Abstract
In 2003, a 72-year-old man underwent combination chemotherapy (cisplatin and etoposide or irinotecan) and 40-Gy radiotherapy for small cell lung carcinoma (SCLC) in the right S4 area. He had a complete response (CR) and showed no sign of recurrence on follow-up. In May 2010, chest CT revealed a 30-mm nodule in the right S3 area. A provisional diagnosis of non-small cell carcinoma of the lung (non-SCLC) was made. Although the right middle lobe adhered to the middle mediastinum due to fibrous adhesions caused by radiation, a right upper lobectomy with a lymph node dissection was performed. A nodule presenting after CR in a SCLC patient is rarely diagnosed as a second primary lung cancer. The present rare case shows that it is possible for a non-SCLC to be resected after CR of SCLC located on the same side, despite adhesions caused by radiation. This case also shows the clinical importance of carefully monitoring such patients for possible local recurrence of SCLC.
