{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T07:41:01Z","timestamp":1768549261175,"version":"3.49.0"},"reference-count":4,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pleomorphic carcinoma is a rare, aggressive subtype of non\u2010small cell lung cancer (NSCLC). Invasion into the left atrium and dissemination to cerebral arteries are exceptionally uncommon, and the role of cardiopulmonary bypass (CPB)\u2013assisted resection remains debated. We report two surgically treated cases with left atrial invasion. Case 1: A 57\u2010year\u2010old man underwent left lower lobectomy with partial atrial resection under CPB. One month later, he developed subarachnoid hemorrhage caused by rupture of a cerebral aneurysm secondary to metastasis; histology of the aneurysmal wall confirmed carcinoma. He remains recurrence\u2010free at 21\u2009months. Case 2: A 62\u2010year\u2010old woman underwent extended left upper lobectomy with partial atrial resection under CPB. Although adrenal metastasis was suspected radiologically, pathological confirmation was lacking preoperatively; surgery was pursued because of symptomatic disease and atrial involvement. She developed postoperative cerebral infarction and rapid adrenal progression and died at 4\u2009months despite chemotherapy. These cases illustrate both the technical feasibility of CPB\u2010assisted atrial resection and the aggressive biology of pleomorphic carcinoma, including atypical vascular metastasis to cerebral arteries. Careful staging, patient selection, and early multidisciplinary planning (thoracic surgery, cardiac surgery, neurosurgery, oncology, and radiology) are essential. Surgery can be justified in selected patients with atrial invasion; however, pleomorphic histology portends poor outcomes and unusual metastatic tropism. Vigilant postoperative surveillance and integration of systemic therapy are required.<\/jats:p>","DOI":"10.1111\/1759-7714.70199","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T23:02:23Z","timestamp":1766790143000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Management of Pleomorphic Lung Carcinoma With Left Atrial Invasion: Two Cases Including One With Cerebral Artery Metastasis"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8983-9239","authenticated-orcid":false,"given":"Eitetsu","family":"Koh","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery Tokyo Women's Medical University Yachiyo Medical Center  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuo","family":"Sekine","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Tokyo Women's Medical University Yachiyo Medical Center  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Saitou","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Tokyo Women's Medical University Yachiyo Medical Center  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenzo","family":"Hiroshima","sequence":"additional","affiliation":[{"name":"Department of Pathology Tokyo Women's Medical University Yachiyo Medical Center  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"issue":"2","key":"e_1_2_12_2_1","first-page":"280","article-title":"Surgical Outcomes of Lung Cancer Involving the Left Atrium","volume":"30","author":"Chida M.","year":"2006","journal-title":"European Journal of Cardio\u2010Thoracic Surgery"},{"key":"e_1_2_12_3_1","article-title":"Surgical Treatment for Non\u2010Small Cell Lung Cancer With Left Atrial Invasion","volume":"9","author":"Yu Y.","year":"2014","journal-title":"Journal of Cardiothoracic Surgery"},{"issue":"6","key":"e_1_2_12_4_1","first-page":"582","article-title":"Pleomorphic (Spindle\/Giant Cell) Carcinoma of the Lung: Clinicopathologic Correlation of 78 Cases","volume":"18","author":"Fishback N. F.","year":"1994","journal-title":"American Journal of Surgical Pathology"},{"key":"e_1_2_12_5_1","article-title":"Pulmonary Carcinoma Metastasizing to the Cerebral Arterial Wall Causing Subarachnoid Hemorrhage","volume":"7","author":"Sato K.","year":"2016","journal-title":"Surgical Neurology International"}],"container-title":["Thoracic Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1759-7714.70199","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1759-7714.70199","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1759-7714.70199","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T03:23:11Z","timestamp":1768447391000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1759-7714.70199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,26]]},"references-count":4,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/1759-7714.70199"],"URL":"https:\/\/doi.org\/10.1111\/1759-7714.70199","archive":["Portico"],"relation":{},"ISSN":["1759-7706","1759-7714"],"issn-type":[{"value":"1759-7706","type":"print"},{"value":"1759-7714","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,26]]},"assertion":[{"value":"2025-09-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70199"}}