A case of pulmonary squamous cell carcinoma with thin-walled cavity, observed in chronological CT findings

Abstract

A previously healthy 53-year-old man presented with cavity lesion in the left middle lung field. Chest computed tomography (CT) showed a thin-walled cavity lesion, 28 mm in diameter, in the left lower lobe. Because transbronchial lung biopsy did not enable the diagnosis of the lesion, the patient was evaluated by thin-section CT 4 months, 7 months, and 9 months later. The lesion had enlarged to 30 mm in diameter at 7 months, but had decreased to 26 mm at 9 months. The thickness of the cavity wall decreased from 3 mm to 2 mm at 9 months. Because positron emission tomography (PET) was positive, video assisted thoracic surgery (VATS) biopsy was performed, from which a frozen section was used to diagnose the lesion as squamous cell carcinoma. VATS lobectomy was performed. The pathological stage was T1N0M0. We suggest that even if the cavity shows a contraction of size and wall thickness during follow-up, the examination for definitive diagnosis is necessary for lesions having malignant findings on CT or PET.