Abstract
We report a case of synchronous triple lung cancers with different pathological findings: carcinoma not otherwise specified, microinvasive adenocarcinoma, and adenocarcinoma in situ. The patient was a 71-year-old man who underwent computed tomography during follow-up for sigmoid colon cancer surgery. Ground-glass nodules (GGNs) were observed bilaterally in the lungs. After 7 years of follow-up, a cavitary lesion in the left lower lobe showed wall thickening and malignancy could not be ruled out. The size of nodule increased rapidly within 2 months and the left hilar lymph node also rapidly increased in size, leading to a diagnosis of cT2aN1M0, stage IIB lung carcinoma. Surgery was performed and revealed that the left hilar lymph node had invaded into the left main bronchus to the tracheal bifurcation and left main pulmonary artery. Therefore, left pneumonectomy was performed but complete resection was not possible. The pathological findings showed the left hilar tumor was carcinoma not otherwise specified, the tumor in the left lower lobe was microinvasive adenocarcinoma, and the GGN in the left upper lobe was adenocarcinoma in situ. Thus, the final diagnosis was synchronous triple lung cancers. In cases with imaging findings of multiple lung lesions, it is necessary to select the treatment considering the possibility of multiple primary lung cancers.
