Abstract
Primary lung cancer usually relapses relatively early after curative resection and rarely recurs after a lapse of five years or more following operation. Recently we experienced a case of lung cancer relapsed with peritoneal carcinomatosis 11 years after curative resection of the primary lesion. The case involved a 71-year-old man who underwent left upper lobectomy with lymph node dissection for lung cancer at the age of 60. His treatment was completed after a nine-year follow-up in the clinic, without any recurrences. He noticed abdominal discomfort when 11 years had elapsed after the operation and the symptom did not improve. Abdominal CT was thus performed and peritoneal carcinomatosis was suspected. Fine needle aspiration cytology of ascetic fluid gave findings of adenocarcinoma. On immunostaining, metastasis of lung cancer was suspected. Laparotomic biopsy to make the definite diagnosis revealed multiple nodes in the abdominal cavity, as well as multiple occurrence of stenosis due to peritoneal dissemination in the small intestine and the left side colon. Pathologic findings of the disseminated foci were compatible with immunostaining findings of the lung cancer resected 11 years previously. Furthermore the both lesions were very similar in morphology in microscopic study. Peritoneal dissemination of lung cancer was diagnosed. The patient died of lung cancer eight months after the diagnosis of metastasis.
