Synchronous double cancers developing from the wall of bullae in the bilateral lungs

A rare case of synchronous double lung cancers having developed from bilateral bullous disease is reported. A 51-year-old man was admitted because of severe cough. Imaging studies revealed a left apical bulla measuring 10 cm, and another bulla measuring 8 cm containing viscous fluid on the right apex. In the next year, chest computed tomography showed increased size of the mass in the right apical bulla. Upper right lobectomy and left bullectomy were performed. Histological examination of the resected specimens revealed a large cell carcinoma having developed the wall of the bulla in the right apex, and a moderately differentiated papillary adenocarcinoma having developed in the wall of the left bulla. The patient had an uneventful recovery and has been in good health without recurrence for 3 years since surgery. We emphasize the need to be aware of the potential development of lung cancer in patients with bullous disease.