Management of the solitary pulmonary nodule: directed resection

The primary goals in management of a solitary pulmonary nodule are: 1) early detection and treatment of lung cancer at a curable stage; 2) avoidance of unnecessary surgery for benign lesions; 3) efficient, economic use of resources in distinguishing between benign and malignant lesions. Management depends on the nature of the nodule, the nature of the patient, and the approach of the physician or surgeon who assumes responsibility for further evaluation and treatment of the solitary pulmonary nodule. By combining appropriate diagnostic studies, and close personal attention, unnecessary excision of benign nodules can be kept to a minimum, patient anxiety allayed and excision of cancers undertaken with appropriate staging and without compromise of outcome.