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LETTER TO THE EDITOR
Year : 2011  |  Volume : 7  |  Issue : 2  |  Page : 230-231

Long-term survival after resection of a lung cancer metastasis


1 Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
2 Department of Pathology, University Hospital of Ioannina, Ioannina, Greece

Date of Web Publication12-Jul-2011

Correspondence Address:
George A Alexiou
University Hospital of Ioannina, Department of Neurosurgery, PO BOX 103, Neohoropoulo, 45500, Ioannina
Greece
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.82937

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How to cite this article:
Fotakopoulos G, Alexiou GA, Goussia A, Voulgaris S. Long-term survival after resection of a lung cancer metastasis. J Can Res Ther 2011;7:230-1

How to cite this URL:
Fotakopoulos G, Alexiou GA, Goussia A, Voulgaris S. Long-term survival after resection of a lung cancer metastasis. J Can Res Ther [serial online] 2011 [cited 2019 Dec 8];7:230-1. Available from: http://www.cancerjournal.net/text.asp?2011/7/2/230/82937

Sir,

A 52-year-old male presented in the emergency department because of acute onset headache and weakness. Neurological examination was unremarkable. For further evaluation, a brain computed tomography (CT) was performed that demonstrated a right temporal space-occupying lesion. Magnetic resonance imaging that ensued revealed a 4.4 x 3.6 x 4.2 cm cystic and solid lesion surrounded by edema and causing mass effect. After contrast administration, there was ring enhancement [Figure 1]a. In order to rule out a metastatic neoplasm, lung and abdominal CT was performed. Lung CT demonstrated a 2-cm lesion in the right middle lobe. A metastatic lesion was suspected and the patient was operated upon through a right temporal craniotomy. The lesion was totally excised. Histology verified the presence of a metastatic neoplasm. Ten days later, a lung biopsy was performed that revealed the presence of a lung adenocarcinoma. The patient was operated upon and the lesion was totally excised with tumor-free margins. The pathological examination showed the presence of a papillary adenocarcinoma. Mediastinal lymph nodes were negative. The patient received whole-brain radiotherapy to a total dose of 30 Gy without chemotherapy. Seven years later, the patient was in excellent condition without evidence of tumor recurrence [Figure 1]b.
Figure 1: (a) Contrast-enhanced T1-weighted MRI demonstrating a right temporal space-occupying lesion. (b) Postoperative MRI seven years later revealing no tumor recurrence or any new lesion

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Primary lung tumors account for 50% of all metastatic brain tumors and nearly 80% of lung cancer patients who will survive for more than two years will have brain metastases. Papillary adenocarcinoma of the lung has been reported to be a more advanced adenocarcinoma subtype than bronchioloalveolar carcinoma. [1],[2] Silver and Askin reported that the disease-free, mean survival of stage I patients was 40% at 3.4 years and of stage II patients was 25% at 3.5 years. [3] In our case, the patient had a brain metastasis and after complete removal of the brain and lung lesions remained disease free for over 7 years.

 
 > References Top

1.Jian Z, Tomizawa Y, Yanagitani N, Iijima H, Sano T, Nakajima T. Papillary adenocarcinoma of the lung is a more advanced adenocarcinoma than bronchioloalveolar carcinoma that is composed of two distinct histological subtypes. Pathol Int 2005;55:619-25.  Back to cited text no. 1
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2.Hwang JH, Lee KS, Han J, Kim TS, Lee JY, Kim J. Papillary adenocarcinoma of the lung: Radiologic and pathologic findings. J Comput Assist Tomogr 1999;23:114-7.  Back to cited text no. 2
[PUBMED]  [FULLTEXT]  
3.Silver SA, Askin FB. True papillary carcinoma of the lung: A distinct clinicopathologic entity. Am J Surg Pathol 1997;21:43-51.  Back to cited text no. 3
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