[Non-Small Cell Lung Cancer in the Right Upper Lobe Was Surgically Resected, after Small Cell Lung Cancer of the Same...

A 60s man presented with leukemia for an underlying disease, which had CR to chemotherapy. By medical examination, an INSM1-positive small cell carcinoma was found next to the right lung hilar region. The patient was diagnosed with cT2aN1M0. Radiation therapy was performed with 45 Gy at the hilum of the lung and mediastinum, and 4 courses of chemotherapy(CDDP 80 mg/m2+VP-16 100 mg/m2)was performed. Whole brain radiation therapy was also performed at 25 Gy. As a result, the lung cancer had CR. However, a small nodule remained in the right upper lobe, which was diagnosed as non-small cell lung cancer using a bronchoscope. There were not metastasis with lymph node or distant station by examination with PET. Right upper lobectomy and lymph node dissection were performed. Pleomorphic carcinoma was diagnosed, and there was no remain of small cell carcinoma. These findings suggest that early detection of the second cancer is important for long-term survival after small cell lung cancer treatment. Improvement of prognosis through surgical resection should be considered.