Occult lung carcinoma ; a case report. The primary lesion appeared on chest X-ray taken 2 year and 10 months after resection of right hilar lymph node metastasis

Abstract

A-63-year-old man had enlarged lymph nodes (3.5 cm in diameter) in the right hilum, but no primary carcinoma could be found. We performed R2 lymph node dissection and bullectomy. The histological diagnosis was metastatic squamous cell carcinoma. However no primary lesion was identified. Thirty-four months after the operation, the mass was appeared in the middle lung field in the chest x-ray. Tumor was appeared B² bronchus by the bronchoscopy. It was suspected that the mass was invaded the basal bronchus and pulmonary artery. We performed right pneumonectomy. The postoperative course has been good with no evidence of recurrence 12 months after the second operation.