Synchronous Primary Lung Cancer Presenting with Small Cell Carcinoma and Adenocarcinoma

Abstract

Case 1A 70-year-old man was referred to our hospital for an abnormal shadow on chest CT. His past medical history was unremarkable but he had a smoking history (Brinkman index: 2040). Physical examination revealed no abnormalities. Serum levels of CYFRA and Pro-GRP were elevated to 3.5 ng/mL (normal range: <2.0) and 85.9 pg/mL (normal range: <81.0), respectively. Chest CT showed an 18-mm-diameter part-solid nodule in the right Segment 10 (Fig. 1A) and enlarged right hilar lymph node (Fig. 1B). Positron emission tomography/CT (PET/CT) revealed low-intensity fluorodeoxyglucose (FDG) uptake of the lesion, with the max standardized uptake value (SUVmax) of 1.70 (Fig. 1C). There was also weak FDG uptake in the right #12 lower lobar node (SUVmax: 2.9) (Fig. 1D). Lung cancer (cT1aN1M0 stage IIA) was suspected, and right lower lobectomy with lymph node dissection was performed in June 2013.Pathological examination of the S10 tumor revealed a minimally invasive mucinous adenocarcinoma (Fig. 1E) Multiple synchronous primary lung cancers presenting with different histologic types are uncommon. Among reported cases with different histologic findings, only a few had small cell lung cancer (SCLC) and adenocarcinoma. This unusual combination of lung cancers has not been well reported. In this report, we describe two cases of synchronous primary lung cancer presenting with lymph node metastasis of SCLC and early-stage adenocarcinoma. Epidermal growth factor receptor (EGFR) mutation was not detected in either SCLC or adenocarcinoma in the two cases.

Bilateral lung cancer showing various responses to immune checkpoint inhibitors: A case report

“…6 The combination of SCLC and adenocarcinoma is a relatively rare cases. [7][8][9] Our patient had a high initial NSE value of 36.9 ng/mL (<16. Presently, ICIs and chemotherapy combination treatment can be used as primary treatment for advanced non-SCLC (NSCLC).…”

“…Many SMPLCs have been reported in combination with Non‐small cell lung cancer 6 . The combination of SCLC and adenocarcinoma is a relatively rare cases 7‐9 …”

Synchronous Primary Lung Cancer — Adenocarcinoma and Oncocytoma: The Rarest of Rare Duet

“…1,2 Adenocarcinoma have been described with small cell lung cancers very rarely in minuscule cases. 3 Adenocarcinoma has also been reported with lymphomas of lung and pleura rarely. 4,5 Yoon et al 6 described a novel case of synchronous triple lung cancer-squamous cell carcinoma, invasive mucinous adenocarcinoma and invasive non-mucinous adenocarcinoma.…”

Isolated Renal Metastasis from Primary Lung Squamous Cell Carcinoma with Synchronous Small Cell Lung Cancer

“…Synchronous occurrence of primary lung cancers with different histology is uncommon, seen in up to only 0.5% of patients with lung cancer [1-2]. Non-small cell lung cancer (NSCLC) constitutes 80% of all lung cancers, and squamous cell carcinoma (SCC) accounts for 40% of these [3].…”

“…Non-small cell lung cancer (NSCLC) constitutes 80% of all lung cancers, and squamous cell carcinoma (SCC) accounts for 40% of these [3]. SCC remains the most common type of lung malignancy seen in any combination of synchronous lung tumors [1]. High mortality resulting from lung cancer has been attributed to metastatic involvement of distant organs.…”