2013 Volume 53 Issue 6 Pages 760-766
Background. It is well known that patients undergoing treatment for small cell lung cancer are at a high risk for developing secondary primary tumors. We herein report three resected cases of non-small cell lung cancer that developed following successful treatment for limited-stage small cell lung cancer (LD-SCLC). Case 1. A 63-year-old male received concurrent chemoradiotherapy for LD-SCLC in the middle lobe. He achieved a clinical complete response (CR) and underwent prophylactic cranial irradiation (PCI); he showed no signs of recurrence for five years. On an annual follow-up examination, chest computed tomography (CT) revealed a solid nodule in the left lower lobe. We performed left basal segmentectomy. A histopathological examination of the resected specimen revealed stage IA squamous cell carcinoma. Case 2. An 81-year-old male underwent right lower lobectomy for poorly differentiated carcinoma. He received adjuvant chemotherapy based on a final pathological diagnosis of LD-SCLC. Fifteen years later, chest CT revealed mixed ground glass nodules in the left upper lobe during follow-up for another disease. He underwent left upper segmentectomy. The histopathological diagnosis revealed stage IB multiple adenocarcinoma. Case 3. A 60-year-old woman received chemotherapy and sequential radiotherapy for LD-SCLC in the bronchus intermedius. She achieved a clinical CR and underwent PCI. Eight years later, CT revealed a pulmonary nodule in the right lower lobe. Positron emission tomography demonstrated uptake of fluorodeoxyglucose in the subcarinal lymph node. She underwent right lower lobectomy and was diagnosed with stage IIIA adenocarcinoma. All subjects were in good health, with no episodes of recurrence. Conclusions. Providing careful follow-up is necessary in order to detect second malignancies in patients with small cell lung cancer who survive for longer periods.
