A Case of Metachronous Triple Squamous Cell Carcinomas of the Lung Treated by Bilateral Bronchoplasty and Laser Therapy

Abstract

We successfully treated a 43-year-old man with metachronous triple squamous cell carcinomas (SCC) of the lung by bilateral bronchoplasty and laser therapy. The patient initially underwent sleeve upper lobectomy for SCC(pT_3N_2) of the right upper lobe bronchus in October 1989, followed by adjuvant chemotherapy and radiotherapy. In October 1991, endobronchial SCC in the left main bronchus was recognized by bronchoscopy, and left main bronchial sleeve resection was performed. This second tumor was pT_2N_0 with slight invasion into the adventitia of the bronchus. In November 1992, a third SCC in the trachea was found by bronchoscopy. This tiny third tumor was diagnosed as early SCC. It was treated by neodymium-yttrium aluminum garnet(Nd-YAG) laser ablation. Throughout the above clinical course, there were no complications related to the treatments. As of December 1995, the patient is alive with no evidence of tumor recurrence. Hilar bronchial SCC has a tendency for multicentric growth. Therefore, in patients surviving an initial operation for hilar SCC, careful follow-up by sputum cytology and bronchoscopy is important for early detection and treatment of second or third primary SCC.