[A case of a synchronous triple primary lung cancer with hamartoma]

We present a case of synchronous triple primary lung cancer. 69-year-old male admitted after mass examination with the tumor shadows on right S3, left S4 and left S8. Further examinations confirmed as squamous cell carcinoma of right S3 and left S8 and as benign tumor of left S4 with right hillar lymph nodal swelling. In addition to these lesion, bronchofiberscopy revealed the squamous cell carcinoma of left basal bronchus. The secondlook operation was planned for bilateral primary lung cancer. At first, patient underwent right S3 segmentectomy with regional lymph nodes dissection. Two month later, left thoractomy was performed, followed by left lower lobectomy. Histopathological examination defined as well differentiated squamous cell carcinoma, moderately differentiated squamous cell carcinoma, squamous cell carcinoma in situ and hamartoma for right S3, left S8, left basal bronchus and left S4, respectively. Lymph node metastasis was found only in #121. Although tumors were resected with good curability, respiratory function was depressed and performance status deteriorated. It is important to attention to the preservation of respiratory function for the surgical treatment to multiple lesions and the combined therapy with radiation, chemotherapy and/or laser may be considered.