2025 Volume 11 Issue 1 Article ID: cr.25-0203
INTRODUCTION: Metastatic lung tumors typically exhibit well-defined, enhanced margins on chest CT. They may rarely present as ground-glass nodules (GGNs), making it challenging to differentiate from primary lung cancers, which can also manifest as progressively enlarging GGNs on CT.
CASE PRESENTATION: The patient is a woman in her 50s who underwent surgery for adenoid cystic carcinoma of the hard palate 19 years ago. Seven years ago, chest CT showed GGNs in the upper lobe of the right lung as well as in the upper and lower lobes of the left lung. The patient underwent bilateral lung wedge resection for multiple lung nodules. The pathological diagnosis of the lung nodules was metastases from adenoid cystic carcinoma of the hard palate. In addition, chest CT performed 3 years ago revealed solid nodules in the left lung (S1+2/10), and a follow-up CT performed 1 year ago showed a solid nodule in the right lung (S1). Consequently, partial lung resections were performed for each lesion via thoracoscopic surgery. The pathological results indicated a metastatic adenoid cystic carcinoma. Recently, an enlarging GGN was found in the left lung (S4), which raised suspicion of primary lung cancer. Therefore, thoracoscopic partial resection of the left lingular segment was performed. The final pathology confirmed pulmonary metastasis of adenoid cystic carcinoma.
CONCLUSIONS: In cases where a patient has a history of malignancy and a GGN on chest CT, metastatic lung tumors should be included in the differential diagnosis.