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Lim, Sim, Lee, Kim, Ryu, Chun, Kim, Lee, Sung, Ahn, and Chang: Synchronous Double Primary Cancers of Lung and Liver
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 62(4): 318-322.

Published online: 30 April 2007

DOI: https://doi.org/10.4046/trd.2007.62.4.318

Synchronous Double Primary Cancers of Lung and Liver

So Yeon Lim, M.D.1, Yun Su Sim, M.D.1, Jin Hwa Lee, M.D.1, Tae-Hun Kim, M.D.1, Yon Ju Ryu, M.D.1, Eun Mi Chun, M.D.1, Yoo Kyung Kim, M.D.2, Jung Kyong Lee, M.D.2, Sun Hee Sung, M.D.3, Jae Ho Ahn, M.D.4, Jung Hyun Chang, M.D.1

1Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.

2Department of Radiology, Ewha Womans University College of Medicine, Seoul, Korea.

3Department of Pathology, Ewha Womans University College of Medicine, Seoul, Korea.

4Department of Thoracic Surgery, Ewha Womans University College of Medicine, Seoul, Korea.

Address for correspondence: Jin Hwa Lee, M.D. Department of Internal Medicine, Ewha Womans University, College of Medicine, 911-1 Mokdong, Yancheon-gu, Seoul, 158-710, Korea. Phone: 82-2-2650-6007, Fax: 82-2-2655-2076, jinhwalee@ewha.ac.kr

Received 23 January 2007       Accepted 9 March 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Although reports of multiple primary malignant tumors have increased recently, cases of synchronous double primary tumors of lung and liver are rare. A 73-year-old man suffered from chronic cough. His chest x-ray showed segmental atelectasis of the right upper lobe. Bronchoscopy revealed a mass occluding the orifice of the anterior segmental bronchus of the right upper lobe, and a biopsy showed a squamous cell carcinoma. A synchronous hepatic mass was found by ultrasonography. However, F18-FDG-PET showed no evidence of a distant metastasis. The liver biopsy revealed a hepatocellular carcinoma. A right upper lobe lobectomy and a sleeve resection were performed for the lung cancer, and radiofrequency ablation was performed for the hepatocellular carcinoma.

Keywords: Double primary cancer, Lung cancer, Hepatocellular carcinoma

Figures and Tables

Figure 1
Chest radiograph shows increased radio-opacity in anterior segment of the right upper lobe.
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Figure 2
Computed tomogram of the chest shows occlusion of right upper lobe bronchus with atelectasis without a definite mass. There are calcified lymph nodes around right upper lobe bronchus and mediastinum and hilar area.
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Figure 3
Ultrasonography of liver shows an about 1.91 cm-sized hypoechoic mass with indistinct margin, which includes echogenic portion.
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Figure 4
F18-FDG positron emission tomogram of whole body shows diffuse mild FDG uptake in segmental atelectasis of the right upper lobe, which includes a focal nodular lesion (SUV=4.1) in the proximal portion. There are hypermetabolic lesions in right lower paratracheal and subcarinal area (SUV=2.9, 2.5). Increased FDG uptake is also seen around right hip prosthesis.
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Figure 5
Bronchoscopy shows a mass occluding the orifice of anterior segmental bronchus of right upper lobe.
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Figure 6
(A) Bronchoscopic lung biopsy specimen shows moderately differentiated squamous cell carcinoma of keratinizing type (HE stain, ×400). (B) Liver biopsy specimen shows well differentiated hepatocellular carcinoma (HE stain, ×400).
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