Bilateral synchronous multiple lung cancer: an emerging problem

Multiple primary lung cancers are becoming increasingly recognised and pose diagnostic and staging uncertainties with challenging management options and prognostication.

We describe a case of synchronous multiple primary lung cancer occurring bilaterally, and the steps in reaching the diagnosis, initial surgical management, the intensive follow-up this underwent, and how its subsequent recurrence led to treatment with radiation therapy in light of the patient's declining fitness.

This case highlighted that cytological recurrence could occur prior to radiological recurrence, especially for endobronchial tumors, and intensive follow-up both radiologically and endoscopically with multidisciplinary input is crucial in the management of these challenging cases where evidence-based guidelines are limited.