Small cell lung cancer presenting as a solitary pulmonary nodule

Abstract

Small cell lung cancer (SCLC) rarely presents radiographically as a solitary pulmonary nodule (SPN). Twenty‐five patients with this feature were identified among 408 individuals with SCLC at McGill University (Montreal, Quebec) from 1979 through 1984. Of these, 15 (60%) were confirmed on pathologic review as SCLC (ten intermediate cell, four oat cell, one indeterminate). Pathologic review of a control group comprising 24 other limited‐disease patients who were long‐term survivors (> 20 months) confirmed 20 (84%) as SCLC (eight intermediate cell, 12 oat cell). Ten of the 15 patients with SPN were resected whereas five had chemotherapy and/or radiotherapy as primary treatment. Postoperative chemotherapy was administered to most of the resected patients. The median survival of the 15 patients with SPN was 24 months, a significantly longer survival than the other patients with SCLC. This improved prognosis in patients with SPN may be due to smaller initial tumor burden or to a fundamental biologic difference between SPN and other forms of SCLC.

Bronchopulmonary neuroendocrine tumors

“…85 Most SCLCs are located centrally and are accompanied by mediastinal and hilar lymphadenopathy, but 5% to 10% occur as nodules without lymphadenopathy. 86 Displacement or narrowing of the bronchial tree and major vessels and major athelectasis are also common features. 87,88 The routine imaging staging of SCLC should include CT scans of the chest and abdomen, a CT scan or magnetic resonance imaging (MRI) of the brain, and a bone scan.…”

Accurate Diagnosis of Peripheral Small Cell Lung Cancer with Computed Tomography

“…SCLCs usually occur centrally, and less than 10% of SCLCs occur peripherally; they present as solitary pulmonary nodules without associated lymphadenopathy on CT images (Gephardt et al 1988;Quoix et al 1990). This type of SCLC is potentially curable by surgery (Quoix et al 1990;Urschel 1994). It is important to know the CT features of solitary SCLCs that are located peripherally and are small in size in order to reduce diagnostic delay and ensure early-stage diagnosis.…”

Surgical Treatment in Small Cell Lung Cancer: Delayed Evaluation?

“…However, today, the reversibility of this situation is increased due to the high accessibility to healthcare services, physicians' sensitivity towards cancer, and the possibility of performing advanced level radiologic examinations at a lower cost and more easily. In Quoix et al (17) study published in 1990, they found a pulmonary nodule in 25 of 408 SCLC patients during a 5-year period. Additionally, a total of 2301 patients with T1 and T2 N0 small cell lung cancer in the national cancer database between the years of 2003-2011 were reviewed in Yang et al (18) latest article published in 2017.…”