Possible delayed cut-end recurrence after limited resection for ground-glass opacity adenocarcinoma, Intraoperatively diagnosed as noguchi type B, in three patients

Junji Yoshida, Genichiro Ishii, Tomoyuki Yokose, Keiju Aokage, Tomoyuki Hishida, Mitsuyo Nishimura, Takuya Onuki, Masayuki Noguchi, Kanji Nagai

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Abstract

INTRODUCTION:: In our limited resection trial of pulmonary peripheral ground-glass opacity (GGO) lesions from 1998 to 2002, limited resection of Noguchi type A and B carcinomas seemed to have a positive outcome. However, recently three of the 24 patients, with mixed GGO lesions intraoperatively diagnosed as type B, developed a solid lesion at the cut-end scar. METHODS:: Medical records and radiology and pathology findings of the three patients were reviewed. We also analyzed epidermal growth factor receptor gene mutations when possible. RESULTS:: Radiologically, these three second tumors were clearly cut-end scar area recurrences. However, other pathologic and mutation findings suggest metachronous primary cancers developed in Case 1, cut-end recurrence in Case 2, and needle biopsy implantation in Case 3. It is difficult to definitively conclude whether the second tumors were recurrences or metachronous primaries. CONCLUSIONS:: These second tumors have convinced us that our initial caution in concluding GGO lesions can be cured by limited resection was very appropriate. The recurrences definitely indicate that continuing follow-up attention for more than 5 years is needed after limited resection even for GGO bronchioloalveolar carcinomas.

Original languageEnglish
Pages (from-to)546-550
Number of pages5
JournalJournal of Thoracic Oncology
Volume5
Issue number4
DOIs
Publication statusPublished - 2010 Apr
Externally publishedYes

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Glass
Adenocarcinoma
Recurrence
Cicatrix
Neoplasms
Bronchiolo-Alveolar Adenocarcinoma
erbB-1 Genes
Mutation
Needle Biopsy
Radiology
Medical Records
Pathology
Carcinoma
Lung

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

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Possible delayed cut-end recurrence after limited resection for ground-glass opacity adenocarcinoma, Intraoperatively diagnosed as noguchi type B, in three patients. / Yoshida, Junji; Ishii, Genichiro; Yokose, Tomoyuki; Aokage, Keiju; Hishida, Tomoyuki; Nishimura, Mitsuyo; Onuki, Takuya; Noguchi, Masayuki; Nagai, Kanji.

In: Journal of Thoracic Oncology, Vol. 5, No. 4, 04.2010, p. 546-550.

Research output: Contribution to journalArticle

Yoshida, Junji ; Ishii, Genichiro ; Yokose, Tomoyuki ; Aokage, Keiju ; Hishida, Tomoyuki ; Nishimura, Mitsuyo ; Onuki, Takuya ; Noguchi, Masayuki ; Nagai, Kanji. / Possible delayed cut-end recurrence after limited resection for ground-glass opacity adenocarcinoma, Intraoperatively diagnosed as noguchi type B, in three patients. In: Journal of Thoracic Oncology. 2010 ; Vol. 5, No. 4. pp. 546-550.
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T1 - Possible delayed cut-end recurrence after limited resection for ground-glass opacity adenocarcinoma, Intraoperatively diagnosed as noguchi type B, in three patients

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AU - Nagai, Kanji

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N2 - INTRODUCTION:: In our limited resection trial of pulmonary peripheral ground-glass opacity (GGO) lesions from 1998 to 2002, limited resection of Noguchi type A and B carcinomas seemed to have a positive outcome. However, recently three of the 24 patients, with mixed GGO lesions intraoperatively diagnosed as type B, developed a solid lesion at the cut-end scar. METHODS:: Medical records and radiology and pathology findings of the three patients were reviewed. We also analyzed epidermal growth factor receptor gene mutations when possible. RESULTS:: Radiologically, these three second tumors were clearly cut-end scar area recurrences. However, other pathologic and mutation findings suggest metachronous primary cancers developed in Case 1, cut-end recurrence in Case 2, and needle biopsy implantation in Case 3. It is difficult to definitively conclude whether the second tumors were recurrences or metachronous primaries. CONCLUSIONS:: These second tumors have convinced us that our initial caution in concluding GGO lesions can be cured by limited resection was very appropriate. The recurrences definitely indicate that continuing follow-up attention for more than 5 years is needed after limited resection even for GGO bronchioloalveolar carcinomas.

AB - INTRODUCTION:: In our limited resection trial of pulmonary peripheral ground-glass opacity (GGO) lesions from 1998 to 2002, limited resection of Noguchi type A and B carcinomas seemed to have a positive outcome. However, recently three of the 24 patients, with mixed GGO lesions intraoperatively diagnosed as type B, developed a solid lesion at the cut-end scar. METHODS:: Medical records and radiology and pathology findings of the three patients were reviewed. We also analyzed epidermal growth factor receptor gene mutations when possible. RESULTS:: Radiologically, these three second tumors were clearly cut-end scar area recurrences. However, other pathologic and mutation findings suggest metachronous primary cancers developed in Case 1, cut-end recurrence in Case 2, and needle biopsy implantation in Case 3. It is difficult to definitively conclude whether the second tumors were recurrences or metachronous primaries. CONCLUSIONS:: These second tumors have convinced us that our initial caution in concluding GGO lesions can be cured by limited resection was very appropriate. The recurrences definitely indicate that continuing follow-up attention for more than 5 years is needed after limited resection even for GGO bronchioloalveolar carcinomas.

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