肺梭形细胞癌是肺肉瘤样癌的一种亚型，是一种非常罕见的肿瘤类型，预后较差。一些病例报告记录了患有间变性淋巴瘤激酶重排的肺肉瘤样癌患者，而间变性淋巴瘤激酶抑制剂的疗效和结果仍不清楚。在此，我们介绍一名患有 IVB 期疾病的 60 岁女性，她被诊断患有转移性脑肿瘤。该患者表现出高水平的程序性细胞死亡配体 1 表达和间变性淋巴瘤激酶重排，并接受派姆单抗作为一线治疗。三周后，派姆单抗未能缩小原发性肺部肿瘤的大小，患者的全身状况也没有改善。该患者接受艾来替尼作为二线治疗。两个月后，发现多发脑转移。因此，对多发性脑转移瘤进行全脑照射治疗，同时给予另一种间变性淋巴瘤激酶抑制剂；然而，这两种治疗方法仍然无效。患者最终在开始一线治疗后 9 个月死亡。本病例报告描述了一名伴有间变性淋巴瘤激酶重排的肺梭形细胞癌患者的治疗过程。© 2023 作者。由巴塞尔 S. Karger AG 出版。

Pulmonary spindle cell carcinoma is a subtype of pulmonary sarcomatoid carcinoma and a very rare tumor type with a poor prognosis. A few case reports have documented patients with pulmonary sarcomatoid carcinoma with anaplastic lymphoma kinase rearrangement, and the efficacy and outcomes of anaplastic lymphoma kinase inhibitors remain unclear. Herein, we present the case of a 60-year-old woman with stage IVB disease who was diagnosed with a metastatic brain tumor. This patient showed high levels of programmed cell death ligand 1 expression and anaplastic lymphoma kinase rearrangement and received pembrolizumab as the first-line treatment. Three weeks later, pembrolizumab failed to reduce the size of the primary pulmonary tumor, and the patient's general condition did not improve. The patient received alectinib as the second-line treatment. Two months later, multiple brain metastases were observed. Hence, whole-brain irradiation was performed as treatment for multiple brain metastases, while another anaplastic lymphoma kinase inhibitor was administered; however, both treatments remained ineffective. The patient eventually died 9 months after the initiation of first-line treatment. The present case report describes the therapeutic course of a patient with pulmonary spindle cell carcinoma with an anaplastic lymphoma kinase rearrangement.© 2023 The Author(s). Published by S. Karger AG, Basel.