project report of literature review

Get science-backed answers as you write with Paperpal's Research feature

What is a Literature Review? How to Write It (with Examples)

A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship, demonstrating your understanding of the topic and showing how your work contributes to the ongoing conversation in the field. Learning how to write a literature review is a critical tool for successful research. Your ability to summarize and synthesize prior research pertaining to a certain topic demonstrates your grasp on the topic of study, and assists in the learning process. 

Table of Contents

• What is the purpose of literature review? 
• a. Habitat Loss and Species Extinction: 
• b. Range Shifts and Phenological Changes: 
• c. Ocean Acidification and Coral Reefs: 
• d. Adaptive Strategies and Conservation Efforts: 
• How to write a good literature review 
• Choose a Topic and Define the Research Question: 
• Decide on the Scope of Your Review: 
• Select Databases for Searches: 
• Conduct Searches and Keep Track: 
• Review the Literature: 
• Organize and Write Your Literature Review: 
• Frequently asked questions 

What is a literature review?

A well-conducted literature review demonstrates the researcher’s familiarity with the existing literature, establishes the context for their own research, and contributes to scholarly conversations on the topic. One of the purposes of a literature review is also to help researchers avoid duplicating previous work and ensure that their research is informed by and builds upon the existing body of knowledge.

What is the purpose of literature review?

A literature review serves several important purposes within academic and research contexts. Here are some key objectives and functions of a literature review: 2  

• Contextualizing the Research Problem: The literature review provides a background and context for the research problem under investigation. It helps to situate the study within the existing body of knowledge. 
• Identifying Gaps in Knowledge: By identifying gaps, contradictions, or areas requiring further research, the researcher can shape the research question and justify the significance of the study. This is crucial for ensuring that the new research contributes something novel to the field. 
• Understanding Theoretical and Conceptual Frameworks: Literature reviews help researchers gain an understanding of the theoretical and conceptual frameworks used in previous studies. This aids in the development of a theoretical framework for the current research. 
• Providing Methodological Insights: Another purpose of literature reviews is that it allows researchers to learn about the methodologies employed in previous studies. This can help in choosing appropriate research methods for the current study and avoiding pitfalls that others may have encountered. 
• Establishing Credibility: A well-conducted literature review demonstrates the researcher’s familiarity with existing scholarship, establishing their credibility and expertise in the field. It also helps in building a solid foundation for the new research. 
• Informing Hypotheses or Research Questions: The literature review guides the formulation of hypotheses or research questions by highlighting relevant findings and areas of uncertainty in existing literature. 

Literature review example

Let’s delve deeper with a literature review example: Let’s say your literature review is about the impact of climate change on biodiversity. You might format your literature review into sections such as the effects of climate change on habitat loss and species extinction, phenological changes, and marine biodiversity. Each section would then summarize and analyze relevant studies in those areas, highlighting key findings and identifying gaps in the research. The review would conclude by emphasizing the need for further research on specific aspects of the relationship between climate change and biodiversity. The following literature review template provides a glimpse into the recommended literature review structure and content, demonstrating how research findings are organized around specific themes within a broader topic. 

Literature Review on Climate Change Impacts on Biodiversity:

Climate change is a global phenomenon with far-reaching consequences, including significant impacts on biodiversity. This literature review synthesizes key findings from various studies: 

a. Habitat Loss and Species Extinction:

Climate change-induced alterations in temperature and precipitation patterns contribute to habitat loss, affecting numerous species (Thomas et al., 2004). The review discusses how these changes increase the risk of extinction, particularly for species with specific habitat requirements. 

b. Range Shifts and Phenological Changes:

Observations of range shifts and changes in the timing of biological events (phenology) are documented in response to changing climatic conditions (Parmesan & Yohe, 2003). These shifts affect ecosystems and may lead to mismatches between species and their resources. 

c. Ocean Acidification and Coral Reefs:

The review explores the impact of climate change on marine biodiversity, emphasizing ocean acidification’s threat to coral reefs (Hoegh-Guldberg et al., 2007). Changes in pH levels negatively affect coral calcification, disrupting the delicate balance of marine ecosystems. 

d. Adaptive Strategies and Conservation Efforts:

Recognizing the urgency of the situation, the literature review discusses various adaptive strategies adopted by species and conservation efforts aimed at mitigating the impacts of climate change on biodiversity (Hannah et al., 2007). It emphasizes the importance of interdisciplinary approaches for effective conservation planning. 

How to write a good literature review

Writing a literature review involves summarizing and synthesizing existing research on a particular topic. A good literature review format should include the following elements. 

Introduction: The introduction sets the stage for your literature review, providing context and introducing the main focus of your review. 

• Opening Statement: Begin with a general statement about the broader topic and its significance in the field. 
• Scope and Purpose: Clearly define the scope of your literature review. Explain the specific research question or objective you aim to address. 
• Organizational Framework: Briefly outline the structure of your literature review, indicating how you will categorize and discuss the existing research. 
• Significance of the Study: Highlight why your literature review is important and how it contributes to the understanding of the chosen topic. 
• Thesis Statement: Conclude the introduction with a concise thesis statement that outlines the main argument or perspective you will develop in the body of the literature review. 

Body: The body of the literature review is where you provide a comprehensive analysis of existing literature, grouping studies based on themes, methodologies, or other relevant criteria. 

• Organize by Theme or Concept: Group studies that share common themes, concepts, or methodologies. Discuss each theme or concept in detail, summarizing key findings and identifying gaps or areas of disagreement. 
• Critical Analysis: Evaluate the strengths and weaknesses of each study. Discuss the methodologies used, the quality of evidence, and the overall contribution of each work to the understanding of the topic. 
• Synthesis of Findings: Synthesize the information from different studies to highlight trends, patterns, or areas of consensus in the literature. 
• Identification of Gaps: Discuss any gaps or limitations in the existing research and explain how your review contributes to filling these gaps. 
• Transition between Sections: Provide smooth transitions between different themes or concepts to maintain the flow of your literature review. 

Conclusion: The conclusion of your literature review should summarize the main findings, highlight the contributions of the review, and suggest avenues for future research. 

• Summary of Key Findings: Recap the main findings from the literature and restate how they contribute to your research question or objective. 
• Contributions to the Field: Discuss the overall contribution of your literature review to the existing knowledge in the field. 
• Implications and Applications: Explore the practical implications of the findings and suggest how they might impact future research or practice. 
• Recommendations for Future Research: Identify areas that require further investigation and propose potential directions for future research in the field. 
• Final Thoughts: Conclude with a final reflection on the importance of your literature review and its relevance to the broader academic community. 

Conducting a literature review

Conducting a literature review is an essential step in research that involves reviewing and analyzing existing literature on a specific topic. It’s important to know how to do a literature review effectively, so here are the steps to follow: 1  

Choose a Topic and Define the Research Question:

• Select a topic that is relevant to your field of study. 
• Clearly define your research question or objective. Determine what specific aspect of the topic do you want to explore? 

Decide on the Scope of Your Review:

• Determine the timeframe for your literature review. Are you focusing on recent developments, or do you want a historical overview? 
• Consider the geographical scope. Is your review global, or are you focusing on a specific region? 
• Define the inclusion and exclusion criteria. What types of sources will you include? Are there specific types of studies or publications you will exclude? 

Select Databases for Searches:

• Identify relevant databases for your field. Examples include PubMed, IEEE Xplore, Scopus, Web of Science, and Google Scholar. 
• Consider searching in library catalogs, institutional repositories, and specialized databases related to your topic. 

Conduct Searches and Keep Track:

• Develop a systematic search strategy using keywords, Boolean operators (AND, OR, NOT), and other search techniques. 
• Record and document your search strategy for transparency and replicability. 
• Keep track of the articles, including publication details, abstracts, and links. Use citation management tools like EndNote, Zotero, or Mendeley to organize your references. 

Review the Literature:

• Evaluate the relevance and quality of each source. Consider the methodology, sample size, and results of studies. 
• Organize the literature by themes or key concepts. Identify patterns, trends, and gaps in the existing research. 
• Summarize key findings and arguments from each source. Compare and contrast different perspectives. 
• Identify areas where there is a consensus in the literature and where there are conflicting opinions. 
• Provide critical analysis and synthesis of the literature. What are the strengths and weaknesses of existing research? 

Organize and Write Your Literature Review:

• Literature review outline should be based on themes, chronological order, or methodological approaches. 
• Write a clear and coherent narrative that synthesizes the information gathered. 
• Use proper citations for each source and ensure consistency in your citation style (APA, MLA, Chicago, etc.). 
• Conclude your literature review by summarizing key findings, identifying gaps, and suggesting areas for future research. 

The literature review sample and detailed advice on writing and conducting a review will help you produce a well-structured report. But remember that a literature review is an ongoing process, and it may be necessary to revisit and update it as your research progresses. 

Frequently asked questions

A literature review is a critical and comprehensive analysis of existing literature (published and unpublished works) on a specific topic or research question and provides a synthesis of the current state of knowledge in a particular field. A well-conducted literature review is crucial for researchers to build upon existing knowledge, avoid duplication of efforts, and contribute to the advancement of their field. It also helps researchers situate their work within a broader context and facilitates the development of a sound theoretical and conceptual framework for their studies.

Literature review is a crucial component of research writing, providing a solid background for a research paper’s investigation. The aim is to keep professionals up to date by providing an understanding of ongoing developments within a specific field, including research methods, and experimental techniques used in that field, and present that knowledge in the form of a written report. Also, the depth and breadth of the literature review emphasizes the credibility of the scholar in his or her field.  

Before writing a literature review, it’s essential to undertake several preparatory steps to ensure that your review is well-researched, organized, and focused. This includes choosing a topic of general interest to you and doing exploratory research on that topic, writing an annotated bibliography, and noting major points, especially those that relate to the position you have taken on the topic. 

Literature reviews and academic research papers are essential components of scholarly work but serve different purposes within the academic realm. 3 A literature review aims to provide a foundation for understanding the current state of research on a particular topic, identify gaps or controversies, and lay the groundwork for future research. Therefore, it draws heavily from existing academic sources, including books, journal articles, and other scholarly publications. In contrast, an academic research paper aims to present new knowledge, contribute to the academic discourse, and advance the understanding of a specific research question. Therefore, it involves a mix of existing literature (in the introduction and literature review sections) and original data or findings obtained through research methods. 

Literature reviews are essential components of academic and research papers, and various strategies can be employed to conduct them effectively. If you want to know how to write a literature review for a research paper, here are four common approaches that are often used by researchers.  Chronological Review: This strategy involves organizing the literature based on the chronological order of publication. It helps to trace the development of a topic over time, showing how ideas, theories, and research have evolved.  Thematic Review: Thematic reviews focus on identifying and analyzing themes or topics that cut across different studies. Instead of organizing the literature chronologically, it is grouped by key themes or concepts, allowing for a comprehensive exploration of various aspects of the topic.  Methodological Review: This strategy involves organizing the literature based on the research methods employed in different studies. It helps to highlight the strengths and weaknesses of various methodologies and allows the reader to evaluate the reliability and validity of the research findings.  Theoretical Review: A theoretical review examines the literature based on the theoretical frameworks used in different studies. This approach helps to identify the key theories that have been applied to the topic and assess their contributions to the understanding of the subject.  It’s important to note that these strategies are not mutually exclusive, and a literature review may combine elements of more than one approach. The choice of strategy depends on the research question, the nature of the literature available, and the goals of the review. Additionally, other strategies, such as integrative reviews or systematic reviews, may be employed depending on the specific requirements of the research.

The literature review format can vary depending on the specific publication guidelines. However, there are some common elements and structures that are often followed. Here is a general guideline for the format of a literature review:  Introduction:   Provide an overview of the topic.  Define the scope and purpose of the literature review.  State the research question or objective.  Body:   Organize the literature by themes, concepts, or chronology.  Critically analyze and evaluate each source.  Discuss the strengths and weaknesses of the studies.  Highlight any methodological limitations or biases.  Identify patterns, connections, or contradictions in the existing research.  Conclusion:   Summarize the key points discussed in the literature review.  Highlight the research gap.  Address the research question or objective stated in the introduction.  Highlight the contributions of the review and suggest directions for future research.

Both annotated bibliographies and literature reviews involve the examination of scholarly sources. While annotated bibliographies focus on individual sources with brief annotations, literature reviews provide a more in-depth, integrated, and comprehensive analysis of existing literature on a specific topic. The key differences are as follows: 

References 

• Denney, A. S., & Tewksbury, R. (2013). How to write a literature review.  Journal of criminal justice education ,  24 (2), 218-234. 
• Pan, M. L. (2016).  Preparing literature reviews: Qualitative and quantitative approaches . Taylor & Francis. 
• Cantero, C. (2019). How to write a literature review.  San José State University Writing Center . 

Paperpal is an AI writing assistant that help academics write better, faster with real-time suggestions for in-depth language and grammar correction. Trained on millions of research manuscripts enhanced by professional academic editors, Paperpal delivers human precision at machine speed.  

Try it for free or upgrade to  Paperpal Prime , which unlocks unlimited access to premium features like academic translation, paraphrasing, contextual synonyms, consistency checks and more. It’s like always having a professional academic editor by your side! Go beyond limitations and experience the future of academic writing.  Get Paperpal Prime now at just US$19 a month!

Related Reads:

• Empirical Research: A Comprehensive Guide for Academics 
• How to Write a Scientific Paper in 10 Steps 
• Life Sciences Papers: 9 Tips for Authors Writing in Biological Sciences
• What is an Argumentative Essay? How to Write It (With Examples)

6 Tips for Post-Doc Researchers to Take Their Career to the Next Level

Self-plagiarism in research: what it is and how to avoid it, you may also like, what is academic writing: tips for students, why traditional editorial process needs an upgrade, paperpal’s new ai research finder empowers authors to..., what is hedging in academic writing  , how to use ai to enhance your college..., ai + human expertise – a paradigm shift..., how to use paperpal to generate emails &..., ai in education: it’s time to change the..., is it ethical to use ai-generated abstracts without..., do plagiarism checkers detect ai content.

Have a language expert improve your writing

Run a free plagiarism check in 10 minutes, automatically generate references for free.

• Knowledge Base
• Dissertation
• What is a Literature Review? | Guide, Template, & Examples

What is a Literature Review? | Guide, Template, & Examples

Published on 22 February 2022 by Shona McCombes . Revised on 7 June 2022.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research.

There are five key steps to writing a literature review:

• Search for relevant literature
• Evaluate sources
• Identify themes, debates and gaps
• Outline the structure
• Write your literature review

A good literature review doesn’t just summarise sources – it analyses, synthesises, and critically evaluates to give a clear picture of the state of knowledge on the subject.

Instantly correct all language mistakes in your text

Be assured that you'll submit flawless writing. Upload your document to correct all your mistakes.

Table of contents

Why write a literature review, examples of literature reviews, step 1: search for relevant literature, step 2: evaluate and select sources, step 3: identify themes, debates and gaps, step 4: outline your literature review’s structure, step 5: write your literature review, frequently asked questions about literature reviews, introduction.

• Quick Run-through
• Step 1 & 2

When you write a dissertation or thesis, you will have to conduct a literature review to situate your research within existing knowledge. The literature review gives you a chance to:

• Demonstrate your familiarity with the topic and scholarly context
• Develop a theoretical framework and methodology for your research
• Position yourself in relation to other researchers and theorists
• Show how your dissertation addresses a gap or contributes to a debate

You might also have to write a literature review as a stand-alone assignment. In this case, the purpose is to evaluate the current state of research and demonstrate your knowledge of scholarly debates around a topic.

The content will look slightly different in each case, but the process of conducting a literature review follows the same steps. We’ve written a step-by-step guide that you can follow below.

The only proofreading tool specialized in correcting academic writing

The academic proofreading tool has been trained on 1000s of academic texts and by native English editors. Making it the most accurate and reliable proofreading tool for students.

Correct my document today

Writing literature reviews can be quite challenging! A good starting point could be to look at some examples, depending on what kind of literature review you’d like to write.

• Example literature review #1: “Why Do People Migrate? A Review of the Theoretical Literature” ( Theoretical literature review about the development of economic migration theory from the 1950s to today.)
• Example literature review #2: “Literature review as a research methodology: An overview and guidelines” ( Methodological literature review about interdisciplinary knowledge acquisition and production.)
• Example literature review #3: “The Use of Technology in English Language Learning: A Literature Review” ( Thematic literature review about the effects of technology on language acquisition.)
• Example literature review #4: “Learners’ Listening Comprehension Difficulties in English Language Learning: A Literature Review” ( Chronological literature review about how the concept of listening skills has changed over time.)

You can also check out our templates with literature review examples and sample outlines at the links below.

Download Word doc Download Google doc

Before you begin searching for literature, you need a clearly defined topic .

If you are writing the literature review section of a dissertation or research paper, you will search for literature related to your research objectives and questions .

If you are writing a literature review as a stand-alone assignment, you will have to choose a focus and develop a central question to direct your search. Unlike a dissertation research question, this question has to be answerable without collecting original data. You should be able to answer it based only on a review of existing publications.

Make a list of keywords

Start by creating a list of keywords related to your research topic. Include each of the key concepts or variables you’re interested in, and list any synonyms and related terms. You can add to this list if you discover new keywords in the process of your literature search.

• Social media, Facebook, Instagram, Twitter, Snapchat, TikTok
• Body image, self-perception, self-esteem, mental health
• Generation Z, teenagers, adolescents, youth

Search for relevant sources

Use your keywords to begin searching for sources. Some databases to search for journals and articles include:

• Your university’s library catalogue
• Google Scholar
• Project Muse (humanities and social sciences)
• Medline (life sciences and biomedicine)
• EconLit (economics)
• Inspec (physics, engineering and computer science)

You can use boolean operators to help narrow down your search:

Read the abstract to find out whether an article is relevant to your question. When you find a useful book or article, you can check the bibliography to find other relevant sources.

To identify the most important publications on your topic, take note of recurring citations. If the same authors, books or articles keep appearing in your reading, make sure to seek them out.

You probably won’t be able to read absolutely everything that has been written on the topic – you’ll have to evaluate which sources are most relevant to your questions.

For each publication, ask yourself:

• What question or problem is the author addressing?
• What are the key concepts and how are they defined?
• What are the key theories, models and methods? Does the research use established frameworks or take an innovative approach?
• What are the results and conclusions of the study?
• How does the publication relate to other literature in the field? Does it confirm, add to, or challenge established knowledge?
• How does the publication contribute to your understanding of the topic? What are its key insights and arguments?
• What are the strengths and weaknesses of the research?

Make sure the sources you use are credible, and make sure you read any landmark studies and major theories in your field of research.

You can find out how many times an article has been cited on Google Scholar – a high citation count means the article has been influential in the field, and should certainly be included in your literature review.

The scope of your review will depend on your topic and discipline: in the sciences you usually only review recent literature, but in the humanities you might take a long historical perspective (for example, to trace how a concept has changed in meaning over time).

Remember that you can use our template to summarise and evaluate sources you’re thinking about using!

Take notes and cite your sources

As you read, you should also begin the writing process. Take notes that you can later incorporate into the text of your literature review.

It’s important to keep track of your sources with references to avoid plagiarism . It can be helpful to make an annotated bibliography, where you compile full reference information and write a paragraph of summary and analysis for each source. This helps you remember what you read and saves time later in the process.

You can use our free APA Reference Generator for quick, correct, consistent citations.

Prevent plagiarism, run a free check.

