Abstract: Pulmonary sarcomatoid carcinoma （PSC） was a rare, poorly differentiated non-small cell lung cancer （NSCLC）, for which radical surgical resection was the main effective treatment in the early stage. For those who can be resected in the middle stage, surgery was the main comprehensive treatment, however, those who cannot be resected are treated mainly with radical radiotherapy. For advanced stages, individualized systemic treatment protocols were developed based on tumor pathology and genetic testing results. Most of the current studies have shown that the prognosis of PSC patients was worse than the rest of NSCLC patients. With the widespread use of molecular testing techniques in clinical practice, 69% to 80% of PSC patients were found to contain at least one genetic mutation. In this paper, a patient with rapid multiple metastases after PSC surgery admitted to the Department of Medical Oncology of Shaanxi Provincial People's Hospital was treated with genetic testing to guide treatment, and the patient achieved more significant remission, and the treatment process was reported in order to provide clinical reference for PSC treatment.