Surgical management of pulmonary metastasis

Because of the clarity of roentgenograms, the lungs act as a window to the body through which we can "watch" the growth of a metastatic tumor. By obtaining serial roentgenograms, we can follow the course of a tumor, as well as its response to different forms of therapy. Usually the mass seen on roentgenogram is only part of a larger tumor found in other metastatic deposits. However, Farrell, in a study of 75 cases, found that 15% of the patients had metastatic lesions confined to the lung. Therefore, a finding of pulmonary metastasis should not imply a completely hopeless prognosis. Many patients may benefit from pulmonary resection of a metastatic lesion, either in terms of ultimate cure or by palliation. This report will discuss the pathogenesis of pulmonary metastasis and the surgical approach based on histology and biologic behavior of these tumors and current concepts of oncology as viewed through the study of pulmonary metastasis.