Does pulmonary resection promote the progression of unresected ground-glass nodules?

The routine use of thin-section, whole-lung computed tomographic scanning helps detect persistent ground-glass nodules (GGNs) co-existing with the target lesion in the underlying lung.

The cases of 10 patients with persistent co-existing GGNs detected on whole-lung computed tomography performed prior to surgery for lung cancer were retrospectively reviewed. The co-existing lesions were not resected at the initial procedure.

Although no masses exhibited progression during the 15.5-month preoperative follow-up period, all lesions displayed enlargement during the first year after the initial procedure, with the exception of one tumor. Three lesions arose in the ipsilateral lung, while the remaining lesions arose in the contralateral lung. The nine enlarged lesions were diagnosed as adenocarcinoma on subsequent resection.

Lung adenocarcinoma with persistent GGNs tends to progress after lung resection for other lesions. This phenomenon should be kept in mind when selecting for surgical procedure in patients with persistent co-existing GGNs.