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The cerebellar tumor was pathologically diagnosed as metastatic lung adenocarcinoma. No other metastases were identified, including in the mediastinal lymph nodes. We therefore resected the primary lung tumor. On final pathological analysis, the tumor in the upper lobe of the left lung was diagnosed as adenosquamous carcinoma with no lymph node metastasis. PD\u2010L1 expression was low in the primary lung adenosquamous carcinoma and high in the cerebellar metastasis. Furthermore, both tumors were <jats:italic>KRAS<\/jats:italic><jats:sup>G12C<\/jats:sup>\u2010positive. Tumor PD\u2010L1 expression is considered important for immune escape. In this case, adenocarcinoma cells in the primary adenosquamous carcinoma may have migrated to form a cerebellar metastasis. In advanced lung cancer, tumor growth may be observed in some lesions even when many other lesions are controlled by chemo\u2010 or immunotherapy. Biopsy to confirm histology and PD\u2010L1 expression is worth considering, depending on the location of the metastases and the invasiveness of the biopsy procedure.<\/jats:p>","DOI":"10.1111\/1759-7714.15061","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T04:59:15Z","timestamp":1691384355000},"page":"2707-2711","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A case of discordant histology and expression of programmed death ligand 1 between primary tumor and brain metastases in adenosquamous carcinoma of the lung"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5438-2479","authenticated-orcid":false,"given":"Hironori","family":"Takagi","sequence":"first","affiliation":[{"name":"Department of Chest Surgery Iwaki City Medical Center  Iwaki Japan"},{"name":"Department of Chest Surgery Fukushima Medical University  Fukushima 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