Rare Synchronous Multiple Primary Lung Cancers with Staged Resection

Background Synchronous multiple primary lung cancer (sMPLC) remains a relatively rare and difficult pathology. Owing to ambiguous guidelines, there are few papers with a limited population that discuss outcomes for patients undergoing treatment for sMPLC. Differentiating sMPLC from metastatic lung lesions is crucial, as it directly influences management strategies, with surgical intervention often preferred. Case Presentation : We report the case of a 58-year-old male with a significant smoking history who was diagnosed with two histologically distinct adenocarcinomas located in the right and left upper lobes of the lungs. A comprehensive preoperative evaluation, including PET‒CT scans, brain magnetic resonance imaging (MRI), and fine needle aspiration biopsies, was conducted. The patient was treated with staged bilateral upper lobectomies, during which intraoperative complications necessitated conversion to open thoracotomy. Pathological analysis confirmed the diagnosis of sMPLC with negative lymph nodes and clear margins, and the tumors were staged as pT1b pN0 M0 and pT1a pN0 M0, respectively. The patient recovered well and remains cancer-free one year postdiagnosis. Conclusions This case underscores the importance of an extensive diagnostic workup and a staged surgical approach in the successful management of sMPLC. The patient's favorable outcome highlights the potential effectiveness of this treatment strategy, although close follow-up is essential to monitor for recurrence, particularly within the first two years following surgery. Ongoing collaboration with databases collecting information on sMPLC is necessary to gain a better understanding of diagnostic and management techniques for this unique class of patients.