To begin organising your literature review’s argument and structure, you need to understand the connections and relationships between the sources you’ve read. Based on your reading and notes, you can look for:

• Trends and patterns (in theory, method or results): do certain approaches become more or less popular over time?
• Themes: what questions or concepts recur across the literature?
• Debates, conflicts and contradictions: where do sources disagree?
• Pivotal publications: are there any influential theories or studies that changed the direction of the field?
• Gaps: what is missing from the literature? Are there weaknesses that need to be addressed?

This step will help you work out the structure of your literature review and (if applicable) show how your own research will contribute to existing knowledge.

• Most research has focused on young women.
• There is an increasing interest in the visual aspects of social media.
• But there is still a lack of robust research on highly-visual platforms like Instagram and Snapchat – this is a gap that you could address in your own research.

There are various approaches to organising the body of a literature review. You should have a rough idea of your strategy before you start writing.

Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

The simplest approach is to trace the development of the topic over time. However, if you choose this strategy, be careful to avoid simply listing and summarising sources in order.

Try to analyse patterns, turning points and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred.

If you have found some recurring central themes, you can organise your literature review into subsections that address different aspects of the topic.

For example, if you are reviewing literature about inequalities in migrant health outcomes, key themes might include healthcare policy, language barriers, cultural attitudes, legal status, and economic access.

Methodological

If you draw your sources from different disciplines or fields that use a variety of research methods , you might want to compare the results and conclusions that emerge from different approaches. For example:

• Look at what results have emerged in qualitative versus quantitative research
• Discuss how the topic has been approached by empirical versus theoretical scholarship
• Divide the literature into sociological, historical, and cultural sources

Theoretical

A literature review is often the foundation for a theoretical framework . You can use it to discuss various theories, models, and definitions of key concepts.

You might argue for the relevance of a specific theoretical approach, or combine various theoretical concepts to create a framework for your research.

Like any other academic text, your literature review should have an introduction , a main body, and a conclusion . What you include in each depends on the objective of your literature review.

The introduction should clearly establish the focus and purpose of the literature review.

If you are writing the literature review as part of your dissertation or thesis, reiterate your central problem or research question and give a brief summary of the scholarly context. You can emphasise the timeliness of the topic (“many recent studies have focused on the problem of x”) or highlight a gap in the literature (“while there has been much research on x, few researchers have taken y into consideration”).

Depending on the length of your literature review, you might want to divide the body into subsections. You can use a subheading for each theme, time period, or methodological approach.

As you write, make sure to follow these tips:

• Summarise and synthesise: give an overview of the main points of each source and combine them into a coherent whole.
• Analyse and interpret: don’t just paraphrase other researchers – add your own interpretations, discussing the significance of findings in relation to the literature as a whole.
• Critically evaluate: mention the strengths and weaknesses of your sources.
• Write in well-structured paragraphs: use transitions and topic sentences to draw connections, comparisons and contrasts.

In the conclusion, you should summarise the key findings you have taken from the literature and emphasise their significance.

If the literature review is part of your dissertation or thesis, reiterate how your research addresses gaps and contributes new knowledge, or discuss how you have drawn on existing theories and methods to build a framework for your research. This can lead directly into your methodology section.

A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a dissertation , thesis, research paper , or proposal .

There are several reasons to conduct a literature review at the beginning of a research project:

• To familiarise yourself with the current state of knowledge on your topic
• To ensure that you’re not just repeating what others have already done
• To identify gaps in knowledge and unresolved problems that your research can address
• To develop your theoretical framework and methodology
• To provide an overview of the key findings and debates on the topic

Writing the literature review shows your reader how your work relates to existing research and what new insights it will contribute.

The literature review usually comes near the beginning of your  dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the ‘Cite this Scribbr article’ button to automatically add the citation to our free Reference Generator.

McCombes, S. (2022, June 07). What is a Literature Review? | Guide, Template, & Examples. Scribbr. Retrieved 22 April 2024, from https://www.scribbr.co.uk/thesis-dissertation/literature-review/

Is this article helpful?

Shona McCombes

Other students also liked, how to write a dissertation proposal | a step-by-step guide, what is a theoretical framework | a step-by-step guide, what is a research methodology | steps & tips.

• Resources Home 🏠
• Try SciSpace Copilot
• Search research papers
• Add Copilot Extension
• Try AI Detector
• Try Paraphraser
• Try Citation Generator
• April Papers
• June Papers
• July Papers

How To Write A Literature Review - A Complete Guide

Table of Contents

A literature review is much more than just another section in your research paper. It forms the very foundation of your research. It is a formal piece of writing where you analyze the existing theoretical framework, principles, and assumptions and use that as a base to shape your approach to the research question.

Curating and drafting a solid literature review section not only lends more credibility to your research paper but also makes your research tighter and better focused. But, writing literature reviews is a difficult task. It requires extensive reading, plus you have to consider market trends and technological and political changes, which tend to change in the blink of an eye.

Now streamline your literature review process with the help of SciSpace Copilot. With this AI research assistant, you can efficiently synthesize and analyze a vast amount of information, identify key themes and trends, and uncover gaps in the existing research. Get real-time explanations, summaries, and answers to your questions for the paper you're reviewing, making navigating and understanding the complex literature landscape easier.

In this comprehensive guide, we will explore everything from the definition of a literature review, its appropriate length, various types of literature reviews, and how to write one.

What is a literature review?

A literature review is a collation of survey, research, critical evaluation, and assessment of the existing literature in a preferred domain.

Eminent researcher and academic Arlene Fink, in her book Conducting Research Literature Reviews , defines it as the following:

“A literature review surveys books, scholarly articles, and any other sources relevant to a particular issue, area of research, or theory, and by so doing, provides a description, summary, and critical evaluation of these works in relation to the research problem being investigated.

Literature reviews are designed to provide an overview of sources you have explored while researching a particular topic, and to demonstrate to your readers how your research fits within a larger field of study.”

Simply put, a literature review can be defined as a critical discussion of relevant pre-existing research around your research question and carving out a definitive place for your study in the existing body of knowledge. Literature reviews can be presented in multiple ways: a section of an article, the whole research paper itself, or a chapter of your thesis.

A literature review does function as a summary of sources, but it also allows you to analyze further, interpret, and examine the stated theories, methods, viewpoints, and, of course, the gaps in the existing content.

As an author, you can discuss and interpret the research question and its various aspects and debate your adopted methods to support the claim.

What is the purpose of a literature review?

A literature review is meant to help your readers understand the relevance of your research question and where it fits within the existing body of knowledge. As a researcher, you should use it to set the context, build your argument, and establish the need for your study.

What is the importance of a literature review?

The literature review is a critical part of research papers because it helps you:

• Gain an in-depth understanding of your research question and the surrounding area
• Convey that you have a thorough understanding of your research area and are up-to-date with the latest changes and advancements
• Establish how your research is connected or builds on the existing body of knowledge and how it could contribute to further research
• Elaborate on the validity and suitability of your theoretical framework and research methodology
• Identify and highlight gaps and shortcomings in the existing body of knowledge and how things need to change
• Convey to readers how your study is different or how it contributes to the research area

How long should a literature review be?

Ideally, the literature review should take up 15%-40% of the total length of your manuscript. So, if you have a 10,000-word research paper, the minimum word count could be 1500.

Your literature review format depends heavily on the kind of manuscript you are writing — an entire chapter in case of doctoral theses, a part of the introductory section in a research article, to a full-fledged review article that examines the previously published research on a topic.

Another determining factor is the type of research you are doing. The literature review section tends to be longer for secondary research projects than primary research projects.

What are the different types of literature reviews?

All literature reviews are not the same. There are a variety of possible approaches that you can take. It all depends on the type of research you are pursuing.

Here are the different types of literature reviews:

Argumentative review

It is called an argumentative review when you carefully present literature that only supports or counters a specific argument or premise to establish a viewpoint.

Integrative review

It is a type of literature review focused on building a comprehensive understanding of a topic by combining available theoretical frameworks and empirical evidence.

Methodological review

This approach delves into the ''how'' and the ''what" of the research question —  you cannot look at the outcome in isolation; you should also review the methodology used.

Systematic review

This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research and collect, report, and analyze data from the studies included in the review.

Meta-analysis review

Meta-analysis uses statistical methods to summarize the results of independent studies. By combining information from all relevant studies, meta-analysis can provide more precise estimates of the effects than those derived from the individual studies included within a review.

Historical review

Historical literature reviews focus on examining research throughout a period, often starting with the first time an issue, concept, theory, or phenomenon emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and identify future research's likely directions.

Theoretical Review

This form aims to examine the corpus of theory accumulated regarding an issue, concept, theory, and phenomenon. The theoretical literature review helps to establish what theories exist, the relationships between them, the degree the existing approaches have been investigated, and to develop new hypotheses to be tested.

Scoping Review

The Scoping Review is often used at the beginning of an article, dissertation, or research proposal. It is conducted before the research to highlight gaps in the existing body of knowledge and explains why the project should be greenlit.

State-of-the-Art Review

The State-of-the-Art review is conducted periodically, focusing on the most recent research. It describes what is currently known, understood, or agreed upon regarding the research topic and highlights where there are still disagreements.

Can you use the first person in a literature review?

When writing literature reviews, you should avoid the usage of first-person pronouns. It means that instead of "I argue that" or "we argue that," the appropriate expression would be "this research paper argues that."

Do you need an abstract for a literature review?

Ideally, yes. It is always good to have a condensed summary that is self-contained and independent of the rest of your review. As for how to draft one, you can follow the same fundamental idea when preparing an abstract for a literature review. It should also include:

• The research topic and your motivation behind selecting it
• A one-sentence thesis statement
• An explanation of the kinds of literature featured in the review
• Summary of what you've learned
• Conclusions you drew from the literature you reviewed
• Potential implications and future scope for research

Here's an example of the abstract of a literature review

Is a literature review written in the past tense?

Yes, the literature review should ideally be written in the past tense. You should not use the present or future tense when writing one. The exceptions are when you have statements describing events that happened earlier than the literature you are reviewing or events that are currently occurring; then, you can use the past perfect or present perfect tenses.

How many sources for a literature review?

There are multiple approaches to deciding how many sources to include in a literature review section. The first approach would be to look level you are at as a researcher. For instance, a doctoral thesis might need 60+ sources. In contrast, you might only need to refer to 5-15 sources at the undergraduate level.

The second approach is based on the kind of literature review you are doing — whether it is merely a chapter of your paper or if it is a self-contained paper in itself. When it is just a chapter, sources should equal the total number of pages in your article's body. In the second scenario, you need at least three times as many sources as there are pages in your work.

Quick tips on how to write a literature review

To know how to write a literature review, you must clearly understand its impact and role in establishing your work as substantive research material.

You need to follow the below-mentioned steps, to write a literature review:

• Outline the purpose behind the literature review
• Search relevant literature
• Examine and assess the relevant resources
• Discover connections by drawing deep insights from the resources
• Structure planning to write a good literature review

1. Outline and identify the purpose of  a literature review

As a first step on how to write a literature review, you must know what the research question or topic is and what shape you want your literature review to take. Ensure you understand the research topic inside out, or else seek clarifications. You must be able to the answer below questions before you start:

• How many sources do I need to include?
• What kind of sources should I analyze?
• How much should I critically evaluate each source?
• Should I summarize, synthesize or offer a critique of the sources?
• Do I need to include any background information or definitions?

Additionally, you should know that the narrower your research topic is, the swifter it will be for you to restrict the number of sources to be analyzed.

2. Search relevant literature

Dig deeper into search engines to discover what has already been published around your chosen topic. Make sure you thoroughly go through appropriate reference sources like books, reports, journal articles, government docs, and web-based resources.

You must prepare a list of keywords and their different variations. You can start your search from any library’s catalog, provided you are an active member of that institution. The exact keywords can be extended to widen your research over other databases and academic search engines like:

• Google Scholar
• Microsoft Academic
• Science.gov

Besides, it is not advisable to go through every resource word by word. Alternatively, what you can do is you can start by reading the abstract and then decide whether that source is relevant to your research or not.

Additionally, you must spend surplus time assessing the quality and relevance of resources. It would help if you tried preparing a list of citations to ensure that there lies no repetition of authors, publications, or articles in the literature review.

3. Examine and assess the sources

It is nearly impossible for you to go through every detail in the research article. So rather than trying to fetch every detail, you have to analyze and decide which research sources resemble closest and appear relevant to your chosen domain.

While analyzing the sources, you should look to find out answers to questions like:

• What question or problem has the author been describing and debating?
• What is the definition of critical aspects?
• How well the theories, approach, and methodology have been explained?
• Whether the research theory used some conventional or new innovative approach?
• How relevant are the key findings of the work?
• In what ways does it relate to other sources on the same topic?
• What challenges does this research paper pose to the existing theory
• What are the possible contributions or benefits it adds to the subject domain?

Be always mindful that you refer only to credible and authentic resources. It would be best if you always take references from different publications to validate your theory.

Always keep track of important information or data you can present in your literature review right from the beginning. It will help steer your path from any threats of plagiarism and also make it easier to curate an annotated bibliography or reference section.

4. Discover connections

At this stage, you must start deciding on the argument and structure of your literature review. To accomplish this, you must discover and identify the relations and connections between various resources while drafting your abstract.

A few aspects that you should be aware of while writing a literature review include:

• Rise to prominence: Theories and methods that have gained reputation and supporters over time.
• Constant scrutiny: Concepts or theories that repeatedly went under examination.
• Contradictions and conflicts: Theories, both the supporting and the contradictory ones, for the research topic.
• Knowledge gaps: What exactly does it fail to address, and how to bridge them with further research?
• Influential resources: Significant research projects available that have been upheld as milestones or perhaps, something that can modify the current trends

Once you join the dots between various past research works, it will be easier for you to draw a conclusion and identify your contribution to the existing knowledge base.

5. Structure planning to write a good literature review

There exist different ways towards planning and executing the structure of a literature review. The format of a literature review varies and depends upon the length of the research.

Like any other research paper, the literature review format must contain three sections: introduction, body, and conclusion. The goals and objectives of the research question determine what goes inside these three sections.

Nevertheless, a good literature review can be structured according to the chronological, thematic, methodological, or theoretical framework approach.

Literature review samples

1. Standalone

2. As a section of a research paper

How SciSpace Discover makes literature review a breeze?

SciSpace Discover is a one-stop solution to do an effective literature search and get barrier-free access to scientific knowledge. It is an excellent repository where you can find millions of only peer-reviewed articles and full-text PDF files. Here’s more on how you can use it:

Find the right information

Find what you want quickly and easily with comprehensive search filters that let you narrow down papers according to PDF availability, year of publishing, document type, and affiliated institution. Moreover, you can sort the results based on the publishing date, citation count, and relevance.

Assess credibility of papers quickly

When doing the literature review, it is critical to establish the quality of your sources. They form the foundation of your research. SciSpace Discover helps you assess the quality of a source by providing an overview of its references, citations, and performance metrics.

Get the complete picture in no time

SciSpace Discover’s personalized suggestion engine helps you stay on course and get the complete picture of the topic from one place. Every time you visit an article page, it provides you links to related papers. Besides that, it helps you understand what’s trending, who are the top authors, and who are the leading publishers on a topic.

Make referring sources super easy

To ensure you don't lose track of your sources, you must start noting down your references when doing the literature review. SciSpace Discover makes this step effortless. Click the 'cite' button on an article page, and you will receive preloaded citation text in multiple styles — all you've to do is copy-paste it into your manuscript.

Final tips on how to write a literature review

A massive chunk of time and effort is required to write a good literature review. But, if you go about it systematically, you'll be able to save a ton of time and build a solid foundation for your research.

We hope this guide has helped you answer several key questions you have about writing literature reviews.

Would you like to explore SciSpace Discover and kick off your literature search right away? You can get started here .

Frequently Asked Questions (FAQs)

1. how to start a literature review.

• What questions do you want to answer?

• What sources do you need to answer these questions?

• What information do these sources contain?

• How can you use this information to answer your questions?

2. What to include in a literature review?

• A brief background of the problem or issue

• What has previously been done to address the problem or issue

• A description of what you will do in your project

• How this study will contribute to research on the subject

3. Why literature review is important?

The literature review is an important part of any research project because it allows the writer to look at previous studies on a topic and determine existing gaps in the literature, as well as what has already been done. It will also help them to choose the most appropriate method for their own study.

4. How to cite a literature review in APA format?

To cite a literature review in APA style, you need to provide the author's name, the title of the article, and the year of publication. For example: Patel, A. B., & Stokes, G. S. (2012). The relationship between personality and intelligence: A meta-analysis of longitudinal research. Personality and Individual Differences, 53(1), 16-21

5. What are the components of a literature review?

• A brief introduction to the topic, including its background and context. The introduction should also include a rationale for why the study is being conducted and what it will accomplish.

• A description of the methodologies used in the study. This can include information about data collection methods, sample size, and statistical analyses.

• A presentation of the findings in an organized format that helps readers follow along with the author's conclusions.

6. What are common errors in writing literature review?

• Not spending enough time to critically evaluate the relevance of resources, observations and conclusions.

• Totally relying on secondary data while ignoring primary data.

• Letting your personal bias seep into your interpretation of existing literature.

• No detailed explanation of the procedure to discover and identify an appropriate literature review.

7. What are the 5 C's of writing literature review?

• Cite - the sources you utilized and referenced in your research.

• Compare - existing arguments, hypotheses, methodologies, and conclusions found in the knowledge base.

• Contrast - the arguments, topics, methodologies, approaches, and disputes that may be found in the literature.

• Critique - the literature and describe the ideas and opinions you find more convincing and why.

• Connect - the various studies you reviewed in your research.

8. How many sources should a literature review have?

When it is just a chapter, sources should equal the total number of pages in your article's body. if it is a self-contained paper in itself, you need at least three times as many sources as there are pages in your work.

9. Can literature review have diagrams?

• To represent an abstract idea or concept

• To explain the steps of a process or procedure

• To help readers understand the relationships between different concepts

10. How old should sources be in a literature review?

Sources for a literature review should be as current as possible or not older than ten years. The only exception to this rule is if you are reviewing a historical topic and need to use older sources.

11. What are the types of literature review?

• Argumentative review

• Integrative review

• Methodological review

• Systematic review

• Meta-analysis review

• Historical review

• Theoretical review

• Scoping review

• State-of-the-Art review

12. Is a literature review mandatory?

Yes. Literature review is a mandatory part of any research project. It is a critical step in the process that allows you to establish the scope of your research, and provide a background for the rest of your work.

But before you go,

• Six Online Tools for Easy Literature Review
• Evaluating literature review: systematic vs. scoping reviews
• Systematic Approaches to a Successful Literature Review
• Writing Integrative Literature Reviews: Guidelines and Examples

You might also like

Consensus GPT vs. SciSpace GPT: Choose the Best GPT for Research

Literature Review and Theoretical Framework: Understanding the Differences

Types of Essays in Academic Writing - Quick Guide (2024)

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• PLoS Comput Biol
• v.9(7); 2013 Jul

Ten Simple Rules for Writing a Literature Review

Marco pautasso.

1 Centre for Functional and Evolutionary Ecology (CEFE), CNRS, Montpellier, France

2 Centre for Biodiversity Synthesis and Analysis (CESAB), FRB, Aix-en-Provence, France

Literature reviews are in great demand in most scientific fields. Their need stems from the ever-increasing output of scientific publications [1] . For example, compared to 1991, in 2008 three, eight, and forty times more papers were indexed in Web of Science on malaria, obesity, and biodiversity, respectively [2] . Given such mountains of papers, scientists cannot be expected to examine in detail every single new paper relevant to their interests [3] . Thus, it is both advantageous and necessary to rely on regular summaries of the recent literature. Although recognition for scientists mainly comes from primary research, timely literature reviews can lead to new synthetic insights and are often widely read [4] . For such summaries to be useful, however, they need to be compiled in a professional way [5] .

