A case study on multidisciplinary support in comprehensive diagnosis and treatment of combined small cell lung cancer and exploration of MRD

doi:10.11958/20251929

Tianjin Medical Journal ›› 2025, Vol. 53 ›› Issue (10): 1091-1097.doi: 10.11958/20251929

• Multidisciplinary Diagnosis and Treatment • Previous Articles Next Articles

A case study on multidisciplinary support in comprehensive diagnosis and treatment of combined small cell lung cancer and exploration of MRD

LIU Chang¹(), MENG Fanlu¹^,^△(), YANG Jing², ZHANG Rongxin³, WANG Junping⁴, XIONG Jianhua⁵, ZHONG Diansheng¹

¹ Department of Oncology, Tianjin Medical University General Hospital, Tianjin 300052, China
² Department of Pathology, Tianjin Medical University General Hospital, Tianjin 300052, China
³ Department of Radiation Oncology, Tianjin Medical University General Hospital, Tianjin 300052, China
⁴ Department of Medical Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
⁵ Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China

Received:2025-05-16 Revised:2025-06-30 Published:2025-10-15 Online:2025-10-12
Contact: ^△E-mail：mengfanlu1101@163.com

LIU Chang, MENG Fanlu, YANG Jing, ZHANG Rongxin, WANG Junping, XIONG Jianhua, ZHONG Diansheng. A case study on multidisciplinary support in comprehensive diagnosis and treatment of combined small cell lung cancer and exploration of MRD[J]. Tianjin Medical Journal, 2025, 53(10): 1091-1097.

Abstract

Abstract:

Combined small cell lung cancer (C-SCLC) accounts for approximately 20% of all SCLC cases, while the propotion of C-SCLC mixed with squamous cell carcinoma component comprises less than 3%. At the pathological level, accurate diagnosis requires to distinguish it from other lung tumor types, and even rely on molecular testing. This article presents a case of a 67-year-old patient initially diagnosed with a peripheral lung tumor. The patient underwent comprehensive multidisciplinary management, including surgical resection, postoperative pathological differential diagnosis, chemotherapy, thoracic radiotherapy, brain metastasis, cranial radiotherapy, dynamic follow-up of imaging changes after cranial radiotherapy, and cranial surgery. Molecular residual disease (MRD) monitoring was integrated at critical time points during dynamic monitoring to inform personalized treatment decisions. The early MDT has brought the patient's condition under control, and the overall survival of the patient exceeded 30 months. Through the introduction of the diagnosis and treatment process of this patient, we aim to offer novel perspectives on clinical decision-making for C-SCLC.

Key words: neoplasms by histologic type, chemoradiotherapy, neoplasm, residual, combined small cell lung cancer, brain metastasis, multi-disciplinary treatment

CLC Number:

R734.2

Figures/Tables 5

Fig.1 Pre-treatment chest CT images of the patient

Fig.2 Postoperative pathological microscopic manifestations of the patient (×200)

Fig.3 PET-CT chest imaging of the patient before radiotherapy and after 4 cycles of chemotherapy after operation

Fig.4 Chest CT findings after thoracic radiotherapy

Fig.5 Changes in cranial MRI findings before and after brain SRS

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A case study on multidisciplinary support in comprehensive diagnosis and treatment of combined small cell lung cancer and exploration of MRD

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