Ulaş KUMBASAR, Adem GÜNGÖR, Ali Osman TOKAT

Synchronous lung cancer cases

Senkron tümör tanımı, bir organda aynı anda iki farklı tümör saptanması olarak özetlenebilir. Akciğerlerde aynı anda farklı lokalizasyonlarda pulmoner tümör saptanması durumunda pulmoner senkron tümörden bahsedilir. Bronş karsinomu serisi içinde karşılaşılan üç pulmoner senkron tümör olgusunu, tanı aşamasındaki ve klinik seyirlerindeki farklılıklar nedeniyle sunulması amaçlandı. Birinci olgu; akciğer kanseri tanısı ile kemoterapi protokolüde iken ikinci tümör saptandı. İkinci olguda senkron tümör tanısı preoperatif “flow-sitometrik”incelemeileortayakonuldu.Üçüncüolguda ise senkron tümör tanısı ameliyat sırasına “frozen” biyopsi ile ispatlandı. Oldukça seyrek olarak görülen senkron tümörler tüm akciğer kanserlerinin yaklaşık % 1-2’sini oluşturmaktadır. Birden fazla kitle ile başvuran olgularda senkron tümör olasılığı akılda tutularak, olgulara cerrahi tedavi şansı verilebilmekte ve cerrahi olmayan tedavi protokollerine göre daha uzun bir sağkalım şansı sağlanabilmektedir.

Senkron akciğer kanseri olguları

Synchronous tumor is described as two different tumors presenting at the same time in the same organ. Pulmonary tumors existing in different lobes or different sides of the lungs at the same time are defined as pulmonary synchronous tumors. We describe three different cases that were diagnosed by different methods and that had different clinical outcomes. Within the first case, the second tumor was determined while the patient was receiving chemotherapy. In the second case, the tumor was diagnosed by flow cytometric examination. And in the third case, the tumor was diagnosed intraoperatively by frozen section. Synchronous tumors are uncommon, they occur in 1-2 % of all bronchial carcinomas. Concerning the better survival rates of surgical treatment, the possibility of synchronous tumor should be remembered in the cases that have separate lesions.

PDF

___

1. Adebonojo SA, Moritz DM, Danby CA. Theresultsofmodernsurgical therapy for multipl primary lung cancers. Chest 1997; 112: 693-701. 2. Pompier RF, Vetto JT, Lee JT et al. Synchronous non-small cell lung cancers. Am J Surg. 1996; 171:521-4. 3. Adebonojo SA, Mortiz DM, Danby CA. TheresultsofModernSurgical TherapyforMultiplePrimaryLungCancers.Chest1997;112: 693-701. 4. Rosengart TK, Martini N, Ghosn P et al. Multipl primary lung carcinomas: prognosis and treatment. Ann ThoracSurg1991;52:773-9. 5. Pairolero PC, Williams DE, Bergstrahl EJ et al. Postsurgical stage I bronchogenic carcinoma: morbid implications of recurrent disease. Ann ThoracSurg1984:38:331. 6. Kitamura K, Mitsudomi T, Ishidsa T et al. Adenocarcinoma and squamos cell carcinoma in the same lobe of the lung. Respiration 1991; 58: 226-8. 7. Aydıner A, Karadeniz A, Uygun K et al. Multipl primary neoplasms at single instution. Am J Clin Oncol 2000; 23: 364-70. 8. Deschamps C, Pairolero PC, Trastek VF et al. Multipl primary lung cancer. J ThoracCardiovascSurg.1990;99:769-78. 9. Hida T, Ariyoshi Y, Sugiura T et al. Synchoronous lung cancer presenting with small cell carcinoma and adeno carcinoma. Chest 1993; 104:1602-4.
10. Martini N, Melamed MR. Multiple primary lung cancers. J ThoracCardiovasc Surg 1975; 70:606-12. 11. Ferguson MK. Synchoronous primary lung cancers. Chest 1993; 103:398-400. 12. Ferguson MK, DeMeester TR, DesLauriers J et al. Diagnosis and management of Synchoronous lung cancers. J ThoracCardiovascSurg 1985; 89:378-85. 13. Carey FA, Donnely SC, Walker WS et al. Synchronous primary lung cancers: Prevalance in surgical material and clinical implications. Thorax1993;48:344-6. 14. Pierard P, Vermylen P, Bosschaerts T et al. Synchronous roentgenographically occult lung carcinoma in patients with resectabl primary lung cancer. Chest 2000; 117:779-85. 15. Colomer EJ, Molina JC, Aguilar X, et al. Synchoronous multiple primary cancer of the lung: A rare association of small cell carcinoma as the main tumor plus epidermoid carcinoma. Arch Bronconeumol 1999; 35:245-7. 16. Hiroshima K, Toyozaki T, Kohno H et al. Synchoronous and metachronous lung carcinomas: molecular evidence for multicentricity. Pathol Int 1998; 48:869-76.