When starting from scratch, reviewing the literature can require a titanic amount of work. That is why researchers who have spent their career working on a certain research issue are in a perfect position to review that literature. Some graduate schools are now offering courses in reviewing the literature, given that most research students start their project by producing an overview of what has already been done on their research issue [6] . However, it is likely that most scientists have not thought in detail about how to approach and carry out a literature review.

Reviewing the literature requires the ability to juggle multiple tasks, from finding and evaluating relevant material to synthesising information from various sources, from critical thinking to paraphrasing, evaluating, and citation skills [7] . In this contribution, I share ten simple rules I learned working on about 25 literature reviews as a PhD and postdoctoral student. Ideas and insights also come from discussions with coauthors and colleagues, as well as feedback from reviewers and editors.

Rule 1: Define a Topic and Audience

How to choose which topic to review? There are so many issues in contemporary science that you could spend a lifetime of attending conferences and reading the literature just pondering what to review. On the one hand, if you take several years to choose, several other people may have had the same idea in the meantime. On the other hand, only a well-considered topic is likely to lead to a brilliant literature review [8] . The topic must at least be:

• interesting to you (ideally, you should have come across a series of recent papers related to your line of work that call for a critical summary),
• an important aspect of the field (so that many readers will be interested in the review and there will be enough material to write it), and
• a well-defined issue (otherwise you could potentially include thousands of publications, which would make the review unhelpful).

Ideas for potential reviews may come from papers providing lists of key research questions to be answered [9] , but also from serendipitous moments during desultory reading and discussions. In addition to choosing your topic, you should also select a target audience. In many cases, the topic (e.g., web services in computational biology) will automatically define an audience (e.g., computational biologists), but that same topic may also be of interest to neighbouring fields (e.g., computer science, biology, etc.).

Rule 2: Search and Re-search the Literature

After having chosen your topic and audience, start by checking the literature and downloading relevant papers. Five pieces of advice here:

• keep track of the search items you use (so that your search can be replicated [10] ),
• keep a list of papers whose pdfs you cannot access immediately (so as to retrieve them later with alternative strategies),
• use a paper management system (e.g., Mendeley, Papers, Qiqqa, Sente),
• define early in the process some criteria for exclusion of irrelevant papers (these criteria can then be described in the review to help define its scope), and
• do not just look for research papers in the area you wish to review, but also seek previous reviews.

The chances are high that someone will already have published a literature review ( Figure 1 ), if not exactly on the issue you are planning to tackle, at least on a related topic. If there are already a few or several reviews of the literature on your issue, my advice is not to give up, but to carry on with your own literature review,

The bottom-right situation (many literature reviews but few research papers) is not just a theoretical situation; it applies, for example, to the study of the impacts of climate change on plant diseases, where there appear to be more literature reviews than research studies [33] .

• discussing in your review the approaches, limitations, and conclusions of past reviews,
• trying to find a new angle that has not been covered adequately in the previous reviews, and
• incorporating new material that has inevitably accumulated since their appearance.

When searching the literature for pertinent papers and reviews, the usual rules apply:

• be thorough,
• use different keywords and database sources (e.g., DBLP, Google Scholar, ISI Proceedings, JSTOR Search, Medline, Scopus, Web of Science), and
• look at who has cited past relevant papers and book chapters.

Rule 3: Take Notes While Reading

If you read the papers first, and only afterwards start writing the review, you will need a very good memory to remember who wrote what, and what your impressions and associations were while reading each single paper. My advice is, while reading, to start writing down interesting pieces of information, insights about how to organize the review, and thoughts on what to write. This way, by the time you have read the literature you selected, you will already have a rough draft of the review.

Of course, this draft will still need much rewriting, restructuring, and rethinking to obtain a text with a coherent argument [11] , but you will have avoided the danger posed by staring at a blank document. Be careful when taking notes to use quotation marks if you are provisionally copying verbatim from the literature. It is advisable then to reformulate such quotes with your own words in the final draft. It is important to be careful in noting the references already at this stage, so as to avoid misattributions. Using referencing software from the very beginning of your endeavour will save you time.

Rule 4: Choose the Type of Review You Wish to Write

After having taken notes while reading the literature, you will have a rough idea of the amount of material available for the review. This is probably a good time to decide whether to go for a mini- or a full review. Some journals are now favouring the publication of rather short reviews focusing on the last few years, with a limit on the number of words and citations. A mini-review is not necessarily a minor review: it may well attract more attention from busy readers, although it will inevitably simplify some issues and leave out some relevant material due to space limitations. A full review will have the advantage of more freedom to cover in detail the complexities of a particular scientific development, but may then be left in the pile of the very important papers “to be read” by readers with little time to spare for major monographs.

There is probably a continuum between mini- and full reviews. The same point applies to the dichotomy of descriptive vs. integrative reviews. While descriptive reviews focus on the methodology, findings, and interpretation of each reviewed study, integrative reviews attempt to find common ideas and concepts from the reviewed material [12] . A similar distinction exists between narrative and systematic reviews: while narrative reviews are qualitative, systematic reviews attempt to test a hypothesis based on the published evidence, which is gathered using a predefined protocol to reduce bias [13] , [14] . When systematic reviews analyse quantitative results in a quantitative way, they become meta-analyses. The choice between different review types will have to be made on a case-by-case basis, depending not just on the nature of the material found and the preferences of the target journal(s), but also on the time available to write the review and the number of coauthors [15] .

Rule 5: Keep the Review Focused, but Make It of Broad Interest

Whether your plan is to write a mini- or a full review, it is good advice to keep it focused 16 , 17 . Including material just for the sake of it can easily lead to reviews that are trying to do too many things at once. The need to keep a review focused can be problematic for interdisciplinary reviews, where the aim is to bridge the gap between fields [18] . If you are writing a review on, for example, how epidemiological approaches are used in modelling the spread of ideas, you may be inclined to include material from both parent fields, epidemiology and the study of cultural diffusion. This may be necessary to some extent, but in this case a focused review would only deal in detail with those studies at the interface between epidemiology and the spread of ideas.

While focus is an important feature of a successful review, this requirement has to be balanced with the need to make the review relevant to a broad audience. This square may be circled by discussing the wider implications of the reviewed topic for other disciplines.

Rule 6: Be Critical and Consistent

Reviewing the literature is not stamp collecting. A good review does not just summarize the literature, but discusses it critically, identifies methodological problems, and points out research gaps [19] . After having read a review of the literature, a reader should have a rough idea of:

• the major achievements in the reviewed field,
• the main areas of debate, and
• the outstanding research questions.

It is challenging to achieve a successful review on all these fronts. A solution can be to involve a set of complementary coauthors: some people are excellent at mapping what has been achieved, some others are very good at identifying dark clouds on the horizon, and some have instead a knack at predicting where solutions are going to come from. If your journal club has exactly this sort of team, then you should definitely write a review of the literature! In addition to critical thinking, a literature review needs consistency, for example in the choice of passive vs. active voice and present vs. past tense.

Rule 7: Find a Logical Structure

Like a well-baked cake, a good review has a number of telling features: it is worth the reader's time, timely, systematic, well written, focused, and critical. It also needs a good structure. With reviews, the usual subdivision of research papers into introduction, methods, results, and discussion does not work or is rarely used. However, a general introduction of the context and, toward the end, a recapitulation of the main points covered and take-home messages make sense also in the case of reviews. For systematic reviews, there is a trend towards including information about how the literature was searched (database, keywords, time limits) [20] .

How can you organize the flow of the main body of the review so that the reader will be drawn into and guided through it? It is generally helpful to draw a conceptual scheme of the review, e.g., with mind-mapping techniques. Such diagrams can help recognize a logical way to order and link the various sections of a review [21] . This is the case not just at the writing stage, but also for readers if the diagram is included in the review as a figure. A careful selection of diagrams and figures relevant to the reviewed topic can be very helpful to structure the text too [22] .

Rule 8: Make Use of Feedback

Reviews of the literature are normally peer-reviewed in the same way as research papers, and rightly so [23] . As a rule, incorporating feedback from reviewers greatly helps improve a review draft. Having read the review with a fresh mind, reviewers may spot inaccuracies, inconsistencies, and ambiguities that had not been noticed by the writers due to rereading the typescript too many times. It is however advisable to reread the draft one more time before submission, as a last-minute correction of typos, leaps, and muddled sentences may enable the reviewers to focus on providing advice on the content rather than the form.

Feedback is vital to writing a good review, and should be sought from a variety of colleagues, so as to obtain a diversity of views on the draft. This may lead in some cases to conflicting views on the merits of the paper, and on how to improve it, but such a situation is better than the absence of feedback. A diversity of feedback perspectives on a literature review can help identify where the consensus view stands in the landscape of the current scientific understanding of an issue [24] .

Rule 9: Include Your Own Relevant Research, but Be Objective

In many cases, reviewers of the literature will have published studies relevant to the review they are writing. This could create a conflict of interest: how can reviewers report objectively on their own work [25] ? Some scientists may be overly enthusiastic about what they have published, and thus risk giving too much importance to their own findings in the review. However, bias could also occur in the other direction: some scientists may be unduly dismissive of their own achievements, so that they will tend to downplay their contribution (if any) to a field when reviewing it.

In general, a review of the literature should neither be a public relations brochure nor an exercise in competitive self-denial. If a reviewer is up to the job of producing a well-organized and methodical review, which flows well and provides a service to the readership, then it should be possible to be objective in reviewing one's own relevant findings. In reviews written by multiple authors, this may be achieved by assigning the review of the results of a coauthor to different coauthors.

Rule 10: Be Up-to-Date, but Do Not Forget Older Studies

Given the progressive acceleration in the publication of scientific papers, today's reviews of the literature need awareness not just of the overall direction and achievements of a field of inquiry, but also of the latest studies, so as not to become out-of-date before they have been published. Ideally, a literature review should not identify as a major research gap an issue that has just been addressed in a series of papers in press (the same applies, of course, to older, overlooked studies (“sleeping beauties” [26] )). This implies that literature reviewers would do well to keep an eye on electronic lists of papers in press, given that it can take months before these appear in scientific databases. Some reviews declare that they have scanned the literature up to a certain point in time, but given that peer review can be a rather lengthy process, a full search for newly appeared literature at the revision stage may be worthwhile. Assessing the contribution of papers that have just appeared is particularly challenging, because there is little perspective with which to gauge their significance and impact on further research and society.

Inevitably, new papers on the reviewed topic (including independently written literature reviews) will appear from all quarters after the review has been published, so that there may soon be the need for an updated review. But this is the nature of science [27] – [32] . I wish everybody good luck with writing a review of the literature.

Acknowledgments

Many thanks to M. Barbosa, K. Dehnen-Schmutz, T. Döring, D. Fontaneto, M. Garbelotto, O. Holdenrieder, M. Jeger, D. Lonsdale, A. MacLeod, P. Mills, M. Moslonka-Lefebvre, G. Stancanelli, P. Weisberg, and X. Xu for insights and discussions, and to P. Bourne, T. Matoni, and D. Smith for helpful comments on a previous draft.

Funding Statement

This work was funded by the French Foundation for Research on Biodiversity (FRB) through its Centre for Synthesis and Analysis of Biodiversity data (CESAB), as part of the NETSEED research project. The funders had no role in the preparation of the manuscript.

Reference management. Clean and simple.

Literature review

How to write a literature review in 6 steps

How do you write a good literature review? This step-by-step guide on how to write an excellent literature review covers all aspects of planning and writing literature reviews for academic papers and theses.

How to write a systematic literature review [9 steps]

How do you write a systematic literature review? What types of systematic literature reviews exist and where do you use them? Learn everything you need to know about a systematic literature review in this guide

What is a literature review? [with examples]

Not sure what a literature review is? This guide covers the definition, purpose, and format of a literature review.

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• Explore content
• About the journal
• Publish with us
• Sign up for alerts
• CAREER FEATURE
• 04 December 2020
• Correction 09 December 2020

How to write a superb literature review

Andy Tay is a freelance writer based in Singapore.

You can also search for this author in PubMed   Google Scholar

Literature reviews are important resources for scientists. They provide historical context for a field while offering opinions on its future trajectory. Creating them can provide inspiration for one’s own research, as well as some practice in writing. But few scientists are trained in how to write a review — or in what constitutes an excellent one. Even picking the appropriate software to use can be an involved decision (see ‘Tools and techniques’). So Nature asked editors and working scientists with well-cited reviews for their tips.

Access options

Access Nature and 54 other Nature Portfolio journals

Get Nature+, our best-value online-access subscription

24,99 € / 30 days

cancel any time

Subscribe to this journal

Receive 51 print issues and online access

185,98 € per year

only 3,65 € per issue

Rent or buy this article

Prices vary by article type

Prices may be subject to local taxes which are calculated during checkout

doi: https://doi.org/10.1038/d41586-020-03422-x

Interviews have been edited for length and clarity.

Updates & Corrections

Correction 09 December 2020 : An earlier version of the tables in this article included some incorrect details about the programs Zotero, Endnote and Manubot. These have now been corrected.

Hsing, I.-M., Xu, Y. & Zhao, W. Electroanalysis 19 , 755–768 (2007).

Article   Google Scholar  

Ledesma, H. A. et al. Nature Nanotechnol. 14 , 645–657 (2019).

Article   PubMed   Google Scholar  

Brahlek, M., Koirala, N., Bansal, N. & Oh, S. Solid State Commun. 215–216 , 54–62 (2015).

Choi, Y. & Lee, S. Y. Nature Rev. Chem . https://doi.org/10.1038/s41570-020-00221-w (2020).

Download references

Related Articles

• Research management

Breaking ice, and helicopter drops: winning photos of working scientists

Career Feature 23 APR 24

Londoners see what a scientist looks like up close in 50 photographs

Career News 18 APR 24

Deadly diseases and inflatable suits: how I found my niche in virology research

Spotlight 17 APR 24

Researchers want a ‘nutrition label’ for academic-paper facts

Nature Index 17 APR 24

How young people benefit from Swiss apprenticeships

How we landed job interviews for professorships straight out of our PhD programmes

Career Column 08 APR 24

Retractions are part of science, but misconduct isn’t — lessons from a superconductivity lab

Editorial 24 APR 24

Technician - Senior Technician in Cell and Molecular Biology

APPLICATION CLOSING DATE: 24.05.2024 Human Technopole (HT) is a distinguished life science research institute founded and supported by the Italian ...

Human Technopole

Postdoctoral Fellow

The Dubal Laboratory of Neuroscience and Aging at the University of California, San Francisco (UCSF) seeks postdoctoral fellows to investigate the ...

San Francisco, California

University of California, San Francsico

Postdoctoral Associate

Houston, Texas (US)

Baylor College of Medicine (BCM)

Postdoctoral Research Fellow

Description Applications are invited for a postdoctoral fellow position at the Lunenfeld-Tanenbaum Research Institute, Sinai Health, to participate...

Toronto (City), Ontario (CA)

Sinai Health

Postdoctoral Research Associate - Surgery

Memphis, Tennessee

St. Jude Children's Research Hospital (St. Jude)

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies

• UConn Library
• Literature Review: The What, Why and How-to Guide
• Introduction

Literature Review: The What, Why and How-to Guide — Introduction

• Getting Started
• How to Pick a Topic
• Strategies to Find Sources
• Evaluating Sources & Lit. Reviews
• Tips for Writing Literature Reviews
• Writing Literature Review: Useful Sites
• Citation Resources
• Other Academic Writings

What are Literature Reviews?

So, what is a literature review? "A literature review is an account of what has been published on a topic by accredited scholars and researchers. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available, or a set of summaries." Taylor, D.  The literature review: A few tips on conducting it . University of Toronto Health Sciences Writing Centre.

Goals of Literature Reviews

What are the goals of creating a Literature Review?  A literature could be written to accomplish different aims:

• To develop a theory or evaluate an existing theory
• To summarize the historical or existing state of a research topic
• Identify a problem in a field of research 

Baumeister, R. F., & Leary, M. R. (1997). Writing narrative literature reviews .  Review of General Psychology , 1 (3), 311-320.

What kinds of sources require a Literature Review?

• A research paper assigned in a course
• A thesis or dissertation
• A grant proposal
• An article intended for publication in a journal

All these instances require you to collect what has been written about your research topic so that you can demonstrate how your own research sheds new light on the topic.

Types of Literature Reviews

What kinds of literature reviews are written?

Narrative review: The purpose of this type of review is to describe the current state of the research on a specific topic/research and to offer a critical analysis of the literature reviewed. Studies are grouped by research/theoretical categories, and themes and trends, strengths and weakness, and gaps are identified. The review ends with a conclusion section which summarizes the findings regarding the state of the research of the specific study, the gaps identify and if applicable, explains how the author's research will address gaps identify in the review and expand the knowledge on the topic reviewed.

• Example : Predictors and Outcomes of U.S. Quality Maternity Leave: A Review and Conceptual Framework:  10.1177/08948453211037398  

Systematic review : "The authors of a systematic review use a specific procedure to search the research literature, select the studies to include in their review, and critically evaluate the studies they find." (p. 139). Nelson, L. K. (2013). Research in Communication Sciences and Disorders . Plural Publishing.

• Example : The effect of leave policies on increasing fertility: a systematic review:  10.1057/s41599-022-01270-w

Meta-analysis : "Meta-analysis is a method of reviewing research findings in a quantitative fashion by transforming the data from individual studies into what is called an effect size and then pooling and analyzing this information. The basic goal in meta-analysis is to explain why different outcomes have occurred in different studies." (p. 197). Roberts, M. C., & Ilardi, S. S. (2003). Handbook of Research Methods in Clinical Psychology . Blackwell Publishing.

• Example : Employment Instability and Fertility in Europe: A Meta-Analysis:  10.1215/00703370-9164737

Meta-synthesis : "Qualitative meta-synthesis is a type of qualitative study that uses as data the findings from other qualitative studies linked by the same or related topic." (p.312). Zimmer, L. (2006). Qualitative meta-synthesis: A question of dialoguing with texts .  Journal of Advanced Nursing , 53 (3), 311-318.

• Example : Women’s perspectives on career successes and barriers: A qualitative meta-synthesis:  10.1177/05390184221113735

Literature Reviews in the Health Sciences

• UConn Health subject guide on systematic reviews Explanation of the different review types used in health sciences literature as well as tools to help you find the right review type
• << Previous: Getting Started
• Next: How to Pick a Topic >>
• Last Updated: Sep 21, 2022 2:16 PM
• URL: https://guides.lib.uconn.edu/literaturereview

Harvey Cushing/John Hay Whitney Medical Library

• Collections
• Research Help

YSN Doctoral Programs: Steps in Conducting a Literature Review

• Biomedical Databases
• Global (Public Health) Databases
• Soc. Sci., History, and Law Databases
• Grey Literature
• Trials Registers
• Data and Statistics
• Public Policy
• Google Tips
• Recommended Books
• Steps in Conducting a Literature Review

What is a literature review?

A literature review is an integrated analysis -- not just a summary-- of scholarly writings and other relevant evidence related directly to your research question.  That is, it represents a synthesis of the evidence that provides background information on your topic and shows a association between the evidence and your research question.

A literature review may be a stand alone work or the introduction to a larger research paper, depending on the assignment.  Rely heavily on the guidelines your instructor has given you.

Why is it important?

