Palliative Surgery and Potential Curative Trajectory in a Nasopharyngeal Cancer Survivor With Isolated Lung...

The role of palliative surgery for excision of metastasis in a patient with nasopharyngeal carcinoma (NPC) is limited. However, judicious patient selection can yield noteworthy long-term survival outcomes. We report a case of the occurrence of isolated lung metastasis and its management in a NPC survivor with a long disease-free interval. The patient underwent radiotherapy and chemotherapy in 2014 for primary NPC cT2N1M0. In November 2019, he presented with a cough and respiratory distress. The investigation unveiled an isolated lung metastasis that partially encased the left upper lobe bronchus and closely abutted the left main bronchus and left pulmonary artery. Following comprehensive multidisciplinary consultations involving the patient and relatives, the patient underwent a left pneumonectomy as an imperative palliative intervention to alleviate the symptomatic respiratory distress and long-term disease control. Remarkably, the patient's disease-free status has persisted post surgery until 2024, evoking consideration of a potential curative trajectory. This case emphasises comprehensive evaluations, multidisciplinary discussions, and individualised treatment plans. It encourages patients to remain optimistic and engaged in their healthcare journey.