Isolated Renal Metastasis from Primary Lung Squamous Cell Carcinoma with Synchronous Small Cell Lung Cancer.

Synchronous multiple primary lung cancer is a unique type of lung carcinomas that are diagnosed with more than two different pathological types in the same or different lung lobes. Isolated metastasis to the kidney is considered rare. Herein, we present a case of a 58-year-old male with a history of chronic obstructive pulmonary disease (COPD) and 40 pack-year of cigarette smoking, who was diagnosed with synchronous small cell lung cancer (SCLC) and squamous cell carcinoma (SCC) with isolated metastasis to the kidney. Isolated kidney metastasis from lung cancer is an infrequent finding; it should be considered when the patient is diagnosed with lung cancer. In the absence of disseminated disease and contraindications, nephrectomy is an option for treatment with chemotherapy or as a palliative measure if the patient is symptomatic.

Different EGFR gene mutations in two patients with synchronous multiple lung cancers: A case report.

Routine clinical and pathological evaluations to determine the relationship between different lesions are often not completely conclusive. Interestingly, detailed genetic analysis of tumor samples may provide important additional information and identify second primary lung cancers. In the present study, we report cases of two synchronous lung adenocarcinomas composed of two distinct pathological subtypes with different EGFR gene mutations: a homozygous deletion in exon 19 of the papillary adenocarcinoma subtype and a point mutation of L858R in exon 21 of the tubular adenocarcinoma. The present report highlights the clinical importance of molecular cancer biomarkers to guide management decisions in cases involving multiple lung tumors.

Triple synchronous primary lung cancer: a case report and review of the literature.

BACKGROUND: Multiple primary lung cancer may present in synchronous or metachronous form. Synchronous multiple primary lung cancer is defined as multiple lung lesions that develop at the same time, whereas metachronous multiple primary lung cancer describes multiple lung lesions that develop at different times, typically following treatment of the primary lung cancer. Patients with previously treated lung cancer are at risk for developing metachronous lung cancer, but with the success of computed tomography and positron emission tomography, the ability to detect both synchronous and metachronous lung cancer has increased. CASE PRESENTATION: We present a case of a 63-year-old Hispanic man who came to our hospital for evaluation of chest pain, dry cough, and weight loss. He had recently been diagnosed with adenocarcinoma in the right upper lobe, with a poorly differentiated carcinoma favoring squamous cell cancer based on bronchoalveolar lavage of the right lower lobe for which treatment was started. Later, bronchoscopy incidentally revealed the patient to have an endobronchial lesion that turned out to be mixed small and large cell neuroendocrine lung cancer. Our patient had triple synchronous primary lung cancers that histologically were variant primary cancers. CONCLUSIONS: Triple synchronous primary lung cancer management continues to be a challenge. Our patient's case suggests that multiple primary lung cancers may still occur at a greater rate than can be detected by high-resolution computed tomography.

Primary synchronous small and non-small cell lung cancer in the same lung lobe: A case report.

Synchronous multiple primary lung cancer (SMPLC) means tumours present at the same time, which are separate and have different histology. We present the case of a 66-year-old patient with a combination of small-cell lung carcinoma (SCLC) with adenocarcinoma in the same lobe with metastasis of SCLC in the mediastinal lymph node. This is a rare case. We performed a standard left upper video-assisted thoracoscopic lobectomy with mediastinal lymphadenectomy and adjuvant therapy targeted to SCLC was administered. Despite advances in imaging methods and diagnostic procedures in pneumology a diagnosis of SMPLC is often discovered only intraoperatively or accidentally during the histological examination. Actually, no guidelines exist for the treatment protocol of such cases. Multiple methods of management of SMPLC, mainly complete anatomical resection with lymphadenectomy combined with chemotherapy or radiotherapy should be adopted according to the histologic types, staging and molecular testing of the tumours. These rare cases of SMPLC require individual treatment and multidisciplinary approach.

The case of synchronous occurrence of primary adenocarcinoma and squamous cell carcinoma in the same lobe of the lung.

Synchronous occurrence of multiple lung cancers in the same lobe of the lung is very rare. Most of the tumors diagnosed in this way have the same histologic type. With imaging methods it is difficult to determine if the multiple lung lesions present hematogenous spread of lung cancer (or cancer from other origin) or these lesions present the second primary lung cancer. We report a rare and unusual case of synchronous occurrence of primary adenocarcinoma and squamous cell carcinoma in the same lobe of the lung. Our case demonstrates that in case of synchronous occurrence of multiple lung lesions each lesion should be sampled and histologic type of every lesion should be determined so the further treatment can be planned accordingly.