A literature review is important because it:

• Explains the background of research on a topic.
• Demonstrates why a topic is significant to a subject area.
• Discovers relationships between research studies/ideas.
• Identifies major themes, concepts, and researchers on a topic.
• Identifies critical gaps and points of disagreement.
• Discusses further research questions that logically come out of the previous studies.

APA7 Style resources

APA Style Blog - for those harder to find answers

1. Choose a topic. Define your research question.

Your literature review should be guided by your central research question.  The literature represents background and research developments related to a specific research question, interpreted and analyzed by you in a synthesized way.

• Make sure your research question is not too broad or too narrow.  Is it manageable?
• Begin writing down terms that are related to your question. These will be useful for searches later.
• If you have the opportunity, discuss your topic with your professor and your class mates.

2. Decide on the scope of your review

How many studies do you need to look at? How comprehensive should it be? How many years should it cover? 

• This may depend on your assignment.  How many sources does the assignment require?

3. Select the databases you will use to conduct your searches.

Make a list of the databases you will search. 

Where to find databases:

• use the tabs on this guide
• Find other databases in the Nursing Information Resources web page
• More on the Medical Library web page
• ... and more on the Yale University Library web page

4. Conduct your searches to find the evidence. Keep track of your searches.

• Use the key words in your question, as well as synonyms for those words, as terms in your search. Use the database tutorials for help.
• Save the searches in the databases. This saves time when you want to redo, or modify, the searches. It is also helpful to use as a guide is the searches are not finding any useful results.
• Review the abstracts of research studies carefully. This will save you time.
• Use the bibliographies and references of research studies you find to locate others.
• Check with your professor, or a subject expert in the field, if you are missing any key works in the field.
• Ask your librarian for help at any time.
• Use a citation manager, such as EndNote as the repository for your citations. See the EndNote tutorials for help.

Review the literature

Some questions to help you analyze the research:

• What was the research question of the study you are reviewing? What were the authors trying to discover?
• Was the research funded by a source that could influence the findings?
• What were the research methodologies? Analyze its literature review, the samples and variables used, the results, and the conclusions.
• Does the research seem to be complete? Could it have been conducted more soundly? What further questions does it raise?
• If there are conflicting studies, why do you think that is?
• How are the authors viewed in the field? Has this study been cited? If so, how has it been analyzed?

Tips: 

• Review the abstracts carefully.  
• Keep careful notes so that you may track your thought processes during the research process.
• Create a matrix of the studies for easy analysis, and synthesis, across all of the studies.
• << Previous: Recommended Books
• Last Updated: Jan 4, 2024 10:52 AM
• URL: https://guides.library.yale.edu/YSNDoctoral

Purdue Online Writing Lab Purdue OWL® College of Liberal Arts

Writing a Literature Review

Welcome to the Purdue OWL

This page is brought to you by the OWL at Purdue University. When printing this page, you must include the entire legal notice.

Copyright ©1995-2018 by The Writing Lab & The OWL at Purdue and Purdue University. All rights reserved. This material may not be published, reproduced, broadcast, rewritten, or redistributed without permission. Use of this site constitutes acceptance of our terms and conditions of fair use.

A literature review is a document or section of a document that collects key sources on a topic and discusses those sources in conversation with each other (also called synthesis ). The lit review is an important genre in many disciplines, not just literature (i.e., the study of works of literature such as novels and plays). When we say “literature review” or refer to “the literature,” we are talking about the research ( scholarship ) in a given field. You will often see the terms “the research,” “the scholarship,” and “the literature” used mostly interchangeably.

Where, when, and why would I write a lit review?

There are a number of different situations where you might write a literature review, each with slightly different expectations; different disciplines, too, have field-specific expectations for what a literature review is and does. For instance, in the humanities, authors might include more overt argumentation and interpretation of source material in their literature reviews, whereas in the sciences, authors are more likely to report study designs and results in their literature reviews; these differences reflect these disciplines’ purposes and conventions in scholarship. You should always look at examples from your own discipline and talk to professors or mentors in your field to be sure you understand your discipline’s conventions, for literature reviews as well as for any other genre.

A literature review can be a part of a research paper or scholarly article, usually falling after the introduction and before the research methods sections. In these cases, the lit review just needs to cover scholarship that is important to the issue you are writing about; sometimes it will also cover key sources that informed your research methodology.

Lit reviews can also be standalone pieces, either as assignments in a class or as publications. In a class, a lit review may be assigned to help students familiarize themselves with a topic and with scholarship in their field, get an idea of the other researchers working on the topic they’re interested in, find gaps in existing research in order to propose new projects, and/or develop a theoretical framework and methodology for later research. As a publication, a lit review usually is meant to help make other scholars’ lives easier by collecting and summarizing, synthesizing, and analyzing existing research on a topic. This can be especially helpful for students or scholars getting into a new research area, or for directing an entire community of scholars toward questions that have not yet been answered.

What are the parts of a lit review?

Most lit reviews use a basic introduction-body-conclusion structure; if your lit review is part of a larger paper, the introduction and conclusion pieces may be just a few sentences while you focus most of your attention on the body. If your lit review is a standalone piece, the introduction and conclusion take up more space and give you a place to discuss your goals, research methods, and conclusions separately from where you discuss the literature itself.

Introduction:

• An introductory paragraph that explains what your working topic and thesis is
• A forecast of key topics or texts that will appear in the review
• Potentially, a description of how you found sources and how you analyzed them for inclusion and discussion in the review (more often found in published, standalone literature reviews than in lit review sections in an article or research paper)
• Summarize and synthesize: Give an overview of the main points of each source and combine them into a coherent whole
• Analyze and interpret: Don’t just paraphrase other researchers – add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
• Critically Evaluate: Mention the strengths and weaknesses of your sources
• Write in well-structured paragraphs: Use transition words and topic sentence to draw connections, comparisons, and contrasts.

Conclusion:

• Summarize the key findings you have taken from the literature and emphasize their significance
• Connect it back to your primary research question

How should I organize my lit review?

Lit reviews can take many different organizational patterns depending on what you are trying to accomplish with the review. Here are some examples:

• Chronological : The simplest approach is to trace the development of the topic over time, which helps familiarize the audience with the topic (for instance if you are introducing something that is not commonly known in your field). If you choose this strategy, be careful to avoid simply listing and summarizing sources in order. Try to analyze the patterns, turning points, and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred (as mentioned previously, this may not be appropriate in your discipline — check with a teacher or mentor if you’re unsure).
• Thematic : If you have found some recurring central themes that you will continue working with throughout your piece, you can organize your literature review into subsections that address different aspects of the topic. For example, if you are reviewing literature about women and religion, key themes can include the role of women in churches and the religious attitude towards women.
• Qualitative versus quantitative research
• Empirical versus theoretical scholarship
• Divide the research by sociological, historical, or cultural sources
• Theoretical : In many humanities articles, the literature review is the foundation for the theoretical framework. You can use it to discuss various theories, models, and definitions of key concepts. You can argue for the relevance of a specific theoretical approach or combine various theorical concepts to create a framework for your research.

What are some strategies or tips I can use while writing my lit review?

Any lit review is only as good as the research it discusses; make sure your sources are well-chosen and your research is thorough. Don’t be afraid to do more research if you discover a new thread as you’re writing. More info on the research process is available in our "Conducting Research" resources .

As you’re doing your research, create an annotated bibliography ( see our page on the this type of document ). Much of the information used in an annotated bibliography can be used also in a literature review, so you’ll be not only partially drafting your lit review as you research, but also developing your sense of the larger conversation going on among scholars, professionals, and any other stakeholders in your topic.

Usually you will need to synthesize research rather than just summarizing it. This means drawing connections between sources to create a picture of the scholarly conversation on a topic over time. Many student writers struggle to synthesize because they feel they don’t have anything to add to the scholars they are citing; here are some strategies to help you:

• It often helps to remember that the point of these kinds of syntheses is to show your readers how you understand your research, to help them read the rest of your paper.
• Writing teachers often say synthesis is like hosting a dinner party: imagine all your sources are together in a room, discussing your topic. What are they saying to each other?
• Look at the in-text citations in each paragraph. Are you citing just one source for each paragraph? This usually indicates summary only. When you have multiple sources cited in a paragraph, you are more likely to be synthesizing them (not always, but often
• Read more about synthesis here.

The most interesting literature reviews are often written as arguments (again, as mentioned at the beginning of the page, this is discipline-specific and doesn’t work for all situations). Often, the literature review is where you can establish your research as filling a particular gap or as relevant in a particular way. You have some chance to do this in your introduction in an article, but the literature review section gives a more extended opportunity to establish the conversation in the way you would like your readers to see it. You can choose the intellectual lineage you would like to be part of and whose definitions matter most to your thinking (mostly humanities-specific, but this goes for sciences as well). In addressing these points, you argue for your place in the conversation, which tends to make the lit review more compelling than a simple reporting of other sources.

• University of Texas Libraries

Literature Reviews

• What is a literature review?
• Steps in the Literature Review Process
• Define your research question
• Determine inclusion and exclusion criteria
• Choose databases and search
• Review Results
• Synthesize Results
• Analyze Results
• Librarian Support

What is a Literature Review?

A literature or narrative review is a comprehensive review and analysis of the published literature on a specific topic or research question. The literature that is reviewed contains: books, articles, academic articles, conference proceedings, association papers, and dissertations. It contains the most pertinent studies and points to important past and current research and practices. It provides background and context, and shows how your research will contribute to the field. 

A literature review should: 

• Provide a comprehensive and updated review of the literature;
• Explain why this review has taken place;
• Articulate a position or hypothesis;
• Acknowledge and account for conflicting and corroborating points of view

From  S age Research Methods

Purpose of a Literature Review

A literature review can be written as an introduction to a study to:

• Demonstrate how a study fills a gap in research
• Compare a study with other research that's been done

Or it can be a separate work (a research article on its own) which:

• Organizes or describes a topic
• Describes variables within a particular issue/problem

Limitations of a Literature Review

Some of the limitations of a literature review are:

• It's a snapshot in time. Unlike other reviews, this one has beginning, a middle and an end. There may be future developments that could make your work less relevant.
• It may be too focused. Some niche studies may miss the bigger picture.
• It can be difficult to be comprehensive. There is no way to make sure all the literature on a topic was considered.
• It is easy to be biased if you stick to top tier journals. There may be other places where people are publishing exemplary research. Look to open access publications and conferences to reflect a more inclusive collection. Also, make sure to include opposing views (and not just supporting evidence).

Source: Grant, Maria J., and Andrew Booth. “A Typology of Reviews: An Analysis of 14 Review Types and Associated Methodologies.” Health Information & Libraries Journal, vol. 26, no. 2, June 2009, pp. 91–108. Wiley Online Library, doi:10.1111/j.1471-1842.2009.00848.x.

Meryl Brodsky : Communication and Information Studies

Hannah Chapman Tripp : Biology, Neuroscience

Carolyn Cunningham : Human Development & Family Sciences, Psychology, Sociology

Larayne Dallas : Engineering

Janelle Hedstrom : Special Education, Curriculum & Instruction, Ed Leadership & Policy ​

Susan Macicak : Linguistics

Imelda Vetter : Dell Medical School

For help in other subject areas, please see the guide to library specialists by subject .

Periodically, UT Libraries runs a workshop covering the basics and library support for literature reviews. While we try to offer these once per academic year, we find providing the recording to be helpful to community members who have missed the session. Following is the most recent recording of the workshop, Conducting a Literature Review. To view the recording, a UT login is required.

• October 26, 2022 recording
• Last Updated: Oct 26, 2022 2:49 PM
• URL: https://guides.lib.utexas.edu/literaturereviews

Engineering: The Literature Review Process

• How to Use This Guide

What is a literature review and why is it important?

Further reading ....

• 2. Precision vs Retrieval
• 3. Equip Your Tool Box
• 4. What to look for
• 5. Where to Look for it
• 6. How to Look for it
• 7. Keeping Current
• 8. Reading Tips
• 9. Writing Tips
• 10. Checklist

A literature review not only summarizes the knowledge of a particular area or field of study, it also evaluates what has been done, what still needs to be done and why all of this is important to the subject.  

• The Stand-Alone Literature Review A literature review may stand alone as an individual document in which the history of the topic is reported and then analyzed for trends, controversial issues, and what still needs to be studied.  The review could just be a few pages for narrow topics or quite extensive with long bibliographies for in-depth reviews.   In-depth review articles are valuable time-savers for professionals and researchers who need a quick introduction or analysis of a topic but they can be very time-consuming for authors to produce. Examples of review articles:   Walker, Sara Louise (2011)   Building mounted wind turbines and their suitability for the urban scale - a review of methods of estimating urban wind resource .   Energy and Buildings  43(8):1852-1862. For this review, the author focused on the different methodologies used to estimate wind speed in urban settings.  After introducing the theory, she explained the difficulty for in-situ measuring, and then followed up by describing each of the different estimation techniques that have been used instead.  Strengths and weaknesses of each method are discussed and suggestions are given on where more study is needed.   Length: 11 pages. References: 59. Calm, J.M. (2008)   The next generation of refrigerants - historical review, considerations, and outlook.   International Journal of Refrigeration  31(7):1123-1133. This review focuses on the evolution of refrigerants and divides the evolution into 4 generations.  In each generation the author describes which type of refrigerants were most popular and discusses how political, environmental, and economic issues as well as chemical properties effected choices.  Length: 11 pages.  References: 51.  
• The Literature Review as a Section Within a Document Literature reviews are also part of dissertations, theses, research reports and scholarly journal articles; these types of documents include the review in a section or chapter that discusses what has gone before, how the research being presented in this document fills a gap in the field's knowledge and why that is important.   Examples of literature reviews within a journal article:  Jobert, Arthur, et al. (2007) Local acceptance of wind energy: factors of success identified in French and German case studies.  Energy Policy  35(5):2751-2760.  In this case, the literature review is a separate, labeled section appearing between the introduction and methodology sections.  Peel, Deborah and Lloyd, Michael Gregory (2007)   Positive planning for wind-turbines in an urban context.   Local Environment  12(4):343-354. In this case the literature review is incorporated into the article's introduction rather than have its own section.   Which version you choose (separate section or within the introduction) depends on format requirements of the publisher (for journal articles), the ASU Graduate College and your academic unit (for ASU dissertations and theses) and application instructions for grants.   If no format is specified choose the method in which you can best explain your research topic, what has come before and the importance of the knowledge you are adding to the field.    Examples of literature reviews within a dissertation or thesis :  Porter, Wayne Eliot (2011)   Renewable Energy in Rural Southeastern Arizona: Decision Factors: A Comparison of the Consumer Profiles of Homeowners Who Purchased Renewable Energy Systems With Those Who Performed Other Home Upgrades or Remodeling Projects .    Arizona State University, M.S. Thesis.  This author effectively uses a separate chapter for the literature review for his detailed analysis.  Magerman, Beth (2014)   Short-Term Wind Power Forecasts using Doppler Lidar.   Arizona State University, M.S. Thesis. The author puts the literature review within Chapter Two presenting it as part of the background information of her topic.   Note that the literature review within a thesis or dissertation more closely resembles the scope and depth of a stand- alone literature review as opposed to the briefer reviews appearing within journal articles.  Within a thesis or dissertation, the review not only presents the status of research in the specific area it also establishes the author's expertise and justifies his/her own research.   

Online tutorials:

• Literature Reviews: An Overview for Graduate Students Created by the North Caroline State University Libraries

Other ASU Library Guides: 

• Literature Reviews and Annotated Bibliographies More general information about the format and content of literature reviews; created by Ed Oetting, History and Political Science Librarian, Hayden Library. ​

Readings: 

• The Literature Review: A Few Tips on Conducting It Written by Dena Taylor, Health Sciences Writing Centre, University of Toronto
• Literature Reviews Created by The Writing Center at the University of North Carolina, Chapel Hill. 
• << Previous: How to Use This Guide
• Next: 2. Precision vs Retrieval >>
• Last updated: Jan 2, 2024 8:27 AM
• URL: https://libguides.asu.edu/engineeringlitreview

The ASU Library acknowledges the twenty-three Native Nations that have inhabited this land for centuries. Arizona State University's four campuses are located in the Salt River Valley on ancestral territories of Indigenous peoples, including the Akimel O’odham (Pima) and Pee Posh (Maricopa) Indian Communities, whose care and keeping of these lands allows us to be here today. ASU Library acknowledges the sovereignty of these nations and seeks to foster an environment of success and possibility for Native American students and patrons. We are advocates for the incorporation of Indigenous knowledge systems and research methodologies within contemporary library practice. ASU Library welcomes members of the Akimel O’odham and Pee Posh, and all Native nations to the Library.

Conduct a literature review

What is a literature review.

A literature review is a summary of the published work in a field of study. This can be a section of a larger paper or article, or can be the focus of an entire paper. Literature reviews show that you have examined the breadth of knowledge and can justify your thesis or research questions. They are also valuable tools for other researchers who need to find a summary of that field of knowledge.

Unlike an annotated bibliography, which is a list of sources with short descriptions, a literature review synthesizes sources into a summary that has a thesis or statement of purpose—stated or implied—at its core.

How do I write a literature review?

Step 1: define your research scope.

• What is the specific research question that your literature review helps to define?
• Are there a maximum or minimum number of sources that your review should include?

Ask us if you have questions about refining your topic, search methods, writing tips, or citation management.

Step 2: Identify the literature

Start by searching broadly. Literature for your review will typically be acquired through scholarly books, journal articles, and/or dissertations. Develop an understanding of what is out there, what terms are accurate and helpful, etc., and keep track of all of it with citation management tools . If you need help figuring out key terms and where to search, ask us .

Use citation searching to track how scholars interact with, and build upon, previous research:

• Mine the references cited section of each relevant source for additional key sources
• Use Google Scholar or Scopus to find other sources that have cited a particular work

Step 3: Critically analyze the literature

Key to your literature review is a critical analysis of the literature collected around your topic. The analysis will explore relationships, major themes, and any critical gaps in the research expressed in the work. Read and summarize each source with an eye toward analyzing authority, currency, coverage, methodology, and relationship to other works. The University of Toronto's Writing Center provides a comprehensive list of questions you can use to analyze your sources.

Step 4: Categorize your resources

Divide the available resources that pertain to your research into categories reflecting their roles in addressing your research question. Possible ways to categorize resources include organization by:

• methodology
• theoretical/philosophical approach

Regardless of the division, each category should be accompanied by thorough discussions and explanations of strengths and weaknesses, value to the overall survey, and comparisons with similar sources. You may have enough resources when:

• You've used multiple databases and other resources (web portals, repositories, etc.) to get a variety of perspectives on the research topic.
• The same citations are showing up in a variety of databases.

Additional resources

Undergraduate student resources.

• Literature Review Handout (University of North Carolina at Chapel Hill)
• Learn how to write a review of literature (University of Wisconsin-Madison)

Graduate student and faculty resources

• Information Research Strategies (University of Arizona)
• Literature Reviews: An Overview for Graduate Students (NC State University)
• Oliver, P. (2012). Succeeding with Your Literature Review: A Handbook for Students [ebook]
• Machi, L. A. & McEvoy, B. T. (2016). The Literature Review: Six Steps to Success

Graustein, J. S. (2012). How to Write an Exceptional Thesis or Dissertation: A Step-by-Step Guide from Proposal to Successful Defense [ebook]

Thomas, R. M. & Brubaker, D. L. (2008). Theses and Dissertations: A Guide to Planning, Research, and Writing

Literature Review Example/Sample

Detailed Walkthrough + Free Literature Review Template

If you’re working on a dissertation or thesis and are looking for an example of a strong literature review chapter , you’ve come to the right place.

