期刊
JOURNAL OF THORACIC ONCOLOGY
卷 5, 期 4, 页码 546-550出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JTO.0b013e3181d0a480
关键词
Lung; Bronchioloalveolar carcinoma; Pseudopapillary structure; Minimal invasion; Limited resection; Ground-glass opacity; Noguchi classification; Delayed cut-end recurrence
资金
- Ministry of Health, Labor and Welfare, Japan
Introduction: In our limited resection trial of pulmonary peripheral ground-glass opacity (GGO) lesions from 1998 to 2002, limited resection of Noguchi type A and B carcinomas seemed to have a positive outcome. However, recently three of the 24 patients, with mixed GGO lesions intraoperatively diagnosed as type B, developed a solid lesion at the cut-end scar. Methods: Medical records and radiology and pathology findings of the three patients were reviewed. We also analyzed epidermal growth factor receptor gene mutations when possible. Results: Radiologically, these three second tumors were clearly cut-end scar area recurrences. However, other pathologic and mutation findings suggest metachronous primary cancers developed in Case 1, cut-end recurrence in Case 2, and needle biopsy implantation in Case 3. It is difficult to definitively conclude whether the second tumors were recurrences or metachronous primaries. Conclusions: These second tumors have convinced us that our initial caution in concluding GGO lesions can be cured by limited resection was very appropriate. The recurrences definitely indicate that continuing follow-up attention for more than 5 years is needed after limited resection even for GGO bronchioloalveolar carcinomas.
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