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• W4387248811 abstract "SESSION TITLE: Lung Cancer Case Report Posters 17 SESSION TYPE: Case Report Posters PRESENTED ON: 10/09/2023 02:10 pm - 02:55 pm INTRODUCTION: Alveolar type sarcomas are a very rare form of sarcomas that presents in children and young adults, accounting for 0.5-1% of all soft tissue sarcomas. It presents as a painless, soft and slow growing mass either in head and neck or muscles of the lower extremities. Metastasis is unfortunately detected in 20% of cases at time of presentation. We present a case of alveolar type sarcoma in a young adult with metastasis to his lung, liver, and bone with stable clinical course. CASE PRESENTATION: Patient is a 23-year-old male with past medical history of alveolar type soft tissue sarcoma. He was diagnosed at age 19 after noticing swelling and tenderness of a right thigh. PET scan showed innumerable pulmonary nodules, hypermetabolic nodules in the liver and lytic lesions in the pelvis. Biopsy of one of the left lung nodules at the time confirmed his diagnosis of alveolar type sarcoma. Patient was started on treatment with Atezolizumab and radiation therapy to his right thigh and resection of the mass. His response to chemotherapy was subpar as patient's surveillance imaging showed enlargement of a pulmonary nodule in the left lower lobe. He received further radiation to his lung nodule with improvement in size of the nodule. Pulmonology was consulted for re-biopsy of the left lung lesion for next generation sequencing and targeted therapy. During bronchoscopy, patient noted to have endobronchial lesions in the LLL causing bronchial obstruction. Cryoprobe biopsy of the lesions were performed, and debulking of the area was performed. Next generation sequencing did not identify any molecular targets for therapeutic intervention and patient continues to be on Atezolizumab with stable disease at this time. DISCUSSION: We present a case of alveolar type sarcoma with metastasis to lung, liver and bone that was diagnosed based on lung tissue biopsy. Repeat biopsy with cryoprobe had to be performed due to persistent lung consolidation on imaging. Given the rarity of this tumor, most clinical data have been based on case series, which indicate surgical resection is associated with the most ideal outcomes. Radiation and chemotherapy have not shown to improve survival, but targeted therapy based on gene expression and immunohistochemical arrays are in development to improve patient outcomes. CONCLUSIONS: Alveolar type sarcoma is a rare form of sarcoma with limited clinical data available regarding management and treatment. Cryoprobe bronchoscopy is a useful tool in performing biopsies for targeted therapy and increase clinical evidence for development of new therapeutic interventions. REFERENCE #1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337503/ DISCLOSURES: No relevant relationships by Saud Alrawaf No relevant relationships by Robert Holladay No relevant relationships by Andrea Ramirez No relevant relationships by Angel Yazdi" @default.
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• W4387248811 date "2023-10-01" @default.
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• W4387248811 title "BRONCHOSCOPY CRYOTHERAPY UTILIZATION IN ASSESSMENT OF ALVEOLAR-TYPE SARCOMA" @default.
• W4387248811 doi "https://doi.org/10.1016/j.chest.2023.07.2838" @default.
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