In this video, we walk you through an A-grade literature review from a dissertation that earned full distinction . We start off by discussing the five core sections of a literature review chapter by unpacking our free literature review template . This includes:

• The literature review opening/ introduction section
• The theoretical framework (or foundation of theory)
• The empirical research
• The research gap
• The closing section

We then progress to the sample literature review (from an A-grade Master’s-level dissertation) to show how these concepts are applied in the literature review chapter. You can access the free resources mentioned in this video below.

FAQ: Literature Review Example

Literature review example: frequently asked questions, is the sample literature review real.

Yes. The literature review example is an extract from a Master’s-level dissertation for an MBA program. It has not been edited in any way.

Can I replicate this literature review for my dissertation?

As we discuss in the video, every literature review will be slightly different, depending on the university’s unique requirements, as well as the nature of the research itself. Therefore, you’ll need to tailor your literature review to suit your specific context.

You can learn more about the basics of writing a literature review here .

Where can I find more examples of literature reviews?

The best place to find more examples of literature review chapters would be within dissertation/thesis databases. These databases include dissertations, theses and research projects that have successfully passed the assessment criteria for the respective university, meaning that you have at least some sort of quality assurance. 

The Open Access Thesis Database (OATD) is a good starting point. 

How do I get the literature review template?

You can access our free literature review chapter template here .

Is the template really free?

Yes. There is no cost for the template and you are free to use it as you wish. 

Psst… there’s more!

This post is an extract from our bestselling short course, Literature Review Bootcamp . If you want to work smart, you don't want to miss this .

You Might Also Like:

What will it take for you to guide me in my Ph.D research work?

Submit a Comment Cancel reply

Your email address will not be published. Required fields are marked *

Save my name, email, and website in this browser for the next time I comment.

• Print Friendly

15 Literature Review Examples

Literature reviews are a necessary step in a research process and often required when writing your research proposal . They involve gathering, analyzing, and evaluating existing knowledge about a topic in order to find gaps in the literature where future studies will be needed.

Ideally, once you have completed your literature review, you will be able to identify how your research project can build upon and extend existing knowledge in your area of study.

Generally, for my undergraduate research students, I recommend a narrative review, where themes can be generated in order for the students to develop sufficient understanding of the topic so they can build upon the themes using unique methods or novel research questions.

If you’re in the process of writing a literature review, I have developed a literature review template for you to use – it’s a huge time-saver and walks you through how to write a literature review step-by-step:

Get your time-saving templates here to write your own literature review.

Literature Review Examples

For the following types of literature review, I present an explanation and overview of the type, followed by links to some real-life literature reviews on the topics.

1. Narrative Review Examples

Also known as a traditional literature review, the narrative review provides a broad overview of the studies done on a particular topic.

It often includes both qualitative and quantitative studies and may cover a wide range of years.

The narrative review’s purpose is to identify commonalities, gaps, and contradictions in the literature .

I recommend to my students that they should gather their studies together, take notes on each study, then try to group them by themes that form the basis for the review (see my step-by-step instructions at the end of the article).

Example Study

Title: Communication in healthcare: a narrative review of the literature and practical recommendations

Citation: Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E., … & Vogelaers, D. (2015). Communication in healthcare: a narrative review of the literature and practical recommendations. International journal of clinical practice , 69 (11), 1257-1267.

Source: https://onlinelibrary.wiley.com/doi/pdf/10.1111/ijcp.12686  

Overview: This narrative review analyzed themes emerging from 69 articles about communication in healthcare contexts. Five key themes were found in the literature: poor communication can lead to various negative outcomes, discontinuity of care, compromise of patient safety, patient dissatisfaction, and inefficient use of resources. After presenting the key themes, the authors recommend that practitioners need to approach healthcare communication in a more structured way, such as by ensuring there is a clear understanding of who is in charge of ensuring effective communication in clinical settings.

Other Examples

• Burnout in United States Healthcare Professionals: A Narrative Review (Reith, 2018) – read here
• Examining the Presence, Consequences, and Reduction of Implicit Bias in Health Care: A Narrative Review (Zestcott, Blair & Stone, 2016) – read here
• A Narrative Review of School-Based Physical Activity for Enhancing Cognition and Learning (Mavilidi et al., 2018) – read here
• A narrative review on burnout experienced by medical students and residents (Dyrbye & Shanafelt, 2015) – read here

2. Systematic Review Examples

This type of literature review is more structured and rigorous than a narrative review. It involves a detailed and comprehensive plan and search strategy derived from a set of specified research questions.

The key way you’d know a systematic review compared to a narrative review is in the methodology: the systematic review will likely have a very clear criteria for how the studies were collected, and clear explanations of exclusion/inclusion criteria. 

The goal is to gather the maximum amount of valid literature on the topic, filter out invalid or low-quality reviews, and minimize bias. Ideally, this will provide more reliable findings, leading to higher-quality conclusions and recommendations for further research.

You may note from the examples below that the ‘method’ sections in systematic reviews tend to be much more explicit, often noting rigid inclusion/exclusion criteria and exact keywords used in searches.

Title: The importance of food naturalness for consumers: Results of a systematic review  

Citation: Roman, S., Sánchez-Siles, L. M., & Siegrist, M. (2017). The importance of food naturalness for consumers: Results of a systematic review. Trends in food science & technology , 67 , 44-57.

Source: https://www.sciencedirect.com/science/article/pii/S092422441730122X  

Overview: This systematic review included 72 studies of food naturalness to explore trends in the literature about its importance for consumers. Keywords used in the data search included: food, naturalness, natural content, and natural ingredients. Studies were included if they examined consumers’ preference for food naturalness and contained empirical data. The authors found that the literature lacks clarity about how naturalness is defined and measured, but also found that food consumption is significantly influenced by perceived naturalness of goods.

• A systematic review of research on online teaching and learning from 2009 to 2018 (Martin, Sun & Westine, 2020) – read here
• Where Is Current Research on Blockchain Technology? (Yli-Huumo et al., 2016) – read here
• Universities—industry collaboration: A systematic review (Ankrah & Al-Tabbaa, 2015) – read here
• Internet of Things Applications: A Systematic Review (Asghari, Rahmani & Javadi, 2019) – read here

3. Meta-analysis

This is a type of systematic review that uses statistical methods to combine and summarize the results of several studies.

Due to its robust methodology, a meta-analysis is often considered the ‘gold standard’ of secondary research , as it provides a more precise estimate of a treatment effect than any individual study contributing to the pooled analysis.

Furthermore, by aggregating data from a range of studies, a meta-analysis can identify patterns, disagreements, or other interesting relationships that may have been hidden in individual studies.

This helps to enhance the generalizability of findings, making the conclusions drawn from a meta-analysis particularly powerful and informative for policy and practice.

Title: Cholesterol and Alzheimer’s Disease Risk: A Meta-Meta-Analysis

Citation: Sáiz-Vazquez, O., Puente-Martínez, A., Ubillos-Landa, S., Pacheco-Bonrostro, J., & Santabárbara, J. (2020). Cholesterol and Alzheimer’s disease risk: a meta-meta-analysis. Brain sciences, 10(6), 386.

Source: https://doi.org/10.3390/brainsci10060386  

O verview: This study examines the relationship between cholesterol and Alzheimer’s disease (AD). Researchers conducted a systematic search of meta-analyses and reviewed several databases, collecting 100 primary studies and five meta-analyses to analyze the connection between cholesterol and Alzheimer’s disease. They find that the literature compellingly demonstrates that low-density lipoprotein cholesterol (LDL-C) levels significantly influence the development of Alzheimer’s disease.

• The power of feedback revisited: A meta-analysis of educational feedback research (Wisniewski, Zierer & Hattie, 2020) – read here
• How Much Does Education Improve Intelligence? A Meta-Analysis (Ritchie & Tucker-Drob, 2018) – read here
• A meta-analysis of factors related to recycling (Geiger et al., 2019) – read here
• Stress management interventions for police officers and recruits (Patterson, Chung & Swan, 2014) – read here

Other Types of Reviews

• Scoping Review: This type of review is used to map the key concepts underpinning a research area and the main sources and types of evidence available. It can be undertaken as stand-alone projects in their own right, or as a precursor to a systematic review.
• Rapid Review: This type of review accelerates the systematic review process in order to produce information in a timely manner. This is achieved by simplifying or omitting stages of the systematic review process.
• Integrative Review: This review method is more inclusive than others, allowing for the simultaneous inclusion of experimental and non-experimental research. The goal is to more comprehensively understand a particular phenomenon.
• Critical Review: This is similar to a narrative review but requires a robust understanding of both the subject and the existing literature. In a critical review, the reviewer not only summarizes the existing literature, but also evaluates its strengths and weaknesses. This is common in the social sciences and humanities .
• State-of-the-Art Review: This considers the current level of advancement in a field or topic and makes recommendations for future research directions. This type of review is common in technological and scientific fields but can be applied to any discipline.

How to Write a Narrative Review (Tips for Undergrad Students)

Most undergraduate students conducting a capstone research project will be writing narrative reviews. Below is a five-step process for conducting a simple review of the literature for your project.

• Search for Relevant Literature: Use scholarly databases related to your field of study, provided by your university library, along with appropriate search terms to identify key scholarly articles that have been published on your topic.
• Evaluate and Select Sources: Filter the source list by selecting studies that are directly relevant and of sufficient quality, considering factors like credibility , objectivity, accuracy, and validity.
• Analyze and Synthesize: Review each source and summarize the main arguments  in one paragraph (or more, for postgrad). Keep these summaries in a table.
• Identify Themes: With all studies summarized, group studies that share common themes, such as studies that have similar findings or methodologies.
• Write the Review: Write your review based upon the themes or subtopics you have identified. Give a thorough overview of each theme, integrating source data, and conclude with a summary of the current state of knowledge then suggestions for future research based upon your evaluation of what is lacking in the literature.

Literature reviews don’t have to be as scary as they seem. Yes, they are difficult and require a strong degree of comprehension of academic studies. But it can be feasibly done through following a structured approach to data collection and analysis. With my undergraduate research students (who tend to conduct small-scale qualitative studies ), I encourage them to conduct a narrative literature review whereby they can identify key themes in the literature. Within each theme, students can critique key studies and their strengths and limitations , in order to get a lay of the land and come to a point where they can identify ways to contribute new insights to the existing academic conversation on their topic.

Ankrah, S., & Omar, A. T. (2015). Universities–industry collaboration: A systematic review. Scandinavian Journal of Management, 31(3), 387-408.

Asghari, P., Rahmani, A. M., & Javadi, H. H. S. (2019). Internet of Things applications: A systematic review. Computer Networks , 148 , 241-261.

Dyrbye, L., & Shanafelt, T. (2016). A narrative review on burnout experienced by medical students and residents. Medical education , 50 (1), 132-149.

Geiger, J. L., Steg, L., Van Der Werff, E., & Ünal, A. B. (2019). A meta-analysis of factors related to recycling. Journal of environmental psychology , 64 , 78-97.

Martin, F., Sun, T., & Westine, C. D. (2020). A systematic review of research on online teaching and learning from 2009 to 2018. Computers & education , 159 , 104009.

Mavilidi, M. F., Ruiter, M., Schmidt, M., Okely, A. D., Loyens, S., Chandler, P., & Paas, F. (2018). A narrative review of school-based physical activity for enhancing cognition and learning: The importance of relevancy and integration. Frontiers in psychology , 2079.

Patterson, G. T., Chung, I. W., & Swan, P. W. (2014). Stress management interventions for police officers and recruits: A meta-analysis. Journal of experimental criminology , 10 , 487-513.

Reith, T. P. (2018). Burnout in United States healthcare professionals: a narrative review. Cureus , 10 (12).

Ritchie, S. J., & Tucker-Drob, E. M. (2018). How much does education improve intelligence? A meta-analysis. Psychological science , 29 (8), 1358-1369.

Roman, S., Sánchez-Siles, L. M., & Siegrist, M. (2017). The importance of food naturalness for consumers: Results of a systematic review. Trends in food science & technology , 67 , 44-57.

Sáiz-Vazquez, O., Puente-Martínez, A., Ubillos-Landa, S., Pacheco-Bonrostro, J., & Santabárbara, J. (2020). Cholesterol and Alzheimer’s disease risk: a meta-meta-analysis. Brain sciences, 10(6), 386.

Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E., … & Vogelaers, D. (2015). Communication in healthcare: a narrative review of the literature and practical recommendations. International journal of clinical practice , 69 (11), 1257-1267.

Wisniewski, B., Zierer, K., & Hattie, J. (2020). The power of feedback revisited: A meta-analysis of educational feedback research. Frontiers in Psychology , 10 , 3087.

Yli-Huumo, J., Ko, D., Choi, S., Park, S., & Smolander, K. (2016). Where is current research on blockchain technology?—a systematic review. PloS one , 11 (10), e0163477.

Zestcott, C. A., Blair, I. V., & Stone, J. (2016). Examining the presence, consequences, and reduction of implicit bias in health care: a narrative review. Group Processes & Intergroup Relations , 19 (4), 528-542

Chris Drew (PhD)

Dr. Chris Drew is the founder of the Helpful Professor. He holds a PhD in education and has published over 20 articles in scholarly journals. He is the former editor of the Journal of Learning Development in Higher Education. [Image Descriptor: Photo of Chris]

• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 5 Top Tips for Succeeding at University
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 50 Durable Goods Examples
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 100 Consumer Goods Examples
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 30 Globalization Pros and Cons

Leave a Comment Cancel Reply

Your email address will not be published. Required fields are marked *

• UWF Libraries

Literature Review: Conducting & Writing

• Sample Literature Reviews
• Steps for Conducting a Lit Review
• Finding "The Literature"
• Organizing/Writing
• APA Style This link opens in a new window
• Chicago: Notes Bibliography This link opens in a new window
• MLA Style This link opens in a new window

Sample Lit Reviews from Communication Arts

Have an exemplary literature review.

• Literature Review Sample 1
• Literature Review Sample 2
• Literature Review Sample 3

Have you written a stellar literature review you care to share for teaching purposes?

Are you an instructor who has received an exemplary literature review and have permission from the student to post?

Please contact Britt McGowan at [email protected] for inclusion in this guide. All disciplines welcome and encouraged.

• << Previous: MLA Style
• Next: Get Help! >>
• Last Updated: Mar 22, 2024 9:37 AM
• URL: https://libguides.uwf.edu/litreview

Literature reviews in student project reports

Ieee account.

• Change Username/Password
• Update Address

Purchase Details

• Payment Options
• Order History
• View Purchased Documents

Profile Information

• Communications Preferences
• Profession and Education
• Technical Interests
• US & Canada: +1 800 678 4333
• Worldwide: +1 732 981 0060
• Contact & Support
• About IEEE Xplore
• Accessibility
• Terms of Use
• Nondiscrimination Policy
• Privacy & Opting Out of Cookies

A not-for-profit organization, IEEE is the world's largest technical professional organization dedicated to advancing technology for the benefit of humanity. © Copyright 2024 IEEE - All rights reserved. Use of this web site signifies your agreement to the terms and conditions.

CASE REPORT article

Sintilimab combined with anlotinib as first-line treatment for advanced sarcomatoid carcinoma of head and neck: a case report and literature review.

• 1 Graduate School of Clinical Medicine, Bengbu Medical University, Bengbu, Anhui, China
• 2 Cancer Center, Department of Medical Oncology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
• 3 Graduate School of Hangzhou Normal University, Hangzhou, Zhejiang, China

Sarcomatoid carcinoma (SC) is a rare, complex, aggressive tumor that spreads rapidly, is highly malignant, and has metastasized. Surgical resection is the primary treatment, and it usually occurs in the lungs and kidneys but rarely in the neck. Patients with advanced sarcomatoid carcinoma (SC) of the head and neck (HN) have a poor progonsis. In recent years, immune checkpoint inhibitors (ICIs) have been established as treatments for many solid tumors; however, the effectiveness of ICIs in treating SC of HN is still little recognized. We report a case study of a middle-aged woman with primary sarcomatoid carcinoma of the neck. She developed sarcomatoid carcinoma of the contralateral neck 7 months after the first surgical treatment. Subsequently, disease recurrence and metastasis occurred 8 months after the second surgery. The patient did not receive any treatment after both surgeries. The tumor showed high programmed death-ligand 1 (PD-L1) expression, with a combined positive score (CPS): 95. The patient’s response to treatment was assessed as partial remission (PR) after 2 cycles of anlotinib combined with sintilimab. The patient has survived for over 2 years and remains in PR status, despite experiencing grade 2 hypothyroidism as an adverse event during treatment. The case highlights the efficacy and safety of anlotinib and sintilimab as a first-line treatment.

Introduction

Sarcomatoid carcinoma (SC) is a rare, complex, and highly malignant tumor that presents biphasically in terms of epithelial carcinoma and mesenchymal-like sarcoma components. Since its first report in 1864, SC has been documented in various organs including the lungs, uterus, kidneys, bladder, colon, liver, gallbladder, and skin ( 1 – 8 ). Among all head and neck malignancies, the incidence of sarcomatoid carcinoma was 0.57% ( 9 ). Most sarcomatoid carcinoma (SC) of the head and neck (HN) originated in the larynx, nasal cavity, and maxillary sinuses, and rarely in the neck. Due to the rarity SC of HN, limited information can be found in previous reports, which mainly consist of case studies or small retrospective studies. These studies have shown a median survival time of 16 months for patients with SC of HN ( 10 ).

Patients with SC of HN often develop lymph node metastasis, which contributes to their poorer prognosis. Currently, there are no specific clinical treatment guidelines available; surgical resection has been shown to be an effective option for early stage SC of HN ( 9 ). However, even after radical surgery in the early stage, recurrence and metastasis remain significant concerns ( 11 ). Most patients with SC of HN are diagnosed at advanced or distantly metastatic, missing the opportunity for surgery. The majority of these patients received palliative radiotherapy and chemotherapy, resulting in poor prognosis. Therefore, there is an urgent need to develop new effective therapeutic options for this condition. In recent years, immune checkpoint inhibitors (ICIs) have shown a positive response in various malignancies. The U.S. Food and Drug Administration has approved pembrolizumab, a programmed death-1 (PD-1) inhibitor, as a first-line treatment for recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) where tumor cells expressing programmed death-ligand 1(PD-L1) with combined positive score CPS≥1 ( 12 ). Babacan et al. found that over 90% of patients with Lung sarcomatoid carcinoma (LSC) had PD-L1 expression level exceeding 1%, and the level of PD-L1 expression was closely correlated with the efficacy of ICIs ( 13 ). Patients with LSC who received ICIs showed significantly better outcomes compared to those underwent traditional radiotherapy and chemotherapy ( 14 ). Besides LSC, high expression of PD-L1 has been found in other types of SC ( 15 ).

Sintilimab, a recombinant fully human immunoglobulin G4 (IgG4)-type anti-programmed cell death receptor-1 monoclonal antibody ( 16 ), has shown good objective response rate (ORR) and overall survival (OS) in advanced HNSCC ( 17 ). Tyrosine kinase inhibitor (TKI) have also demonstrated positive responses in various malignancies. Several TKIs targeting head and neck malignancies are currently under investigation, with the hope of benefiting from clinical trials ( 18 ). Anlotinib is a multi-targeted TKI that inhibits tumor angiogenesis and proliferation ( 19 ). It is approved by the National Medical Products Administration for the treatment of advanced non-small cell lung cancer and soft tissue sarcomas. Due to the low incidence of SC of HN, the use of ICIs in combination with targeted therapy has been reported to be restricted. Maybe SC of HN has a positive response to PD-1/PD-L1 inhibitors in combination with targeted therapy.

