[Triple synchronous primary lung adenocarcinoma: A diagnostic challenge]

Multiple primary lung cancer can be synchronous or metachronous based on the timing of lesion onset. Despite the existing classification criteria for lung cancer with multiple lung involvement, it is sometimes challenging to distinguish between lung cancer with multiple lung involvement and intrapulmonary metastases. Moreover, differentiating synchronous multiple primary lung cancer from multifocal ground-glass/lepidic-pattern lung cancer is crucial. While histologic evaluation can aid in diagnosis, molecular analyses are often necessary. We present the case of a female patient diagnosed with triple synchronous primary lung adenocarcinomas. Although the lesions shared the same histological subtype, they exhibited distinct histological patterns and molecular profiles. In cases of lung cancer with multiple lung involvement, it is essential to perform a detailed pathological study for an accurate diagnosis and appropriate therapeutic interventions.