Surgical Treatment of Lung Cancer.

In this chapter, we discuss the preoperative evaluation that is necessary prior to surgical resection, stage-specific surgical management of lung cancer, and the procedural steps as well as the indications to a variety of surgical approaches to lung resection.

Clinical and radiological features of synchronous pure ground-glass nodules observed along with operable non-small cell lung cancer.

BACKGROUND: It is common to observe synchronous pure ground-glass nodules (PGN) along with operable primary tumor on initial CT scans while clinical and radiological features of these PGNs remain unclear. METHODS: We included patients with primary tumor and PGNs detected between June 2010 and December 2013 retrospectively. The radiographic manifestations of all PGNs, pathologic findings of resected PGNs, and follow-up outcomes of unresected PGNs were analyzed to determine the predictors of malignant PGNs. RESULTS: Overall, 84 PGNs in 71 patients were included, of which 41 were resected at primary surgery and 43 were followed up. In resected group, there were 17 carcinomatous PGNs, 11 atypical adenomatous hyperplasia, and 13 benign lesions. In a follow-up group, 7 out of 43 PGNs grew, out of which four PGNs were diagnosed as adenocarcinoma and the remaining three PGNs were still followed up. In univariate analysis, size (P < 0.001), air bronchogram (P = 0.001), bubble lucency (P = 0.038), and pleural tag (P = 0.004) were the factors for malignant potential of PGNs. Multivariate analysis showed that size was an independent risk factor (P = 0.005), and the cut-off value was 9.4 mm. CONCLUSIONS: The initial size and imaging signs may be useful in assessing the malignant potential of synchronous PGNs before surgery. J. Surg. Oncol. 2016;113:738-744. © 2016 Wiley Periodicals, Inc.

Metachronous lung cancer that presented as bilateral synchronous lung cancer.

Every patient undergoing curative treatment for primary lung cancer is a candidate for metachronous lung cancer, with a reported risk of 5% per year. The majority of cases are stage I patients. Patients who undergo resection for lung cancer should be followed regularly. A metachronous lung cancer that develops as bilateral synchronous lung cancer is very rare.

Different clinical courses of two lung masses / 대한내과학회지

No abstract available.

Primary Synchronous Lung Cancer Detected using Autofluorescence Bronchoscopy / 결핵및호흡기질환

OBJECTIVE: Patients with lung cancer have a relative high risk of developing secondary primary lung cancers. This study examined the additional value of autofluorescence bronchoscopy (AFB) for diagnosing synchronous lung cancers and premalignant lesions. METHODS: Patients diagnosed with lung cancer from January 2005 to December 2005 were enrolled in this study. The patients underwent a lung cancer evaluation, which included white light bronchoscopy (WLB), followed by AFB. In addition to the primary lesions, any abnormal or suspicious lesions detected during WLB and AFB were biopsied. RESULTS: Seventy-six patients had non-small cell lung cancer (NSCLC) and 23 had small cell lung cancer (SCLC). In addition to the primary lesions, 84 endobronchial biopsies were performed in 46 patients. Five definite synchronous cancerous lesions were detected in three patients with initial unresectable NSCLC and in one with SCLC. The secondary malignant lesions found in two patients were considered metastatic because of the presence of mediastinal nodes or systemic involvement. One patient with an unresectable NSCLC, two with a resectable NSCLC, and one with SCLC had severe dysplasia. The detection rate for cancerous lesions by the clinician was 6.0% (6/99) including AFB compared with 3.0% (3/99) with WLB alone. The prevalence of definite synchronized cancer was 4.0% (4/99) after using AFB compared with 2.0% (2/99) before, and the staging-up effect was 1.0% (1/99) after AFB. Since the majority of patients were diagnosed with advanced disease, the subjects with newly detected cancerous lesions did not have their treatment plans altered, except for one patient with a stage-up IV NSCLC who did not undergo radiotherapy. CONCLUSIONS: Additional AFB is effective in detecting early secondary cancerous lesions and is a more precise tool in the staging workup of patients with primary lung cancer than with WLB alone.