Abstract
Surgical treatment is recommended only for the patients with the stage I disease among those with small cell lung cancer (SCLC). However, according to the large retrospective study by American NCD database in 2015, even if the stage is II or more, the disease could be curable by combination of surgery and chemotherapy if it only locally advances, like a case that we report herein. A 64-year-old man presenting with persisted cough visited a clinic and a left hilar mass was pointed out by chest radiography. He was referred to our hospital for further evaluation. A chest CT scan demonstrated an about 5-cm left hilar mass. Bronchoscopic biopsy disclosed small cell carcinoma. No systemic dissemination was pointed out by both positron emission CT scans and brain magnetic resonance imaging. He was diagnosed as to have c-T2aN0M0 c-stage IB disease. Concerning his wish to have surgical treatment, left pneumonectomy was planned. Pericardial invasion was suspected intraoperatively, thus, combined resection of the pericardium with left pneumonectomy and mediastinal dissection were carried out. Pericardial invasion was pathologically evidenced and the disease was diagnosed as p-T3N0M0 p-stage IIB. As adjuvant chemotherapy, six courses of CBDCA+VP-16 were administrated. Then, prophylactic whole brain irradiation was added. He is doing well without the disease 3 years and 9 months after the surgery.
