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Mentions: A 56-year-old man, who was well except for hypertension of over 10 years duration for which he received regular treatment, presented to our hospital complaining of intermittent chest tightness for a month. The chest tightness, which had been aggravated in the previous week, was located in the left precordal area, and was persistent in character and induced by exercise. On examination, the patient was slightly anxious but generally well. A mass was noted over the left side of his neck and he stated that this had been present for more than 4 years. He did not pay attention to it initially because it had been growing very slowly. However, he had noted mild labor on respiration in recent months. No abnormal breath sounds or heart murmurs were noted. The hemogram and blood chemistry were normal. Chest X-ray revealed a mass in the left lower lung field (Figure 1). Computed tomography (CT) revealed a nodule, 3.5 cm in diameter, in the left lower lobe of the lung with pleural retraction (Figure 2A), and also a mass, 5 cm in diameter, within the left lobe of the thyroid (Figure 2B). Fiberoptic bronchoscopy was negative for any intraluminal lesions. An adenocarcinoma of the lung was confirmed by CT-guided biopsy. A whole body bone scan was negative for skeletal metastasis. A fluorodeoxyglucose-positron emission tomography revealed a hypermetabolic focus in the left lower lobe of the lung and in the left lobe of the thyroid. He was admitted for further evaluation and treatment.
Double primary bronchogenic carcinoma of the lung and papillary thyroid carcinoma: a case report
Bottom Line: A computed tomography scan of the neck revealed a left thyroid mass compressing the trachea towards the right side.There was no cervical lymphadenopathy.A left thyroid lobectomy was performed and pathology revealed a papillary carcinoma.
Affiliation: Department of Thoracic Medicine and Surgery, Chia-Yi Christian Hospital, Taiwan. email@example.com
Introduction: Double primary bronchogenic carcinoma and papillary carcinoma of the thyroid are extremely rare. We describe the case of a patient who underwent surgical resection for these two cancers.
Case presentation: A 56-year-old man presented to our hospital complaining of a cough with blood-tinged sputum. A slowly growing mass in the left lobe of the lung had been noted for about 1 year. He underwent video-assisted thoracic surgery of the left lower lobe and mediastinal lymph node dissection through an 8 cm utility incision. Pathology revealed a well-differentiated adenocarcinoma and the dissected lymph nodes were negative for malignancy. He also complained of a mass in his neck, which had grown slowly for over 5 years. A computed tomography scan of the neck revealed a left thyroid mass compressing the trachea towards the right side. There was no cervical lymphadenopathy. A left thyroid lobectomy was performed and pathology revealed a papillary carcinoma. Thus, he underwent a second operation to remove the right lobe of the thyroid. He underwent subsequent adjuvant chemotherapy.
Conclusion: In a review of the literature, it appears that there has only been one previously reported case of these two cancers, which was in Japan. The relationship between these two cancers is still unclear, and more case reports are required to determine this relationship.