Multiple pulmonary metastases of lung adenocarcinoma to a different ipsilateral lobe after pulmonary lobectomy

Pulmonary metastases (PM) to different lobes are classified as M1 disease in non-small cell lung cancer. We report on three patients with lung adenocarcinoma who had undergone complete resection as the initial treatment and thereafter had recurrence of multiple PMs but only in a different ipsilateral lobe 19, 9, and 6 months after surgery. Two patients underwent completion pneumonectomy for the ipsilateral recurrent PM and are doing well without recurrence at 7 and 1 year after the second operations. The other patient received three regimens of chemotherapy over 2.5 years and is alive with PM but without any other metastases. Our findings suggest that some patients with recurrent multiple PM limited to a different ipsilateral lobe have a good prognosis with aggressive treatment, including surgery, and suggest that the PM in such patients occurs through a local route within the ipsilateral thorax.