Yoshino R, Yoshida N, Yasuda S, Ito A, Nakatsubo M, Yuzawa S, Kitada M. Synchronous multiple lung cancers with hilar lymph node metastasis of small cell carcinoma: A case report. World J Clin Cases 2023; 11(25): 5919-5925 [PMID: 37727492 DOI: 10.12998/wjcc.v11.i25.5919]
Corresponding Author of This Article
Ryusei Yoshino, MD, Doctor, Thoracic Surgery and Breast Surgery, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa-shi, Hokkaido, Asahikawa 078-8510, Japan. ryusei.0628.ppp@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ryusei Yoshino, Nana Yoshida, Shunsuke Yasuda, Akane Ito, Masaki Nakatsubo, Masahiro Kitada, Thoracic Surgery and Breast Surgery, Asahikawa Medical University, Asahikawa 078-8510, Japan
Sayaka Yuzawa, Diagnostic Pathology, Asahikawa Medical University Hospital, Hokkaido 078-8510, Japan
Author contributions: Yoshino R contributed to the study conceptualization and original draft preparation; Yasuda S, Yoshida N, Yuzawa S, Ito A, and Nakatsubo M contributed to the review and editing of the manuscript; Kitada M validated and visualized the study; and Kitada M supervised the study; all the authors have read and approved the final version of the manuscript.
Informed consent statement: Written informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ryusei Yoshino, MD, Doctor, Thoracic Surgery and Breast Surgery, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa-shi, Hokkaido, Asahikawa 078-8510, Japan. ryusei.0628.ppp@gmail.com
Received: March 25, 2023 Peer-review started: March 25, 2023 First decision: June 21, 2023 Revised: July 5, 2023 Accepted: August 7, 2023 Article in press: August 7, 2023 Published online: September 6, 2023 Processing time: 160 Days and 0.1 Hours
Abstract
BACKGROUND
Synchronous multiple lung cancers are rare and refer to the simultaneous presence of two or more primary lung tumors, which present significant challenges in terms of diagnosis and treatment.
CASE SUMMARY
We report a case of multiple synchronous lung cancers with hilar lymph node metastasis of small cell carcinoma of unknown origin in a 73-year-old man. Transbronchial lung biopsy revealed squamous cell carcinoma. Although enlargement of lymph node 12u was detected, no distant metastases were observed. The patient was preoperatively diagnosed with T1cN0M0 and underwent thoracoscopic right upper lobectomy with nodal dissection (ND2a). Based on histopathological findings, the primary lesion was squamous cell carcinoma. A microinvasive adenocarcinoma was also observed on the cranial side of the primary lesion. Tumors were detected in two resected lymph nodes (#12u and #11s). Both tumors were pathologically diagnosed as small cell carcinomas. The primary lesion of the small cell carcinoma could not be identified even by whole-body imaging; however, chemotherapy was initiated for hilar lymph node metastasis of the small cell carcinoma of unknown origin.
CONCLUSION
Multiple synchronous lung cancers can be accompanied by hilar lymph node metastasis of small cell carcinomas of unknown origin.
Core Tip: Synchronous multiple lung cancer is relatively rare. We report a case of synchronous multiple lung cancers with lymph node metastasis in the hilar region of a small cell carcinoma of unknown origin. Immunohistochemistry was helpful in aiding the diagnosis. As such cases have a poor prognosis, an accurate diagnosis is necessary to determine treatment options.
