Long-term Survival of a patient after surgery for synchronous triple primary lung cancers

• Published in: Nihon Kokyuki Geka Gakkai zasshi (Kyoto, 1992) Vol. 28; no. 5; pp. 676 - 681
• Main Authors: Katsumata, Hiroshi, Yatsuyanagi, Eiji
• Format: Journal Article
• Language: Japanese; English
• Published: The Japanese Association for Chest Surgery 15.07.2014
• Subjects: limited operation; synchronous multiple primary lung cancer; triple cancer
• ISSN: 0919-0945; 1881-4158
• DOI: 10.2995/jacsurg.28.676

A 70-year-old male was pointed out as showing a high serum level of CEA and bilateral lung shadows on chest CT during a medical checkup. He was referred to our hospital to investigate the lung shadows. Chest CT showed a 15×10-mm ground-glass opacity in S2a and a 16×13-mm tumor shadow with spiculation in S2b of the right lung. Chest CT also showed a 35×23-mm tumor shadow with spiculation and cavitation in S6 of the left lung. Although a histopathological diagnosis of the abnormal shadow in the right lung S2a could not be made, both shadows in the right S2b and left S6 were diagnosed as adenocarcinoma by transbronchial lung biopsy. They were thought to be synchronous triple primary lung cancers based on CT findings. Lower lobectomy with mediastinal dissection was first performed because the left S6 tumor was thought to be the most advanced cancer. The right S2a and S2b tumors were resected by partial lung resection, respectively, because he refused a segmentectomy at 3 months after the first operation. The left S6 tumor was histopathologically diagnosed as papillary adenocarcinoma (pT2aN0M0). The right lung tumors in S2b and S2a were histopathologically diagnosed as adenosquamous carcinoma (pT1aN0M0) and adenocarcinoma with a mixed subtype (pT1bN0M0), respectively. Both the left S6 and right S2a tumors had in situ components. So, these tumors were histopathologically confirmed as synchronous triple primary lung cancers. His postoperative course was uneventful. He was alive without any evidence of recurrence as of 6 years after surgery.