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Eur J Cardiothorac Surg 2001;20:1101-1105
© 2001 Elsevier Science NL

Significance of a single pulmonary nodule in patients with previous history of malignancy

Department of Surgical, Anesthesiological and Radiological Sciences, University of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy

Received 23 April 2001; received in revised form 20 July 2001; accepted 3 September 2001.

Corresponding author. Tel.: +39-532-236385; fax: +39-532-207653
e-mail: srn{at}unife.it

Objectives: To determine the diagnosis, treatment and follow-up in patients with a solitary lung nodule and a previous primary extrapulmonary neoplasm. Methods: The authors evaluated the charts of 45 patients with an extrapulmonary malignant neoplasm and a solitary pulmonary nodule. The histologic characteristics of the nodule were correlated with those of the extrapulmonary neoplasm. Results: The histology of the nodule was not known preoperatively in 43 cases (93.5%); in the remaining three cases cytologic examination had shown the presence of atypical cells. The majority of pulmonary lesions (73.9%) were found during the follow-up of the previous tumour, but a significant percentage of nodules (17.4%) were found incidentally. Pre- or intraoperative localisation of the nodule was done in 19 cases (41.3%), and was successful in nine cases (47.4%). Thoracoscopy was performed in 44 patients (95.6%). The coincidence between the pathology of the previous tumour and that of the nodule was 41.3% (19/46). The coincidence rate was 100% for the tumours of ovary, prostate, and sarcomas. Conclusions: The advent of minimally invasive surgical techniques has made a definitive diagnosis likely, providing also therapy with a less painful engagement for the patient and a less cost for the community.

Key Words: Single pulmonary nodule • Thoracoscopic surgery • Extrapulmonary neoplasms

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