Triple synchronous primary lung adenocarcinoma: A diagnostic challenge
DOI:
https://doi.org/10.23938/ASSN.1104Keywords:
Neoplasms, Multiple Primary, Carcinoma, Non-Small-Cell Lung, High-Throughput Nucleotide Sequencing, Thoracic Surgery, Video-AssistedAbstract
Multiple primary lung cancer can be synchronous or metachronous based on the timing of lesion onset. Despite the existing classification criteria for lung cancer with multiple lung involvement, it is sometimes challenging to distinguish between lung cancer with multiple lung involvement and intrapulmonary metastases. Moreover, differentiating synchronous multiple primary lung cancer from multifocal ground-glass/lepidic-pattern lung cancer is crucial. While histologic evaluation can aid in diagnosis, molecular analyses are often necessary.
We present the case of a female patient diagnosed with triple synchronous primary lung adenocarcinomas. Although the lesions shared the same histological subtype, they exhibited distinct histological patterns and molecular profiles. In cases of lung cancer with multiple lung involvement, it is essential to perform a detailed pathological study for an accurate diagnosis and appropriate therapeutic interventions.
Downloads
References
DETTERBECK FC, NICHOLSON AG, FRANKLIN WA, MARON EM, TRAVIS WD, GIRARD N et al. The IASLC lung cancer staging project: Summary of proposals for revisions of the classification of lung cancers with multiple pulmonary sites of involvement in the forthcoming eighth edition of the TNM classification. J Thorac Oncol 2016; 11(5): 639-650. https://doi.org/10.1016/j.jtho.2016.01.024
CHIANG CL, TSAI PC, YEH YC, WU YH, HSU HS, CHEN YM. Recent advances in the diagnosis and management of multiple primary lung cancer. Cancers (Basel) 2022; 14(1): 242. https://doi.org/10.3390/cancers14010242
WERNER R, STEINMANN N, DECALUWE H, DATE H, DE RUYSSCHER D, OPITZ I. Complex situations in lung cancer: multifocal disease, oligoprogression and oligorecurrence. Eur Respir Rev 2024; 33(172): 230200. https://doi.org/10.1183/16000617.0200-2023
TIAN H, BAI G, YANG Z, CHEN P, XU J, LIU T et al. Multiple primary lung cancer: Updates of clinical management and genomic features. Front Oncol 2023; 13: 1034752. https://doi.org/10.3389/fonc.2023.1034752
TIE H, LUO J, SHI R, LI Z, CHEN D, WU Q. Characteristics and prognosis of synchronous multiple primary lung cancer after surgical treatment: a systematic review and meta-analysis of current evidence. Cancer Med 2021; 10(2): 507-520. https://doi.org/10.1002/cam4.3614
GREGOIRE J. Guiding principles in the management of synchronous and metachronous primary non-small cell lung cancer. Thorac Surg Clin 2021; 31(3): 237-254. https://doi.org/10.1016/j.thorsurg.2021.05.001
MARTINI N, MELAMED MR. Multiple primary lung cancers. J Thorac Cardiovasc Surg 1975; 70(4): 606-612.
SUH YJ, LEE HJ, SUNG P, YOEN H, KIM S, HAN S et al. A novel algorithm to differentiate between multiple primary lung cancers and intrapulmonary metastasis in multiple lung cancers with multiple pulmonary sites of involvement. J Thorac Oncol 2020; 15(2): 203-215. https://doi.org/10.1016/j.jtho.2019.09.221
NIE Y, WANG X, YANG F, ZHOU Z, WANG J, CHEN K. Surgical prognosis of synchronous multiple primary lung cancer: systematic review and meta-analysis. Clin Lung Cancer 2021; 22(4): 341.e3-350.e3. https://doi.org/10.1016/j.cllc.2020.10.022
TAMBURINI N, BOMBARDINI C, CHIAPPETTA M, MANISCALCO P, VALPIANI G, CESARIO A et al. Association of the extent of resection with survival in multiple primary lung cancer: A systematic review. Thorac Cardiovasc Surg 2023; 71(2): 145-158. https://doi.org/10.1055/s-0042-1742756
KASHIF M, AYYADURAI P, THANHA L, KHAJA M. Triple synchronous primary lung cancer: a case report and review of the literature. J Med Case Rep 2017; 11(1): 245. https://doi.org/10.1186/s13256-017-1410-4
EGUREN-SANTAMARIA I, SANCHEZ-BAYONA R, PATIÑO-GARCIA A, GIL-BAZO I, LOPEZ-PICAZO JM. Targeted DNA sequencing for assessing clonality in multiple lung tumors: a new approach to an old dilemma. Lung Cancer 2018; 122: 120-123. https://doi.org/10.1016/j.lungcan.2018.05.029
13.KOYAMA T, SHIMIZU K, UEHARA T, MATSUOKA S, TAKEDA T, Yamada K et al. Synchronous triple primary lung cancer with three different histological subtypes in the same lobe: a case report. Thorac Cancer 2021; 12(5): 711-714. https://doi.org/10.1111/1759-7714.13796
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
La revista Anales del Sistema Sanitario de Navarra es publicada por el Departamento de Salud del Gobierno de Navarra (España), quien conserva los derechos patrimoniales (copyright ) sobre el artículo publicado y favorece y permite la difusión del mismo bajo licencia Creative Commons Reconocimiento-CompartirIgual 4.0 Internacional (CC BY-SA 4.0). Esta licencia permite copiar, usar, difundir, transmitir y exponer públicamente el artículo, siempre que siempre que se cite la autoría y la publicación inicial en Anales del Sistema Sanitario de Navarra, y se distinga la existencia de esta licencia de uso.


