2018 Volume 32 Issue 7 Pages 808-812
A 58-year-old man was admitted to our hospital for examination of right chest back pain persisting for 4 months and a tumor shadow noted in the upper right lung field on a chest radiograph. A tumor shadow of 42 mm was observed in contact with the upper right lobe chest wall on a chest CT and the peripheral rib margin in the vicinity was irregular and chest wall invasion was suspected. Confirmation of the diagnosis by bronchoscopy was not obtained but primary lung cancer (cT3N0M0 cStage IIB) was strongly suspected. Right upper lobectomy with resection of the chest wall including the 3rd-5th intercostal muscles and lymph node dissection (ND2a) was performed with posterior lateral incision. Intraoperative fine needle aspiration (FNA) revealed poorly differentiated cancer and the postoperative pathologic diagnosis was lung primary pleomorphic carcinoma (pT3N0M0 stage IIB). Bone metastasis to the 7th thoracic vertebrate body was noted on MRI taken 1 month after surgery. We performed combined chemoradiotherapy (Chemotherapy: Carboplatin (CBDCA) +weekly Paclitaxel (PTX) 4 Cool Radiotherapy: 30 Gy). The FDG accumulation in the 7th thoracic vertebrae disappeared after treatment, and the patient has survived without recurrence for nine years and two months until the present.
