[Bilateral Metastatic Lung Tumor with Different Primary Organs]

Area of Science:

• Oncology
• Thoracic Surgery
• Gastroenterology

Background:

• A 72-year-old woman with prior left breast cancer surgery presented with sigmoid colon cancer and a left upper lobe pulmonary tumor.
• Initial diagnosis via transbronchial biopsy suggested adenocarcinoma of unknown origin.
• The complexity of diagnosing metastatic disease from multiple potential primary sites is a significant clinical challenge.

Observation:

• Surgical resection of the left lung segment and sigmoid colon was performed.
• The left pulmonary tumor was identified as metastasis from breast cancer.
• A subsequent right pulmonary tumor, initially suspected as breast cancer metastasis and treated with chemotherapy, was surgically removed.

Findings:

• Pathological diagnosis confirmed the left pulmonary tumor as breast cancer metastasis.
• The right pulmonary tumor was definitively diagnosed as metastasis from sigmoid colon cancer.
• Chemotherapy for the right pulmonary tumor was ineffective, necessitating surgical intervention.

Implications:

• This case underscores the critical need to consider distinct primary sites when encountering multiple pulmonary metastases.
• Accurate pathological diagnosis is essential for appropriate treatment of metastatic disease from double primary cancers.
• Clinical vigilance is required to differentiate metastases from synchronous or metachronous primary malignancies.