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J Thorac Cardiovasc Surg 2007;134:1078-1080
© 2007 The American Association for Thoracic Surgery

Brief Communication

Right lower lobectomy after right upper lobectomy for multiple metastases in lung cancer of the right lower lobe: Benefit of middle lobe preservation

^a Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, Gifu, Japan
^b Department of Radiology, Graduate School of Medicine, Gifu University, Gifu, Japan.

Received for publication December 29, 2006; revisions received February 13, 2007; accepted for publication February 23, 2007.

^_* Address for reprints: Hisashi Iwata, MD, PhD, Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu City, Gifu 5011194, Japan. (Email: ihisashi@gifu-u.ac.jp).

The first 20% of the full text of this article appears below.

Drs Matsumoto, Shirahashi, Takemura, Iwata, Kiryu, and Matsui (left to right)

Postoperative respiratory function is a crucial factor when considering surgical treatment for lung cancer, particularly for relapse or secondary lung cancer. We describe herein a case of lobectomy for multiple metastases in the right lower lobe of the lung with preservation of the middle lobe after initial right upper lobectomy.

Clinical Summary

A 60-year-old woman with lung cancer underwent right upper lobectomy. The tumor specimen was a well-differentiated adenocarcinoma, pathologic stage IA (T1 N0 M0). Multiple slow-growing nodules were noted in the right lower lobe 4 years postoperatively. Recurrent lesions are generally multiple and disseminated, and additional surgical intervention is not usually indicated. However, no nodules were apparent in other lobes during 1 year of follow-up. The patient was therefore referred to our department for surgical treatment. Routine blood biochemistry and coagulation studies yielded normal results and carcinoembryonic antigen level was 2.6 ng/mL. A chest computed tomographic scan from 4 years earlier showed the primary lung cancer as a solid tumor in the right upper lobe (Figure 1, A), compared with the scan of multiple . . . [Full Text of this Article]