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Vol.60 No.2 contents | Japanese/English |
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- Case Report -
A Case of Multiple Cancers of the Lung and Rectum Requiring Differentiation of the Primary Lesion of Metastatic Lung Tumors and Exhibiting Histological Changes Caused by Treatment During the Course
Haruka Ito1, Masaru Ito1, Hidetoshi Kawashima1, Taketsugu Yamamoto2, Takeshi Kaneko3, Yukio Kakuta4, Takamitsu Maehara21Department of Respiratory Medicine, 2Department of Thoracic Surgery, Yokohama Rosai Hospital, Japan, 3Department of Pulmonology, Yokohama City University Graduate School of Medicine, Japan, 4Department of Pathology, Yokohama Rosai Hospital, Japan
Background. When metastatic pulmonary nodules are found in patients with multiple primary cancers, then making a histopathological diagnosis is important in order to make accurate treatment decisions. We diagnosed a patient with multiple cancers of the rectum and lung cancer. After performing partial thoracoscopic lung resection, we histopathologically evaluated the changes over time as well as the histopathology of the metastatic lesions. Case. A 63-year-old woman was found to have left upper lobe lung cancer, rectal cancer, and multiple metastatic lung nodules in the right lung at the time of the initial examination. The rectal tumor was judged to be of an early stage. We thus considered that the patient's lung cancer should be treated first and thus administered afatinib. Thoracoscopic right lower lobe partial resection was performed to determine the diagnosis and guide the treatment decisions. The histological diagnosis was lung metastasis of rectal cancer. Laparoscopic rectal resection was performed. Since a marked reduction was observed in the size of the left lung tumor, radical lung resection was performed and afatinib was terminated. Subsequently, multiple metastatic nodular shadows were found again in the right lung, and thoracoscopic right partial lung resection was performed for diagnostic purposes. Metastasis of lung cancer was detected in two of the six biopsy sites; metastasis of rectal cancer was detected at the other sites. Conclusion. The early diagnosis of metastasis is important for guiding treatment decisions. Physicians should take care that they not miss the opportunity to resect the primary lesion.
key words: Lung cancer, Rectal cancer, Double cancer
Received: September 19, 2019
Accepted: January 8, 2020
JJLC 60 (2): 109-114, 2020