Here, we report a case of advanced primary sarcomatoid carcinoma of the neck with multiple metastases showing high expression of PD-L1 (CPS: 95). This is the first reported case demonstrating the efficacy of anlotinib in combination with sintilimab as a first-line treatment for SC of HN.

Case description

A 66-year-old female patient with a 4.5 cm subcutaneous lump on her left side of the neck arrived at a local hospital in December 2021. She reported no swelling or pain, and denied any family history of tumors and had no obvious medical history. Then, the lump was surgically removed under local anesthesia. The pathology report revealed that the tumor exhibited infiltrative growth, was situated in the dermis and subcutis, and consisted of heterogeneous cells with vacuolated nuclei and eosinophilic nucleoli, as well as easily visible mitotic pictures. The immunohistochemical (IHC) staining results were as follows: CK(pan)(+), Ki-67(70%+), P63 (–), MelanA (–), S100 (–), SOX10 (–), CD35 (–), EBER (–), ALK (–), CD20, lymphocyte(+), CD30lymphocyte(+), Desmin (–), CD34 (–), EMA (–), SMA (–), ERG (–), CK7(+), CK5/6 (–), CK8(+). PD-L1 was expressed the CPS was 30. SC of the left neck was considered according to the aforementioned results combined with IHC data. The patient did not receive any treatment after the surgery.

In August 2022, 7 months after surgery, the patient developed a 4 cm subcutaneous nodule on the right side of her neck. In November 2021, the patient returned to the local hospital for an ultrasound examination of the neck, which revealed enlargement of the left lymph nodes. Considering that the patient had a history of SC on the left neck, an “ Enlargement Excision Procedure of the tumor in the right neck + clearance procedure of the left lymph nodes” was performed on November 23, 2022. The pathological results showed a large number of tumor cells were diffusely distributed in the dermis and subcutis with infiltrative growth. The tumor cells were heterogeneous, and the nuclear schizophrenia was easy to see with a large number of chronic inflammatory cells infiltrating the interstitium, and some areas of necrosis. Additionally, the left neck lymph node specimen revealed a malignant tumor with lymph node metastasis. IHC staining showed: GATA-3(+), INI-1(+), CK(pan)(+), SOX10 (–), Vimentin(+), MelanA(+), TTF-1 (–). PD-L1 was strongly expressed with a CPS was 95 ( Figure 1 ). SC of the right side of the neck with lymph node metastasis was diagnosed on the basis of pathological and IHC findings. Despite the diagnosis, the patient did not pursue further treatment after the second operation.

Figure 1 Histopathology and immunohistochemistry (IHC) of HNSC. (A, B) H&E stain, original magnification ×100,×400. (C) IHC CK(pan)(+) original magnification ×200. (D) IHC Vimentin(+), original magnification ×200. (E) IHC GATA3(+) original magnification ×20. (F) IHC Melan(+) original magnification ×20. (G) PD-L1 IHC (Dako22C3), original magnification ×40. Combined Positive Score [CPS]: 95. (CPS was defined as the number of PD-L1 stained cells (tumor cells, lymphocytes, macrophages) divided by the number of all tumor cells and multiplied by 100.).

In June 2023, the patient came back to the hospital with self-conscious neck pain as well as limitation of movement. Enhanced magnetic resonance imaging (MRI) of the cervical spine showed abnormal signals in the C3 vertebrae and intervertebral foramina on both sides. In July 2023, positron emission tomography (PET)/CT suggested multiple lymph node metastases in the left neck and axillary fossa; and inhomogeneous increase in 18F-fluorodeoxyglucose (18F-FDG) metabolism in the C2-C4 vertebrae and their surrounding soft tissues ( Figures 2A, B ). We recommended chemotherapy to the patient, but the patient strongly refused due to concerns about its side effects and requested an immune checkpoint inhibitor. Previous reported cases of other types of SC, the PD-1 inhibitor combined with anilotinib regimen had good efficacy. Given the patient’s high PD-L1 expression, after full discussion with the patient and her family, they agreed to use the sintilimab in combination with anilotinib regimen. The PD-1 inhibitor sintilimab 200 mg q3w and anlotinib 8mg (2 weeks on/1 week off) was implemented on August 1, 2023. After 2 cycles of targeted and immunotherapy, on September 13, 2024, the patient’s thyroid function was abnormal, and she was evaluated by an endocrinologist to confirm the diagnosis of drug-induced hypothyroidism, and was given eugenol 50ug per day as replacement therapy. We temporarily internpted sintilimab and anlotinib. On October 18, 2023, an enhanced Computed tomography (CT) examination of the patient’s neck suggested significant tumor reduction ( Figures 2C, D ), and the function of the thyroid was better than before. According to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria, the efficacy was evaluated as partial remission (PR). Due to the significant anti-tumor therapy, we continued with the original regimen. After 4 cycles, the tumor was further reduced and the clinical efficacy was evaluated PR ( Figures 2E, F ). The patient is continuing treatment. The treatment timeline is shown in Figure 3 .

Figure 2 Imaging performance. (A, B) Eight months after the second surgery, the patient’s PET/CT examination suggested tumor recurrence and metastasis with multiple lymph node metastases in the left side of the neck. (C–F) continuous shrinkage of the tumor lesion and metastatic lymph nodes following sintilimab combined with anlotinib treatment in October 2023, December 2023, respectively.

Figure 3 Timeline of treatment process.

SC is a rare aggressive cancer that can occur in various organs, with the lungs and kidneys being the most common primary sites. SC of HN has a low incidence and is considered to be a monoclonal dedifferentiated form of HNSCC with a high degree of malignancy and poor prognosis. Several studies have indicated that SC patients are mainly male, and the age of onset is around 60 years old. The etiology and the pathogenesis of the disease are still unclear; however, current evidence suggests that smoking, alcoholism, and exposure to radiation may contribute to its development ( 12 – 14 ). There are no specific clinical manifestations in the early stages of SC of HN, and no specific changes on relevant radiological images. Histopathology and IHC are the gold standard for diagnosing the disease, which microscopically shows a biphasic manifestation of coexistence of epithelioid carcinoma component and mesenchymal sarcoma component. IHC analysis reveals positivity for cytokeratin (CK) in the epithelial component and vimentin in the sarcomatoid component, or a combination of both markers ( 11 ). Our case is an elderly female with nonspecific clinical symptoms ultimately diagnosed with a classic sarcomatoid carcinoma of the head and neck based on immunohistochemical findings.

SC of HN is much more malignant than squamous cell carcinoma. It has a tendency for early lymph node metastasis, rapid progression, and a poor prognosis. The main factors influencing the prognosis of SC of HN include tumor location, tumor size, tumor stage, and lymph node metastasis ( 9 , 10 , 15 ). Although surgical resection is currently the best treatment, it is susceptible to metastasis and recurrence even following early intervention with surgical resection. Naijen et al. conducted a study on 78 patients with SC of HN, revealing that 66% of 64 patients who underwent surgery experienced recurrence, the average survival period post-recurrence ranged from 2 to 5 months ( 16 ). Our patient developed sarcomatoid carcinoma of the contralateral neck 7 months after the first surgical treatment, and disease recurrence and metastasis 8 months after the second surgery, without adjuvant radiotherapy after both surgeries, indicating that sarcomatoid carcinoma of the head and neck is aggressive, highly malignant, and easily metastasized. Controversy still exists as to whether preoperative or postoperative chemotherapy or radiotherapy can reduce tumor recurrence and metastasis. In a study on laryngeal sarcomatoid carcinoma by Dubal et al. ( 17 ), it was observed that the disease-specific survival (DSS) at 5 years after surgery was found to be 84.1%, which was much higher than the DSS at 5 years for non-surgical treatments (57.1%), and it also found that the addition of adjuvant radiotherapy did not significantly improve the survival rate. In another report on hypopharyngeal sarcomatoid carcinoma, researchers discovered that adjuvant therapy after surgery did not result in an improvement in DSS ( 15 ). However, both radiotherapy and chemotherapy are still effective in the treatment of local and distant metastases of head and neck tumors. Further clinical studies are needed to ascertain the effectiveness of adjuvant radiotherapy and chemotherapy in SC.

Several studies have found that PD-L1 is highly expressed in patients with SC. Approximately 72% in LSC ( 18 ), 50% in sarcomatoid renal cell carcinoma ( 19 ) and about 75% in SC of HN ( 20 ). These results suggest that SC may be sensitive to immunotherapy. So far, there are no guidelines recommending immunotherapy for advanced SC, mainly case reports and retrospective studies. We searched for previously published papers on ICIs for the treatment of various SC and summarized them in Table 1 . Whether it is single immunotherapy or immunotherapy combined with amlotinib, progress free survival (PFS) and overall survival (OS) are satisfying. The higher the patient’s PD-L1 expression, the better the effect.

Table 1 Previous reports of SC treated with ICIs.

The PD-L1 expression in our patient was remarkably elevated at 95%, potentially explaining the favorable response to sintilimab. Sintilimab, a highly specific fully humanized IgG4 monoclonal antibody, functions by obstructing the binding site of PD-1. It has been shown to be effective in the treatment of a variety of tumors, including HNSCC ( 50 ). Anti-angiogenic treatment may also benefit patients with sarcomatoid carcinoma. Kong et al. reported sustained remission in patients with advanced LSC through the application of apatinib in combination with chemotherapy ( 51 ). In addition, anlotinib has exhibited positive clinical outcomes in patients with LCS ( 32 , 43 ). Anlotinib, a new oral tyrosine kinase inhibitor (TKI), targets platelet-derived growth factor receptor, fibroblast growth factor receptor, and vascular endothelial growth factor receptor. It has obtained approval for NSCLC, soft tissue sarcoma, and medullary thyroid carcinoma ( 52 ). The clinical benefit for our patients was probably due to the coordinated effect of anti-angiogenic drugs in combination with ICIs. Anlotinib promoted the normalization of tumor vasculature, improved the tumor microenvironment(TME), which changed the immunosuppressive TME into an immunostimulatory TME, and inhibited tumor growth. Additionally, anlotinib can reverse the immunosuppression induced by PD-1 inhibitors, prolonging the time of vascular normalization, and ultimately lead to the elimination of tumors ( 53 ). As far as we know, it’s the first case that SC of HC was treated with sintilimab and anlotinib, and the patient sustained PR. Unfortunately, the patient refused genetic testing and we were unable to learn more about the mutation status. A phase II clinical trial is underway ( https://classic.clinicaltrials.gov/ct2/show/NCT05265793 ), enrolling patients with untreated advanced SC to evaluate the effect of first-line karelizumab combination with apatinib treatment, and we look forward to the publication of their results.

Although the efficacy of immunotherapy in SC seems to be satisfactory, accurate biomarkers are still needed to predict the efficacy of ICIs treatment. Current research hotspots mainly include PD-L1 expression, TMB mutations, etc. ( Table 1 ). The effect and mechanism of PD-L1 expression in SC are not clear. However, recent studies have shown that PFS was significantly increased in the PD-L1 ≥ 1% group compared with the PD-L1 < 1% group in SC treated with ICIs (14.4 months vs. 2.7 months). In addition, there was a positive correlation between the expression of PD-L1 and the effectiveness of immunotherapy. Higher levels of PD-L1 expression resulting in better efficacy. A retrospective study showed ORR of 33.3%, 72.7%, and 85.7%, and mPFS of 6.0, 6.7, and 10.3 months in patients with PD-L1 TPS <1%, 1-49%, and ≥50%, respectively ( 49 , 54 ).

TMB is a marker for predicting the efficacy of ICIs. The KEYNOTE-012 trial showed a correlation between TMB values and clinical response in patients with HCSCC. Patients with high TMB had a higher PFS, which was not associated with PD-L1 expression ( 55 ). Doomblides, C et al. showed a report on LSC that patients with high TMB had a median OS of 18 months, while the low TMB population had only 1.84 months ( 48 ). Other case reports of sarcomatoid carcinoma have also shown a longer survival time with a higher TMB ( 32 , 43 , 56 , 57 ).The median value of TMB in patients with sarcomatoid carcinoma of the head and neck was 4.34 (0.71-14.71) muts/Mb, and TMB was significantly higher in patients with advanced stages compared to those with early stages ( 20 ). However, the relationship between TMB and immunotherapy in patients with sarcomatoid carcinoma of the head and neck has not been confirmed.

In a small sample, gene sequencing showed that 62% of patients with SC of HN had a CDKN2 mutation, which may be a positive biomarker for response to targeted CDK4/6 inhibitors in patients with advanced SC of HN. Moreover, they found that more than 50% of patients had at least one mutation in RTK such as EGFR, ALK, MET, suggesting that multiple targeting drugs approved may improve the long-term survival of patients with SC of HN. For example, a patient with SC of HN with an ALK translocation had stable disease for more than 4 months after treatment with crizotinib ( 20 , 58 ).

In this case, the patient experienced a grade 2 adverse drug reaction of hypothyroidism during the course of treatment. As it was not possible to determine which specific medication caused the reaction, we decided to temporarily suspend the anti-tumor therapy and initiate thyroid hormone replacement therapy. After one month of treatment, the patient’s thyroid function recovered to a grade 1 level, and subsequently, we resumed the anti-tumor treatment. Hypothyroidism is one of the most common endocrine diseases in ICIs therapy, usually occur within 3 weeks to 10 months after the start of ICIs treatment. Studies have indicated that the incidence of hypothyroidism when using PD-1 inhibitors alone ranges from 3.9% to 8.5%, while it increases to 10.2% to 16.4% with combination ICIs therapy ( 59 ). It is important to note that our patient did not experience any severe immune-related adverse reactions aside from hypothyroidism. Common adverse effects associated with the use of anlotinib include hypertension, hand-foot syndrome, hypothyroidism, fatigue, and diarrhea ( 60 ). Yu et al. conducted a retrospective study showing that hypothyroidism and liver function abnormalities were the most frequently observed adverse reactions in patients receiving ICIs combined with anlotinib for small cell lung cancer treatment ( 61 ). In this case, the concurrent use of sintilimab and anlotinib seems to increase the risk of developing hypothyroidism. Therefore, we regularly monitor indicators such as liver function, kidney function, cardiac enzyme profile, thyroid function, adrenal cortex function, and blood pressure to prevent and promptly manage potential adverse reactions.

Overall, although previous studies have shown that the average survival of patients with advanced head and neck sarcomatoid carcinoma with recurrent metastases is in the range of 2-5 months, our patient achieved good local control after receiving first-line antitumor therapy with anlotinib in combination with sintilimab, and is still in PR. Therefore, based on this case and previous studies, we propose that antiangiogenic agents combined with ICIs may be an effective strategy for the treatment of patients with advanced sarcomatoid carcinoma of the head and neck. This regimen has the potential to significantly improve patients’ quality of life and prolong survival time. Of course, there are some limitations in this case. Firstly, only one patient was reported in this paper and the limited data failed to analyze the genetic mutation status of the patient. In the future, we need more large-scale randomized controlled trials to study the efficacy and safety of ICIs in patients with sarcomatoid carcinoma of the head and neck.

Data availability statement

The original contributions presented in the study are included in the article/supplementary material. Further inquiries can be directed to the corresponding author.

Ethics statement

Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.

Author contributions

LW: Writing – original draft, Writing – review & editing. YH: Writing – review & editing. XS: Writing – original draft, Writing – review & editing.

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

1. Xu X, Lin M, Wang S, Jin Z, Han S, Liu X, et al. Lung sarcomatoid carcinoma metastasis to skin: A case report and review of the literature. Cancer Invest . (2016) 34:286–92. doi: 10.1080/07357907.2016.1193744

PubMed Abstract | CrossRef Full Text | Google Scholar

2. Raychaudhuri R, Riese MJ, Bylow K, Burfeind J, Mackinnon AC, Tolat PP, et al. Immune check point inhibition in sarcomatoid renal cell carcinoma: A new treatment paradigm. Clin Genitourin cancer . (2017) 15:e897–901. doi: 10.1016/j.clgc.2017.05.018

3. Naser ZJ, Morrissey S. Sarcomatoid carcinoma of the ascending colon: A case report and literature review. Am J Case Rep . (2022) 23:e937548. doi: 10.12659/AJCR.937548

4. Ren S, Feng H, Bao Y, Wei Y, Ou Y, Wang Y, et al. Ureteral urothelial carcinoma with squamous cell carcinoma and sarcomatoid carcinoma differentiation: a case report. BMC Surg . (2021) 21:96. doi: 10.1186/s12893-021-01099-1

5. Jain A, Dhandapani S, Meher R, Khurana N. Sarcomatoid carcinoma of larynx: A rare case. Indian J Otolaryngol Head Neck Surg . (2023) 75:3825–9. doi: 10.1007/s12070-023-03880-5

6. Shi Y, Chen J, Chen H, Hong X. Sarcomatoid carcinoma of the gallbladder: a case report. J Int Med Res . (2020) 48:300060520935283. doi: 10.1177/0300060520935283

7. Sintra S, Costa R, Filipe C, Simão A. Intrahepatic sarcomatoid cholangiocarcinoma. BMJ Case Rep . (2018) 2018:bcr2018225017. doi: 10.1136/bcr-2018-225017

8. Liaw TY. Primary cutaneous sarcomatoid carcinoma presenting as a rapidly-growing and ulcerative tumor of the skin. Kaohsiung J Med Sci . (2017) 33:315–7. doi: 10.1016/j.kjms.2017.03.006

9. Chang NJ, Kao DS, Lee LY, Chang JW, Hou MM, Lam WL, et al. Sarcomatoid carcinoma in head and neck: a review of 30 years of experience–clinical outcomes and reconstructive results. Ann Plast Surg . (2013) 71 Suppl 1:S1–7. doi: 10.1097/SAP.0000000000000069

10. Guo X, Liu L, Wang J, Chen L, Sang J, Cao H, et al. [Clinical analysis of 17 cases of sarcomatoid carcinoma of head and neck]. Lin chuang er bi yan hou tou jing wai ke za zhi = J Clin otorhinolaryngology head Neck Surg . (2022) 36:125–9. doi: 10.13201/j.issn.2096-7993.2022.02.010

CrossRef Full Text | Google Scholar

11. Viswanathan S, Rahman K, Pallavi S, Sachin J, Patil A, Chaturvedi P, et al. Sarcomatoid (spindle cell) carcinoma of the head and neck mucosal region: a clinicopathologic review of 103 cases from a tertiary referral cancer centre. Head Neck Pathol . (2010) 4:265–75. doi: 10.1007/s12105-010-0204-4

12. Perrone F, Bossi P, Cortelazzi B, Dagrada GP, Paielli N, Licitra L, et al. Absence of ALK and MET alterations in head and neck sarcomatoid carcinoma. Oral Oncol . (2016) 58:e4–5. doi: 10.1016/j.oraloncology.2016.05.015

13. Liu X, Wang F, Xu C, Chen X, Hou X, Li Q, et al. Genomic origin and intratumor heterogeneity revealed by sequencing on carcinomatous and sarcomatous components of pulmonary sarcomatoid carcinoma. Oncogene . (2021) 40:821–32. doi: 10.1038/s41388-020-01573-9

14. Oktay M, Kokenek-Unal TD, Ocal B, Saylam G, Korkmaz MH, Alper M. Spindle cell carcinoma of the tongue: a rare tumor in an unusual location. Pathol Res Int . (2011) 2011:572381. doi: 10.4061/2011/572381

