemical, and molecular analyses of 17 cases. (2013) The American journal of surgical pathology. 37 (6): 924-32. doi:10.1097/PAS.0b013e31827e1e83 - Pubmed
- 4. Patnayak R, Jena A, Rukmangadha N, Lakshmi AY, Chandra A. Well-differentiated fetal adenocarcinoma of the lung in an adult male: report of an unusual tumor with a brief review of literature. (2014) Journal of cancer research and therapeutics. 10 (2): 419-21. doi:10.4103/0973-1482.136677 - Pubmed
- 5. Longo M, Levra MG, Capelletto E, Billè A, Ardissone F, Familiari U, Novello S. Fetal adenocarcinoma of the lung in a 25-year-old woman. (2008) Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer. 3 (4): 441-3. doi:10.1097/JTO.0b013e318169cd9a - Pubmed
- 6. Kawai T, Miyake T, Hara K, Hara F, Nakashima T. [Pulmonary adenocarcinoma of the fetal lung type; report of a case]. (2003) Kyobu geka. The Japanese journal of thoracic surgery. 56 (4): 340-3. Pubmed