Early clinical diagnosis of synchronous multiple primary lung cancer

Abstract

Abstract. The diagnosis of synchronous multiple primary lung cancer (SMPLC) remains a formidable challenge. The aim of the present study was to identify useful clues for the clinical diagnosis of SMPLC, in particular for the early stages. The medical records of 10 patients diagnosed with SMPLC with different histological types were analyzed retrospectively. Chest computed tomography (CT) findings showed two pulmonary lesions in all patients. The two lesions displayed malignant characteristics of primary lung cancer. The levels of a number of tumor markers, including carcinoembryonic antigen, neuron-specific enolase, cytokeratin fragment 21-1, squamous cell carcinoma and CA125 increased in 2 patients. Auxiliary examinations of other physical sites in these patients did not show signs of neoplasm metastasis. Two tumors were separately staged and appropriate treatment was carried out based on the revised stage, which provided more benefits for SMPLC patients. The diagnosis of SMPLC might be delayed or mistaken owing to its similarity to neoplasm metastasis. A high index of awareness is required for the early diagnosis of this disease. The malignant characteristics of primary lung cancer in various lesions may be valuable clues for the diagnosis of SMPLC. Alterations in the levels of tumor markers may be a poor diagnostic tool for the detection of SMPLC. Separate biopsies for different pulmonary masses should be performed for clinical staging as soon as possible and reasonable treatment based on the stage should also be selected.

Synchronous primary lung cancers in a 51-year-old woman – a and literature review

“…It is worth noting that the patient's smoking habit confirms the results of previous reports [10] suggesting that tobacco smokers are more susceptible to synchronous lung cancers.…”

“…Selected studies are presented in Tables I and II. As mentioned above, SMPLCs are diagnosed relatively rarely. The analyses by individual authors presented in Table I [5,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] were based on sets of 3 [19] to 175 [17] case studies gathered over periods of time lasting from 4 [26] to 28 [28] years. The included authors conducted retrospective observations and confronted the employed treatment with the achieved long-term survival rates.…”

“…Xue et al [10] present 10 case studies with different treatment regimens. All of the operated patients were negative for lymph node involvement.…”

MUC16: molecular analysis and its functional implications in benign and malignant conditions

“…MUC16 was identified as the most overexpressed antigen in ovarian cancer (6,7). Since its identification, MUC16 has been shown to be overexpressed in several other cancers, including breast (21), pancreatic (20,101), non-small-cell lung cancer (102,103), intrahepatic cholangiocarcinoma-mass forming type (104), adenocarcinoma of the uterine cervix (105), and adenocarcinoma of the gastric tract (106,107) (Table 2). Not much is known with respect to the specific role of MUC16 in cancer except for ovarian, pancreatic, and breast cancer, which has been discussed below.…”

Diagnosis of multiple primary lung cancer: A systematic review

“…Our study of the use of computed tomography (CT) images showed that diagnosis of synchronous MPLC might be delayed or mistaken for intrapulmonary metastasis, and that the malignant characteristics of primary lung cancer lesions may provide valuable diagnostic clues. 19 Although the introduction of more sensitive CT or positron emission tomography scanning and fluorescence endoscopy (together with increased surveillance) have improved the detection of MPLC, 15,[20][21][22][23] there remains a lack of uniform guidelines for MPLC diagnosis.…”