15. Dai L, Fang Q, Li P, Liu F, Zhang X. Oncologic outcomes of patients with sarcomatoid carcinoma of the hypopharynx. Front Oncol . (2019) 9:950. doi: 10.3389/fonc.2019.00950

16. Blum KA, Gupta S, Tickoo SK, Chan TA, Russo P, Motzer RJ, et al. Sarcomatoid renal cell carcinoma: biology, natural history and management. Nat Rev Urol . (2020) 17:659–78. doi: 10.1038/s41585-020-00382-9

17. Dubal PM, Marchiano E, Kam D, Dutta R, Kalyoussef E, Baredes S, et al. Laryngeal spindle cell carcinoma: A population-based analysis of incidence and survival. Laryngoscope . (2015) 125:2709–14. doi: 10.1002/lary.25383

18. Ağaçkıran Y, Aksu F, Akyürek N, Ercan C, Demiröz M, Aksu K. Programmed death ligand-1 expression levels, clinicopathologic features, and survival in surgically resected sarcomatoid lung carcinoma. Asia-Pacific J Clin Oncol . (2021) 17:280–8. doi: 10.1111/ajco.13460

19. Joseph RW, Millis SZ, Carballido EM, Bryant D, Gatalica Z, Reddy S, et al. PD-1 and PD-L1 expression in renal cell carcinoma with sarcomatoid differentiation. Cancer Immunol Res . (2015) 3:1303–7. doi: 10.1158/2326-6066.CIR-15-0150

20. Chen HB, Gong XY, Li W, Chen DS, Zhao LL, Li S, et al. Genomic landscape and tumor mutation burden analysis of Chinese patients with sarcomatoid carcinoma of the head and neck. Oral Oncol . (2021) 121:105436. doi: 10.1016/j.oraloncology.2021.105436

21. Gounant V, Brosseau S, Naltet C, Opsomer MA, Antoine M, Danel C, et al. Nivolumab-induced organizing pneumonitis in a patient with lung sarcomatoid carcinoma. Lung Cancer (Amsterdam Netherlands) . (2016) 99:162–5. doi: 10.1016/j.lungcan.2016.07.010

22. Salati M, Baldessari C, Calabrese F, Rossi G, Pettorelli E, Grizzi G, et al. Nivolumab-induced impressive response of refractory pulmonary sarcomatoid carcinoma with brain metastasis. Case Rep Oncol . (2018) 11:615–21. doi: 10.1159/000492666

23. Kotlowska MP, Rueda AG, Olmedo ME, Benito A, Roldán AS, Fernandez Méndez MA, et al. Efficacy of immunotherapy in sarcomatoid lung cancer, a case report and literature review. Respir Med Case Rep . (2019) 26:310–4. doi: 10.1016/j.rmcr.2019.02.017

24. Roesel C, Kambartel K, Kopeika U, Berzins A, Voshaar T, Krbek T. Lazarus-type tumour response to therapy with nivolumab for sarcomatoid carcinomas of the lung. Curr Oncol (Toronto Ont) . (2019) 26:e270–e3. doi: 10.3747/co.26.4377

25. Sukrithan V, Sandler J, Gucalp R, Gralla R, Halmos B. Immune checkpoint blockade is associated with durable responses in pulmonary sarcomatoid carcinoma. Clin Lung cancer . (2019) 20:e242–e6. doi: 10.1016/j.cllc.2018.12.013

26. Chen P, Yu M, Zhang JL, Chen WY, Zhu L, Song Y, et al. Significant benefits of pembrolizumab in treating refractory advanced pulmonary sarcomatoid carcinoma: A case report. World J Clin cases . (2020) 8:2876–84. doi: 10.12998/wjcc.v8.i13.2876

27. Kong F, Wang W, Gong L, Wu W, Liu Y. Anti-PD-1 antibody camrelizumab plus doxorubicin showed durable response in pulmonary sarcomatoid carcinoma: Case report and literature review. J Clin Pharm Ther . (2020) 45:1489–96. doi: 10.1111/jcpt.13234

28. Jin C, Yang B. Dramatic response of pulmonary sarcomatoid carcinoma to nivolumab combined with anlotinib: A case report. Case Rep Oncol . (2020) 13:601–5. doi: 10.1159/000507568

29. Nishino K, Kunimasa K, Kimura M, Inoue T, Tamiya M, Kuhara H, et al. Favorable response to pembrolizumab after durvalumab failure in a stage III sarcomatoid carcinoma of the lung: a case report. BMC Pharmacol Toxicol . (2020) 21:26. doi: 10.1186/s40360-020-00404-7

30. Taniguchi H, Takemoto S, Ozasa M, Honda N, Suyama T, Umeyama Y, et al. Remarkable response to pembrolizumab with platinum-doublet in PD-L1-low pulmonary sarcomatoid carcinoma: A case report. Thorac cancer . (2021) 12:1126–30. doi: 10.1111/1759-7714.13890

31. Jiao Y, Liu M, Luo N, Guo H, Li J. Successful treatment of advanced pulmonary sarcomatoid carcinoma with the PD-1 inhibitor toripalimab: A case report. Oral Oncol . (2021) 112:104992. doi: 10.1016/j.oraloncology.2020.104992

32. Li YF, Zhao XF, Tian Y, Xiao XY, Yan CY, Shen H. Case Report: Pulmonary sarcomatoid carcinoma complicating TP53 mutation treated successfully with Tislelizumab combined with Anlotinib-a case report. Front Genet . (2022) 13:949989. doi: 10.3389/fgene.2022.949989

33. Piao MN, Ma XT, Tankere P, Liam CK, Li JL, Wang JP. Anlotinib combined with chemotherapy and immunotherapy for advanced pulmonary sarcomatoid cancer: a case report and literature review. Ann Trans Med . (2022) 10:1030. doi: 10.21037/atm

34. Sawatari K, Izumi M, Sone R, Hattori T, Sugimoto A, Eguchi Y, et al. A case of PD-L1 negative advanced pulmonary sarcomatoid carcinoma effectively treated with atezolizumab, carboplatin, paclitaxel, and bevacizumab. Respir Med Case Rep . (2022) 36:101579. doi: 10.1016/j.rmcr.2022.101579

35. Wan Y, Wang Z, Yang N, Liu F. Treatment of multiple primary Malignancies with PD-1 inhibitor camrelizumab: A case report and brief literature review. Front Oncol . (2022) 12:911961. doi: 10.3389/fonc.2022.911961

36. Xu L, Tao NN, Liang B, Li DW, Li HC, Su LL. Use of PD-1 inhibitor tislelizumab in the treatment of advanced pulmonary sarcomatoid carcinoma: A case report. Thorac cancer . (2022) 13:502–5. doi: 10.1111/1759-7714.14290

37. Tolay S, Nair R, McIntosh AF, Sopka DM, Nair SG. Dramatic response to concurrent anti-PD-1 therapy and radiation in resistant tumors with sarcomatoid differentiation. oncologist . (2019) 24:e49–52. doi: 10.1634/theoncologist.2018-0205

38. Hino C, Nishino K, Pham B, Jeon WJ, Nguyen M, Cao H. Nivolumab plus ipilimumab induced endocrinopathy and acute interstitial nephritis in metastatic sarcomatoid renal-cell carcinoma: A case report and review of literature. Front Immunol . (2022) 13:993622. doi: 10.3389/fimmu.2022.993622

39. Tomioka M, Nakane K, Ozawa K, Iinuma K, Suzui N, Miyazaki T, et al. A case of multiple metastatic sarcomatoid renal cell carcinoma with complete response to nivolumab. Cancer Rep (Hoboken NJ) . (2021) 4:e1356. doi: 10.1002/cnr2.1356

40. Fuu T, Iijima K, Kusama Y, Otsuki T, Kato H. Complete response to combination therapy using nivolumab and ipilimumab for metastatic, sarcomatoid collecting duct carcinoma presenting with high expression of programmed death-ligand 1: a case report. J Med Case Rep . (2022) 16:193. doi: 10.1186/s13256-022-03426-3

41. Anraku T, Hashidate H, Nakahara A, Imai T, Kawakami Y. Sarcomatoid urothelial carcinoma of the renal pelvis treated with immunotherapy. BMC Urol . (2023) 23:38. doi: 10.1186/s12894-023-01210-z

42. Qiu H, Hao CY. Neoadjuvant therapy for sarcomatoid carcinoma of the pancreas: a case report and review of the literature. J Med Case Rep . (2023) 17:293. doi: 10.1186/s13256-023-04006-9

43. Zhu S, Yu C, Wang C, Ding G, Cheng S. Case report: Significant benefits of tislelizumab combined with anlotinib in first-line treatment of metastatic renal pelvic urothelial carcinoma with sarcomatoid carcinoma differentiation. Front Oncol . (2022) 12:969106. doi: 10.3389/fonc.2022.969106

44. Zhang L, Chen L, Xiao M, Xie X, Wang F. Locally advanced undifferentiated sarcomatoid carcinoma of the right maxillary sinus with PDCD6-TERT fusion: A rare case report. Oral Oncol . (2022) 124:105466. doi: 10.1016/j.oraloncology.2021.105466

45. Wang Z, Jiang Z, Yang Y, Li J, Zhang C, Liu Z. [A case of tonsil sarcomatoid carcinoma]. Lin chuang er bi yan hou tou jing wai ke za zhi = J Clin otorhinolaryngology head Neck Surg . (2020) 34:183–5. doi: 10.13201/j.issn.1001-1781.2020.02.021

46. Qian X, Wang Y, Liu F, Yuan Y, Fang C, Zhang X, et al. The efficacy and safety analysis of first-line immune checkpoint inhibitors in pulmonary sarcomatoid carcinoma. Front Immunol . (2022) 13:956982. doi: 10.3389/fimmu.2022.956982

47. Wei JW, Hao Y, Xiang J, Pu XX, Wang LP, Jiang ZS, et al. The prognostic impact of immune checkpoint inhibitors for the treatment of pulmonary sarcomatoid carcinoma: A multicenter retrospective study. Neoplasma . (2022) 69:1437–44. doi: 10.4149/neo_2022_220617N644

48. Domblides C, Leroy K, Monnet I, Mazières J, Barlesi F, Gounant V, et al. Efficacy of immune checkpoint inhibitors in lung sarcomatoid carcinoma. J Thorac Oncol . (2020) 15:860–6. doi: 10.1016/j.jtho.2020.01.014

49. Zhou F, Guo H, Zhou X, Xie H, Tian T, Zhao W, et al. Immune checkpoint inhibitors plus chemotherapy in patients with locally advanced or metastatic pulmonary sarcomatoid carcinoma: a multicentric real-world study. Ther Adv Med Oncol . (2022) 14:17588359221136759. doi: 10.1177/17588359221136759

50. Li X, Fang Q, Du W, Zhang X, Dai L, Qiao Y. Induction chemotherapy combined with immunotherapy in locally advanced head and neck squamous cell carcinoma. BMC cancer . (2021) 21:622. doi: 10.1186/s12885-021-08373-8

51. Kong FW, Wang WM, Liu L, Wu WB, Wang X, Zhang M. First-line albumin-bound paclitaxel/carboplatin plus apatinib in advanced pulmonary sarcomatoid carcinoma: A case series and review of the literature. Medicine . (2020) 99:e20667. doi: 10.1097/MD.0000000000020667

52. Li S. Anlotinib: A novel targeted drug for bone and soft tissue sarcoma. Front Oncol . (2021) 11:664853. doi: 10.3389/fonc.2021.664853

53. Su Y, Luo B, Lu Y, Wang D, Yan J, Zheng J, et al. Anlotinib induces a T cell-inflamed tumor microenvironment by facilitating vessel normalization and enhances the efficacy of PD-1 checkpoint blockade in neuroblastoma. Clin Cancer Res . (2022) 28:793–809. doi: 10.1158/1078-0432.CCR-21-2241

54. Babacan NA, Pina IB, Signorelli D, Prelaj A, Garassino MC, Tanvetyanon T. Relationship between programmed death receptor-ligand 1 expression and response to checkpoint inhibitor immunotherapy in pulmonary sarcomatoid carcinoma: A pooled analysis. Clin Lung cancer . (2020) 21:e456–e63. doi: 10.1016/j.cllc.2020.02.022

55. Haddad RI, Seiwert TY, Chow LQM, Gupta S, Weiss J, Gluck I, et al. Influence of tumor mutational burden, inflammatory gene expression profile, and PD-L1 expression on response to pembrolizumab in head and neck squamous cell carcinoma. J Immunother Cancer . (2022) 10:e003026. doi: 10.1136/jitc-2021-003026

56. Wen Y, Dong Y, Yi L, Yang G, Xiao M, Li Q, et al. Anlotinib combined with pembrolizumab as first-line treatment for advanced pulmonary sarcomatoid carcinoma: a case report and literature review. Front Oncol . (2023) 13:1241475. doi: 10.3389/fonc.2023.1241475

57. Wu S, Wu S, Liao X, Zhou C, Qiu F, Wang C, et al. Pembrolizumab combined with anlotinib improves therapeutic efficacy in pulmonary sarcomatoid carcinoma with TMB-H and PD-L1 expression: a case report and literature review. Front Immunol . (2023) 14:1274937. doi: 10.3389/fimmu.2023.1274937

58. Kim SM, Kim MJ, Jung HA, Sun JM, Choi YL, Ko YH, et al. Presence of anaplastic lymphoma kinase translocation in sarcomatoid carcinoma of head and neck and treatment effect of crizotinib: A case series. Head neck . (2015) 37:E66–9. doi: 10.1002/hed.v37.5

59. Karaviti D, Kani ER, Karaviti E, Gerontiti E, Michalopoulou O, Stefanaki K, et al. Thyroid disorders induced by immune checkpoint inhibitors. Endocrine . (2024). doi: 10.1007/s12020-024-03718-2

60. Li S, Wang H. Research progress on mechanism and management of adverse drug reactions of anlotinib. Drug design Dev Ther . (2023) 17:3429–37. doi: 10.2147/DDDT.S426898

61. Yu L, Xu J, Qiao R, Han B, Zhong H, Zhong R. Efficacy and safety of anlotinib combined with PD-1/PD-L1 inhibitors as second-line and subsequent therapy in advanced small-cell lung cancer. Cancer Med . (2023) 12:5372–83. doi: 10.1002/cam4.5360

Keywords: sarcomatoid carcinoma, head and neck, anlotinib, sintilimab, immune checkpoint inhibitors

Citation: Wang L, Huang Y and Sun X (2024) Sintilimab combined with anlotinib as first-line treatment for advanced sarcomatoid carcinoma of head and neck: a case report and literature review. Front. Oncol. 14:1362160. doi: 10.3389/fonc.2024.1362160

Received: 27 December 2023; Accepted: 10 April 2024; Published: 24 April 2024.

Reviewed by:

Copyright © 2024 Wang, Huang and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Xin Sun, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

• Case Report
• Open access
• Published: 24 April 2024

Disseminated mycobacterium genavense infection with central nervous system involvement in an HIV patient: a case report and literature review

• Ali Hassanzadeh   ORCID: orcid.org/0000-0002-0734-3888 1 ,
• Malihe Hasannezhad   ORCID: orcid.org/0000-0002-2412-1208 1 , 2 ,
• Ladan Abbasian   ORCID: orcid.org/0000-0003-3206-8053 1 , 2 ,
• Sara Ghaderkhani   ORCID: orcid.org/0000-0001-7604-151X 1 , 2 ,
• Fereshteh Ameli   ORCID: orcid.org/0000-0001-7441-7675 3 &
• Mehdi Allahdadi   ORCID: orcid.org/0009-0000-9612-6123 1  

BMC Infectious Diseases volume  24 , Article number:  437 ( 2024 ) Cite this article

Metrics details

Immunodeficient patients, particularly HIV patients, are at risk of opportunistic infections. Nontuberculous mycobacteria can cause severe complications in immunodeficient patients.

Case Presentation

We describe a 57-year-old HIV patient, primarily presented with coughs and constitutional symptoms, with a unique Mycobacterium genavense abdominal, pulmonary, and central nervous system infection, accompanied by intracranial masses.

The diagnosis of NTM, including M. genavense , must always be considered by clinicians in immunodeficient patients, especially those with HIV, who have a compromised immune system.

Peer Review reports

Nontuberculous mycobacterial (NTM) infections are a major concern for HIV-infected patients. Their main habitats in the environment are water sources and dust [ 1 ] and they can infect multiple organs in the host [ 2 ]. Mycobacterium genavense ( M. genavense ) is reported to be responsible for more than 10% of disseminated NTM infections [ 3 , 4 ]. Abdominal organs, including lymph nodes, liver, spleen and gastrointestinal tracts are the main targets for M. genavense infection [ 5 ]. Despite the improvements in survival by antiretroviral therapies (ART) in the recent years, the prognosis of this infection remains poor [ 5 ] due to the long treatment periods and high prevalence of side effects, plus non-specific diagnostic and treatment tools [ 6 , 7 , 8 ].

The disseminated presentation of the infection has been repeatedly reported across the world; however, involvement of the central nervous system (CNS) is rarely observed. In this paper, we will discuss a case admitted to our center and review the published literature to investigate the diagnostic means of this unique form of infection.

Case presentation

Our patient is a 57-year-old male, with a four-month history of HIV infection (CD4 count = 10/µL, HIV viral load > 3,000,000 copies/ml) and cytomegalovirus (CMV) retinitis, who complained of worsening fatigue and nausea for two months. He also complained of progressive unintentional weight loss (over 30 kg in this period) and a productive cough. No vision or sensory symptoms was reported. Additionally, there was no evidence of fever, loss of consciousness, or cognitive-behavioral demonstration; however, he had given a history of disrupted gait. Although, the neurological (i.e., finger-to-nose, heel-to-shin, and limb forces) and meningitis tests (i.e., neck stiffness, Brudzinski’s and Kernig’s signs) were normal. This could be related to the severe generalized weakness, as no neurological deficit was identified. He was on a drug regimen consisting of Truvada® (emtricitabine 200 mg– tenofovir disoproxil 300 mg) q24h, dolutegravir 50 mg q24h, and valganciclovir 450 mg q12h and was compliant with treatment. Laboratory results showed a pancytopenia (WBC = 1,500/µL, Hb = 6 g/dL, and platelets = 125,000/µL) and elevated CRP level of 92 mg/L. Lung CT-scan showed a 9 mm×6 mm nodule in the right middle lobe and a tree-in-bud pattern at the lower levels of the left lung (Fig.  1 ). Abdominal ultrasound investigation revealed an enlarged spleen (15.5 cm), multiple enlarged paraaortic lymph nodes, and a 7 mm lymph node in the porta hepatis .

Pulmonary nodule (white arrow) and tree-in-bud pattern (circled area) in the chest CT scan

A cerebrospinal fluid (CSF) analysis indicated a decreased glucose level (24 mg/dL) as well as a normal protein level of 28 mg/dL and a WBC count of 0–1/L. Acid fast bacilli (AFB) staining in both sputum and CSF was positive. Viral, namely CMV and varicella zoster virus, and fungal diagnostic tests on the CSF specimen for probable agents were negative. No pathological finding in brain MRI was observed at this stage. Considering Mycobacterium tuberculosis (MTB) infection, we started an anti-MTB empirical treatment, consisting of isoniazid, pyrazinamide, ethambutol, and rifampin (liver function tests were normal). Due to the pharmacokinetic interactions of rifampin and dolutegravir [ 9 ], we increased the dose of dolutegravir to 50 mg q12 h. No MTB growth was observed in the culture and GeneXpert® molecular tests of sputum and CSF were negative for MTB, raising the probability of NTM infection. Due to low blood cell counts, lymphadenopathy, and splenomegaly, we performed a simultaneous bone marrow biopsy and observed foamy histiocytes and NTM presence (AFB staining positive and GeneXpert® negative) (Fig.  2 ). Clarithromycin was added to the previous regimen, for NTM infection coverage. At this stage, the results of previously-requested NTM polymerase chain reaction (PCR) analysis from the CSF specimen detected M. genavense presence (complete match to hsp65 gene) (Fig.  3 ). Considering the NTM infection in the respiratory system and bone marrow, and M. genavense meningitis, we made a disseminated M. genavense infection diagnosis. The patient was discharged with NTM combinational drug treatment (five-drug) accompanied by ART and valganciclovir as his medical condition was stable.

