Significance of a single pulmonary nodule in patients with previous history of malignancy.
OBJECTIVE
To determine the diagnosis, treatment and follow-up in patients with a solitary lung nodule and a previous primary extrapulmonary neoplasm.


METHODS
The authors evaluated the charts of 45 patients with an extrapulmonary malignant neoplasm and a solitary pulmonary nodule. The histologic characteristics of the nodule were correlated with those of the extrapulmonary neoplasm.


RESULTS
The histology of the nodule was not known preoperatively in 43 cases (93.5%); in the remaining three cases cytologic examination had shown the presence of atypical cells. The majority of pulmonary lesions (73.9%) were found during the follow-up of the previous tumour, but a significant percentage of nodules (17.4%) were found incidentally. Pre- or intraoperative localisation of the nodule was done in 19 cases (41.3%), and was successful in nine cases (47.4%). Thoracoscopy was performed in 44 patients (95.6%). The coincidence between the pathology of the previous tumour and that of the nodule was 41.3% (19/46). The coincidence rate was 100% for the tumours of ovary, prostate, and sarcomas.


CONCLUSIONS
The advent of minimally invasive surgical techniques has made a definitive diagnosis likely, providing also therapy with a less painful engagement for the patient and a less cost for the community.
Sortini
A
A
Department of Surgical, Anesthesiological and Radiological Sciences, University of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy. srn@unife.it
Carcoforo
P
P
Ascanelli
S
S
Sortini
D
D
Pozza
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000473:pathology; D013906:Thoracoscopy