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

Kashif, Muhammad; Ayyadurai, Puvanalingam; Thanha, Luong; Khaja, Misbahuddin

doi:10.1186/s13256-017-1410-4

Cited by 8 publications

(11 citation statements)

References 24 publications

(28 reference statements)

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“…Of the multiple primary lung cancer patients described in the literature, 2 had triple metachronous lung cancers [ 9 ] (including our patient) and 4 had triple synchronous [ 10 – 13 ] (Table 2 ). The only other patient with triple metachronous cancers described in the literature was a smoker who had 2 subsequent primary lung cancers.…”

Section: Discussionmentioning

confidence: 95%

Three metachronous primary lung cancers in a chronic smoker

et al. 2020

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Rationale: Lung cancer is a leading cause of cancer-related deaths. Smoking is major risk factor for initial and subsequent lung cancer especially in active smokers. Treatment of subsequent lung cancer depends on whether it is synchronous or metachronous. We report a rare case of triple metachronous lung cancer and review of literature of patients with triple metachronous cancers. This will be the second case reported of triple metachronous lung cancer. Patient concerns: A 60-year-old male, active smoker with diabetes mellitus, chronic obstructive pulmonary disease (COPD) and peripheral arterial disease presented with cough and hemoptysis. Initial computed tomography (CT) scan showed right upper lobe spiculated mass. Diagnosis: He underwent transthoracic needle biopsy for right upper lobe mass, showing primary lung adenocarcinoma (ADC)-Stage-IIIA. He continued to smoke and 9-years later had new left upper lobe spiculated nodule, which on surgical resection showed squamous cell carcinoma (SCC)-Stage-IA1. Despite counselling on smoking cessation, he was unable to quit. Six months later, he presented with shortness of breath and CT chest showing right hilar adenopathy in right upper and lower lobes. He underwent transbronchial biopsies of lesion which showed small cell lung carcinoma (SCLC). Interventions: His initial lung ADC-Stage-IIIA, was treated with chemotherapy, weekly thoracic radiation and additional chemotherapy cycles. Nine years later, his left upper lobe mass showing SCC-Stage-IA1 was deemed curative after apical resection and he was kept on surveillance. Six months later, after diagnosis of SCLC in right upper and lower lobe, patient was not a candidate for systemic chemotherapy due to poor performance status and opted for hospice care. Outcomes: His initial lung ADC-Stage-IIIA showed complete radiological response with chemotherapy and radiation. Subsequent SCC-Stage-IA1 was deemed curative after resection. Due to his poor performance status, he was not a candidate for chemotherapy for SCLC and patient opted for hospice care. Lessons: Smoking is a major risk factor for developing lung cancer and with continued smoking, patients are at higher risk for developing subsequent primary lung cancers. We recommend, patients with lung cancer must quit smoking, and those who do not, should remain on long-term surveillance.

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Section: Discussionmentioning

confidence: 95%

Three metachronous primary lung cancers in a chronic smoker

et al. 2020

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“…This is why we choose to sample not only the mass but also the areas of consolidation, which showed, in contrast, an indistinctive margin, no bronchial obstruction and diffusion throughout the lungs. All these latter characteristics are typical of PLA [26,27]; however, the coexistence of a pulmonary carcinoid and PLA has rarely been reported [28][29][30][31]. It is still unclear whether identification of sMPLC in resected specimens (including a comprehensive histological assessment) can be applied to limited preoperative biopsy samples, but performing multiple biopsies on different lung sites during bronchoscopy could be particularly useful, especially in the presence of different endoscopic characteristics of the lesions.…”

Section: Discussionmentioning

confidence: 99%

A case of haemoptysis and bilateral areas of lung consolidation sparing the right lower lobe

Corcione

Ponticiello

Campione³

et al. 2021

Breathe

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“…In the past, MPLC was considered a rare disease, with the incidence of MPLC reported to be 0.2%–8% 2 . However, the incidence of MPLC is increasing with the popularity of low‐dose spiral computed tomography (CT) in recent years, and more cases of MPLC are being diagnosed 3 . Determining whether the tumor is primary or metastatic has been a longstanding clinical dilemma.…”

Section: Introductionmentioning

confidence: 99%

Coexistence of atypical adenomatous hyperplasia, minimally invasive adenocarcinoma and invasive adenocarcinoma: Gene mutation analysis

Song

Yang

et al. 2021

Thoracic Cancer

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Multiple primary lung cancer (MPLC) refers to the simultaneous occurrence of two or more lung primary malignant tumors in one individual. The detection rate of MPLC has increased significantly in recent years, and the distinction between MPLC and lung metastasis has strong clinical significance. Whole exome sequencing (WES) can clearly identify the heterogeneity between MPLC nodules. Here, we report a case of a 50‐year‐old Asian female without a history of smoking. She underwent a lung computed tomography (CT) scan and three ground‐glass nodules (GGNs) were found which were pathologically confirmed as atypical adenomatous hyperplasia (AAH), minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IA), respectively. We performed WES on the three pulmonary nodules and analyzed the sequencing results. We believe that this is the first published report of a case of “three phases” of lung adenocarcinoma analyzed by WES. Under the same genetic background and internal environment, these three nodules showed significant genetic differences and developed into “three phases” of lung adenocarcinoma. Analysis of the WES results supported the lung adenocarcinoma model from AAH to MIA and IA, and explored possible potential driver genes and therapeutic targets. Key points Significant findings of the study We used WES to analyze the gene mutation status of three tumors in one individual. We found that even if under the same genetic background, AAH, MIA and IA showed significant genetic differences and developed into “three phases” of lung adenocarcinoma. What this study adds Analysis of the WES results supported the lung adenocarcinoma model from AAH to MIA and IA, and explored possible potential driver genes and therapeutic targets.

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

Cited by 8 publications

References 24 publications

Three metachronous primary lung cancers in a chronic smoker

Three metachronous primary lung cancers in a chronic smoker

A case of haemoptysis and bilateral areas of lung consolidation sparing the right lower lobe

Coexistence of atypical adenomatous hyperplasia, minimally invasive adenocarcinoma and invasive adenocarcinoma: Gene mutation analysis

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