Pathology sections of bone marrow biopsy specimen; Low magnification of bone marrow biopsy shows replacement of hematopoietic elements by numerous foamy macrophages (circled area) arranged in sheet (H&E section, x40 & x100). Higher magnification reveals histiocytes (circled area) containing abundant organisms (H&E section x400). Frequent positive acid-fast bacilli (white arrows) were present in foamy macrophages on Ziehl-Nielsen stain (x400)

hsp65 gene sequencing

Four months later he presented with generalized fatigue and anorexia, while claiming he had not consumed the NTM prescription appropriately; however, he was compliant with ART and valganciclovir. There were no abnormal findings in the examinations. CD4 count was 13/µL and lung CT scan prevailed that the tree-in-bud pattern vanished but the nodule was present with no significant size change. According to his previous history, we requested a brain MRI, which showed a right hemispherical mass in the corpus callosum with mass effects on the ventricle, accompanied by edema and two lesions in both hemispheres of the cerebellum (Fig.  4 ). The patient did not consent for a cerebral biopsy to investigate potential diagnoses, such as toxoplasmosis and malignancies. However, considering the previously confirmed presence of M. genavense in CNS and poor Anti-NTM regimen compliance, the intracranial masses were most likely formed in the background of disseminated M. genavense infection. Anti-NTM drug combinations (ethambutol 1,200 mg q24h, rifampin 600 mg q24h, clarithromycin 500 mg q12h, levofloxacin 750 mg q24h, and amikacin 1,000 mg q24h) were initiated in conjunction with ART, valganciclovir, and prophylactic trimethoprim-sulfamethoxazole. We started dexamethasone eight mg q12h for perilesional edema. The next MRI within one week showed that the edema had regressed and reduced cerebral mass size, favoring the diagnosis. After the treatment, his clinical progression was desirable and he was discharged with the same prescriptions as of admission (except for amikacin, which was discontinued due to a rise in serum creatinine up to 1.8 mg/dL, and then improved before discharge to baseline by discontinuing the drug and hydrating). Dexamethasone was replaced by prednisolone, which was tapered gradually over the following weeks. Three months later, his symptoms were relieved, his drug compliance was complete, and he was clinically stable (Fig.  5 ).

Brain MRI reveals a right sided mass (white arrowheads) in the corpus callosum with perilesional edema (white arrows) and mass effects on the ventricle, and two lesions (white arrowheads) in the hemispheres of cerebellum accompanied by edema (white arrows). [Left to right: T1 with gadolinium contrast, T2, and FLAIR views]

Clinical course of the patient (HRZE: anti-TB therapy combination including isoniazid, rifampin, pyrazinamide, and ethambutol; TMP-SMX: trimethoprim-sulfamethoxazole

Discussion and conclusions

M. genavense is one of the most common causes of mycobacterial infections in avians, especially parrots [ 10 ]. Colonization of M. genavense in the human body is common and almost always does not result in disease; however, a case of disseminated infection has recently been published in a previously healthy pet keeper, hypothesizing the zoonotic transmission probability [ 11 ]. As a widespread family, NTM could be isolated from various specimens due to colonization or specimen contamination [ 12 , 13 ]. M. genavense has been detected more frequently in HIV patients [ 5 , 12 ]. Despite this fact, multiple reports have discussed M. genavense infection in non-HIV immunodeficiencies, namely sarcoidosis, solid organ recipients, and primary immunodeficiencies [ 14 , 15 , 16 , 17 ]. Diagnostic and treatment challenges are the most significant challenges in disease management.

As well as constitutional symptoms, M. genavense commonly manifests symptoms involving the gastrointestinal and abdominal organs, including abdominal pain, hepatosplenomegaly, and lymphadenopathy [ 3 , 5 ]. Thomsen et al. have hypothesized that more frequent abdominal manifestations might be a result of the presence of the microorganism in the GI tract of the infected [ 18 ]. Only a few cases with M. genavense CNS involvement have been reported worldwide. After a systematic literature review in PubMed, Embase, and Web of Science online databases with ‘Genavense’ AND ‘HIV’ keywords, we have identified seven cases with background immunodeficiency plus CNS M. genavense infection. Five cases were HIV infected [ 19 , 20 , 21 , 22 , 23 ] and the remaining two were primary immunodeficiency cases (including a case of hypogammaglobulinemia [ 24 ] and an Adenosine Deaminase deficiency patient with a history of gastrointestinal M. genavense infection [ 25 ]). Table  1 provides the main clinical and laboratory characteristics of HIV cases with M. genavense CNS involvement.

Our case is the sixth reported HIV case with M. genavense CNS involvement. Previously, the microorganism was isolated from the CSF of two cases [ 20 , 23 ], and one developed a cerebral mass without other organ involvement [ 23 ]. Other three cases suffered from intracranial masses, but their CSF were not examined [ 19 , 21 , 22 ]. One of these patients had simultaneous lung nodule and pleural involvement [ 22 ], while the authors of the remaining studies did not address further involvement [ 19 , 21 ]. The present case is a composite abdominal, pulmonary, and CNS infection caused by M. genavense , accompanied by intracranial lesions, which is unique. Disseminated M. genavense diagnosis was highly plausible in this case due to the synchronicity of M. genavense isolation from CNS, and pulmonary and bone marrow NTM involvement. Also, due to the history of CNS involvement and poor drug compliance, the intracranial masses are likely to be related to the M. genavense background; However further measures would be mandatory in the case of clinical course reverse or probable drug resistance. Interestingly, no neurological abnormality was present in physical examination in the second admission, similar to three of the previous cases [ 21 , 22 , 23 ]. This may originate from the chronic and insidious and chronic clinical progression of the NTM [ 26 , 27 ]. Imaging and pathology beside molecular tests play a key role in M. genavense infection confirmation. However, the diagnosis should be highly concerned when NTM infection is present (when culture and TB molecular tests are inconclusive) in an immune-compromised patient. Microbiology tests must rely on molecular assessments [ 28 ], as the time to identification in fortified growth media could be as long as 91 days or more [ 14 , 20 , 29 ].

Recent introduction of ART has improved overall survival significantly; however, M. genavense could be lethal [ 5 ]. Treatment of the disease remains controversial. A recent individual patient meta-analysis concluded that macrolides might be related to lower fatalities; and other agents, such as amikacin, have no significant association with survival [ 5 ]. It has been shown that azithromycin, ethambutol, and rifampicin combination may be effective for M. genavense lung disease [ 28 ].

CNS infection treatment knowledge is restricted to previous experiences. Kuczynski et al. and Berman et al. initiated corticosteroid and an anti-NTM regimen without mass resection and the patients were stable after nine [ 23 ] and twelve months [ 19 ]. The Belgian case died roughly two weeks after treatment (clarithromycin, ethambutol, rifabutin, moxifloxacin, and amikacin) due to unsteady hemodynamics and consciousness [ 20 ]. Toussi et al. performed lesion resection due to high pre- and intraoperative malignancy suspicion and no follow-up was provided [ 21 ]. Another case presented with pulmonary involvement of M. genavense with an incidental, asymptomatic intracranial mass. The patient underwent surgical lesion excision; nevertheless, his condition worsened and he died due to respiratory failure [ 22 ]. Our patient was primarily diagnosed with M. genavense meningitis with no pathologic findings on imaging. However, he developed multiple intracranial masses after months. Medication noncompliance might be a reason for this progression, and one reason is the high quantity of medications [ 30 , 31 ]. The NTM infection has a poor prognosis, with a mortality rate estimated at 32–39.3% among HIV patients [ 5 , 12 ], which illustrates the pathogen’s invasiveness and ineffective treatment methods. A recent systematic review of NTM CNS infections reported a 37.5% case fatality rate; although this review did not include any M. genavense cases [ 32 ].

Clinicians must always consider the diagnosis of NTM, including M. genavense , in immunodeficient patients, especially those with HIV. The outcomes remain unfavorable despite ART and antibiotic developments. Due to the low prevalence of the disease, no consensus management of CNS involvement is available. As we have reviewed, invasive CNS treatment must be decided according to medical status due to possible lack of effectiveness. Macrolides, ethambutol, and rifamycins might improve disseminated infection outcomes and should be considered first-line treatment. Further multicenter prospective studies might identify poor outcomes predictors.

Data availability

Not applicable.

Abbreviations

Nontuberculous Mycobacterium

Antiretroviral Therapy

Central Nervous System

Cytomegalovirus

Acid Fast Bacilli

Mycobacterium tuberculosis

Cerebrospinal Fluid

Polymerase Chain Reaction

Honda JR, Virdi R, Chan ED. Global Environmental Nontuberculous Mycobacteria and Their Contemporaneous Man-Made and Natural Niches. Front Microbiol 2018, 9:2029.

Sharma SK, Upadhyay V. Epidemiology, diagnosis & treatment of non-tuberculous mycobacterial diseases. Indian J Med Res. 2020;152(3):185–226.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Charles P, Lortholary O, Dechartres A, Doustdar F, Viard JP, Lecuit M, Gutierrez MC. Mycobacterium genavense infections: a retrospective multicenter study in France, 1996–2007. Med (Baltim). 2011;90(4):223–30.

Article   Google Scholar  

Pechère M, Opravil M, Wald A, Chave JP, Bessesen M, Sievers A, Hein R, von Overbeck J, Clark RA, Tortoli E, et al. Clinical and epidemiologic features of infection with Mycobacterium genavense. Swiss HIV Cohort Study. Arch Intern Med. 1995;155(4):400–4.

Article   PubMed   Google Scholar  

Wetzstein N, Kessel J, Bingold TM, Carney J, Graf C, Koch BF, Meier F, Baumgarten J, Küpper-Tetzel CP, Khodamoradi Y, et al. High overall mortality of Mycobacterium genavense infections and impact of antimycobacterial therapy: systematic review and individual patient data meta-analysis. J Infect. 2022;84(1):8–16.

Article   CAS   PubMed   Google Scholar  

Varley CD, Streifel AC, Bair AM, Winthrop KL. Nontuberculous Mycobacterial Pulmonary Disease in the immunocompromised host. Clin Chest Med. 2023;44(4):829–38.

Joao I, Bujdáková H, Jordao L. Opportunist coinfections by Nontuberculous Mycobacteria and Fungi in Immunocompromised patients. Antibiot (Basel) 2020, 9(11).

Gopalaswamy R, Shanmugam S, Mondal R, Subbian S. Of tuberculosis and non-tuberculous mycobacterial infections - a comparative analysis of epidemiology, diagnosis and treatment. J Biomed Sci. 2020;27(1):74.

Article   PubMed   PubMed Central   Google Scholar  

Dooley KE, Sayre P, Borland J, Purdy E, Chen S, Song I, Peppercorn A, Everts S, Piscitelli S, Flexner C. Safety, tolerability, and pharmacokinetics of the HIV integrase inhibitor dolutegravir given twice daily with rifampin or once daily with rifabutin: results of a phase 1 study among healthy subjects. J Acquir Immune Defic Syndr. 2013;62(1):21–7.

Palmieri C, Roy P, Dhillon AS, Shivaprasad HL. Avian mycobacteriosis in Psittacines: a retrospective study of 123 cases. J Comp Pathol. 2013;148(2–3):126–38.

Trauth J, Discher T, Fritzenwanker M, Imirzalioglu C, Arnold T, Steiner D, Richter E, Crisponi L, Grimbacher B, Herold S. Hodgkin Lymphoma after disseminated Mycobacterium genavense infection, Germany. Emerg Infect Dis. 2022;28(7):1506–9.

Ruas R, Abreu I, Nuak J, Ramos A, Carvalho T, Ribeiro M, Guimarães J, Sarmento A. Nontuberculous mycobacteria in a tertiary hospital in Portugal: a clinical review. Int J Mycobacteriology. 2017;6(4):344–8.

Schwenkenbecher P, Neyazi A, Donnerstag F, Ringshausen FC, Jacobs R, Stoll M, Kirschner P, Länger FP, Valizada E, Gingele S et al. Chronic granulomatous disease first diagnosed in adulthood presenting with spinal cord infection. Frontiers in Immunology 2018, 9(JUN).

Mahmood M, Ajmal S, Abu Saleh OM, Bryson A, Marcelin JR, Wilson JW. Mycobacterium genavense infections in non-HIV immunocompromised hosts: a systematic review. Infect Dis (Lond). 2018;50(5):329–39.

Denicolò S, Laydevant S, Fink J, Geiger C, Pizzini A, Sarcletti M, Zschocke J, Bellmann-Weiler R, Weiss G, Tancevski I. Sarcoid-like lesions obfuscating the diagnosis of disseminated Mycobacterium genavense infection in a patient with IL-12Rβ1-associated immunodeficiency. BMC Infect Dis. 2022;22(1):770.

Chen J, Nguyen M, Cheong E, Sean Riminton D, Reddel S. Refractory Mycobacterium genavense infection secondary to thymoma-associated endogenous IL-12 inhibitor. BMJ Neurol Open. 2022;4(1):e000285.

Baldolli A, Chocron R, Dargère S, Michon J, Daurel C, Thuillier-Lecouf A, Verdon R. Mycobacterium genavense infections in immunocompromised patients without HIV: Case Series of Solid Organ Transplant patients and Literature Review. Open Forum Infect Dis. 2022;9(10):ofac498.

Thomsen VO, Dragsted UB, Bauer J, Fuursted K, Lundgren J. Disseminated infection with Mycobacterium genavense: a challenge to physicians and mycobacteriologists. J Clin Microbiol. 1999;37(12):3901–5.

Berman SM, Kim RC, Haghighat D, Mulligan ME, Fierer J, Wyle FC. Mycobacterium genavense infection presenting as a solitary brain mass in a patient with AIDS: case report and review. Clin Infect Dis. 1994;19(6):1152–4.

Kyrilli A, Payen MC, Antoine-Moussiaux T, Dewit S, Clumeck N. Meningitis and splenic infarction due to disseminated Mycobacterium genavense infection in an HIV patient. Case report and review of the literature. Acta Clin Belg. 2013;68(3):220–2.

Toussi A, Goodarzi A, Kulubya E, Lee DJ, Waldau B. Mycobacterium Genavense Granuloma mimicking a brain tumor: a Case Report. Cureus. 2017;9(8):e1547.

PubMed   PubMed Central   Google Scholar  

Vazquez E, Nicita D, Masini D, Matteo M, Costa N, Franze O, Trione N, Corti M. Mycobacterium genavense: a rare cause of cerebral mass lesion. Neurologia Argentina 2022.

Kuczynski AM, Krajden S, Spears J, Kus JV, Munoz DG, Ostrowski M, Chen Y, Supala-Berger A. Mycobacterium genavense Central Nervous System infection in a patient with AIDS. Can J Neurol Sci. 2023;50(2):305–7.

Uchino H, Terasaka S, Yamaguchi S, Kobayashi H, Kawai K, Kubota K, Ooe S, Houkin K. [Multiple infectious intracranial lesions of Mycobacterium genavense in an immunocompromised patient]. Brain Nerve. 2011;63(1):79–83.

PubMed   Google Scholar  

Grunebaum E, Reid B, Naqvi A, Hershfield MS, Kim VH, Muller MP, Hicks LK, Lee E, Betschel S, Roifman CM. Morbidity in an adenosine deaminase-deficient patient during 27 years of enzyme replacement therapy. Clin Immunol. 2020;211:108321.

Winthrop KL, Chang E, Yamashita S, Iademarco MF, LoBue PA. Nontuberculous mycobacteria infections and anti-tumor necrosis factor-alpha therapy. Emerg Infect Dis. 2009;15(10):1556–61.

Ratnatunga CN, Lutzky VP, Kupz A, Doolan DL, Reid DW, Field M, Bell SC, Thomson RM, Miles JJ. The rise of Non-tuberculosis Mycobacterial Lung Disease. Front Immunol. 2020;11:303.

Lange C, Böttger EC, Cambau E, Griffith DE, Guglielmetti L, van Ingen J, Knight SL, Marras TK, Olivier KN, Santin M, et al. Consensus management recommendations for less common non-tuberculous mycobacterial pulmonary diseases. Lancet Infect Dis. 2022;22(7):e178–90.

Wilson ML, Stone BL, Hildred MV, Reves RR. Prolonged incubation of blood and bone marrow cultures in 12B bottles processed on the BACTEC 460 TB system does not increase microbial recovery. Diagn Microbiol Infect Dis. 1996;25(3):113–5.

Alsayed SSR, Gunosewoyo H. Tuberculosis: Pathogenesis, current treatment regimens and new drug targets. Int J Mol Sci 2023, 24(6).

Chiang CY, Centis R, Migliori GB. Drug-resistant tuberculosis: past, present, future. Respirology. 2010;15(3):413–32.

Meena DS, Kumar D, Meena V, Bohra GK, Tak V, Garg MK. Epidemiology, clinical presentation, and predictors of outcome in nontuberculous mycobacterial central nervous system infection: a systematic review. Trop Med Health. 2023;51(1):54.

Download references

Acknowledgements

No funding was received to assist with the preparation of this manuscript.

Author information

Authors and affiliations.

Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, End of Keshavarz Boulevard, 1419733141, Tehran, Iran

Ali Hassanzadeh, Malihe Hasannezhad, Ladan Abbasian, Sara Ghaderkhani & Mehdi Allahdadi

Iranian Research Center for HIV/AIDS, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

Malihe Hasannezhad, Ladan Abbasian & Sara Ghaderkhani

Department of Pathology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Fereshteh Ameli

You can also search for this author in PubMed   Google Scholar

Contributions

AH and MA drafted the primary manuscript. AH, MH, LA, SG, FA, and MA revised the manuscript. MH, LA, and SG were involved in the clinical management and follow-up of the patient. FA re-examined histopathology and reported the findings.

Corresponding author

Correspondence to Malihe Hasannezhad .

Ethics declarations

Ethics approval and consent to participate.

Informed consent was obtained from the patient. Imam Khomeini Hospital Complex Ethical Committee has approved this report under the code IR.TUMS.IKHC.REC.1402.276.

Consent for publication

Written informed consent was obtained from the patient for publication of case report and accompanying images.

Competing interests

The authors declare that they have no competing interests" in this section.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Hassanzadeh, A., Hasannezhad, M., Abbasian, L. et al. Disseminated mycobacterium genavense infection with central nervous system involvement in an HIV patient: a case report and literature review. BMC Infect Dis 24 , 437 (2024). https://doi.org/10.1186/s12879-024-09316-x

Download citation

Received : 03 November 2023

Accepted : 11 April 2024

Published : 24 April 2024

DOI : https://doi.org/10.1186/s12879-024-09316-x

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Mycobacterium genavense
• Central nervous system
• Case report

BMC Infectious Diseases

ISSN: 1471-2334

• Submission enquiries: [email protected]
• General enquiries: [email protected]