Synchronous pulmonary and hepatic nodules in a patient with previous bronchogenic carcinoma: the relevance of histopathological confirmation.
The synchronous presentation of pulmonary and hepatic nodules in a patient with previously resected bronchogenic carcinoma raises suspicion of recurrence and mandates restaging. We present the case of a 71-year-old male with a history of lobectomy with pericardial resection and mediastinal lymphadenectomy (T3N0M0). At five years after the operation, he presented with a new pulmonary lesion. Restaging detected a synchronous nodule in the liver. Despite the strong suspicion of tumor recurrence, further investigation with a percutaneous liver biopsy revealed hepatocellular carcinoma. In order to investigate the etiology of the pulmonary lesion (hypotheses of recurrent bronchial cancer and of metastatic hepatocellular carcinoma), an open lung biopsy was performed, which revealed chronic inflammatory tissue with foci of anthracosis and dystrophic calcification. The patient was submitted to a non-anatomic resection of the liver lesion. The postoperative course was uneventful, and the patient was discharged on postoperative day 10. This report highlights the relevance of the histopathological diagnosis in patients with a history of bronchogenic carcinoma and suspicion of tumor recurrence. Differential diagnoses and the treatment administered are discussed.
Camargo
José de Jesus Peixoto
Jde J
Department of Thoracic Surgery, Porto Alegre Santa Casa Sisters of Mercy Hospital, Porto Alegre, Brazil.
Machuca
Tiago Noguchi
TN
Camargo
Spencer Marcantonio
SM
Schio
Sadi Marcelo
SM
Bello
Rodrigo Moreira
RM
D000368:Aged; D001706:Biopsy; D002114:Calcinosis / Q000150:complications* / Q000175:diagnosis; D002283:Carcinoma, Bronchogenic / Q000601:surgery; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008171:Lung Diseases / Q000150:complications* / Q000175:diagnosis; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D009367:Neoplasm Staging; D014057:Tomography, X-Ray Computed