Three cases of synchronous bilateral multiple primary lung cancer in early stage.

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In recent years, with improvement in computed tomography (CT), the opportunity to find small ground-glass opacities has increased. We experienced three cases of synchronous bilateral multiple primary lung cancer in early stage. Chest X-ray revealed no abnormal shadow in any case. Chest CT revealed tumors with a diameter of 1 cm or less, and the clinical stage was stage IA in each. The standard medical treatment of synchronous bilateral multiple primary lung cancer has not been established. It is reported that there is no lymph node metastasis in the case whose tumor diameter is 1 cm or less in type A or type B of Noguchi's classification, and in order to preserve respiratory function, the limited operations (wide wedge resection, segmental resection) were performed. The tumors were diagnosed as well differentiated adenocarcinoma (bronchiolo-alveolar carcinoma) histologically in those three cases. In two of the three cases, atypical adenomatous hyperplasia (AAH) was also seen. Recurrence has not been seen for 20-27 months in each. The limited operation is considered to be an appropriate treatment for synchronous bilateral multiple primary lung cancers in early stage.