[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-371322-105":59,"doc-detail-371322-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","concurrent-small-cell-and-non-small-cell-lung-cancers-the-diagnostic-and-management-challenges-of-synchronous-primary-lung-tumors","Concurrent Small Cell and Non-Small Cell Lung Cancers: The Diagnostic and Management Challenges of Synchronous Primary Lung Tumors","","Case report on synchronous primary lung cancers (SPLC) presenting with two distinct histologic types in a single patient. The report details initial CT findings of multiple small pulmonary nodules and a later spiculated right lower lobe mass, including negative early biopsy, subsequent loss to follow-up, growth of the mass, and repeat biopsy confirming invasive squamous cell carcinoma. Advanced PET and endobronchial ultrasound biopsy identified small cell lung cancer in the right hilum. Staging supported NSCLC stage IIA for the squamous component and limited-stage SCLC for the second tumor, prompting concurrent chemoradiation and planned durvalumab.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/concurrent-small-cell-and-non-small-cell-lung-cancers-the-diagnostic-and-management-challenges-of-synchronous-primary-lung-tumors/371322/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/concurrent-small-cell-and-non-small-cell-lung-cancers-the-diagnostic-and-management-challenges-of-synchronous-primary-lung-tumors/371322.png","ImageObject",300,407,{"name":92,"@type":93},"Theodore","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is synchronous primary lung cancer (SPLC) and why is it challenging to diagnose?","Question",{"text":113,"@type":114},"SPLC involves two or more anatomically distinct primary cancer regions in the lungs that are not connected by common lymphatic channels. Challenges include obtaining tissue from multiple intrapulmonary lesions, distinguishing molecular and histologic profiles, and limited consensus on management strategies.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were the two different lung cancer types identified in this case?",{"text":118,"@type":114},"CT revealed a growing right lower lobe mass and PET demonstrated hypermetabolic activity plus metastatic adenopathy. CT-guided biopsy of the mass showed moderately differentiated squamous cell carcinoma, while endobronchial ultrasound-guided biopsy of the right hilar mass showed small cell lung cancer.",{"name":120,"@type":111,"acceptedAnswer":121},"What treatment was selected after staging?",{"text":122,"@type":114},"The NSCLC (squamous cell carcinoma) was staged as stage IIA and the SCLC was limited stage with nodal involvement attributed to SCLC. The patient received concurrent chemoradiation with cisplatin and etoposide starting from the second cycle, with plans for adjuvant durvalumab.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},371322,1790619266,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":24},7971461740886,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","KANSAS JOURNAL of MEDICIN E  \nCase Report   \nConcurrent Small Cell and Non-Small Cell Lung Cancers: The Diagnostic and Management Challenges of Synchronous Primary Lung Tumors  \nJoseph O. Odeyemi, M.D.1, Abdel-GhanieH. Abu-Samra, M.D.2 1The University of Kansas School of Medicine-Wichita, Wichita, Kansas, Department of Internal Medicine/Pediatrics 2Ascension Via Christi Medical Group Pulmonology and Critical Care, Wichita, Kansas  \nReceived Sep. 7, 2024; Acceptedfor publication Jan. 10, 2025; Published online Feb. 17, 2025 Kans J Med 2025 Jan-Feb; 18:23-24. [https://doi.org/10.17161/kjm.vol18.22810](https://doi.org/10.17161/kjm.vol18.22810)  \nINTRODUCTION  \nLung cancer patients may present with two distinct primary tumors simultaneously, a condition termed synchronous primary lung cancers (SPLC), or they may develop a second primary lung cancer during or after treatment of the initial tumor, referred to as metachronous primary lung cancer.1 Advancements in lung cancer screening, surveillance, and management have led to an increase in the incidence of these conditions, posing significant challenges in accurate diagnosis, classification, and management.1 These challenges arise from the complexities of obtaining tissue samples from multiple intrapulmonary lesions, distinguishing the molecular and histological profiles of different tumors, and addressing the lack of consensus on management strategies, which often depend on the degree of similarity between tumors.1,2  \nAlthough SPLC is increasingly recognized, it remains uncommon, with a reported prevalence of 0.5% to 5%.3 SPLC typically is defined asthe presence of two or more anatomically distinct cancerous regions within the lungs that are not connected via common lymphatic channels.3 This scenario raises critical questions about which lesions should be prioritized for biopsy in patients with multiple suspicious lung lesions. Current guidelines highlight the importance of multidisciplinary team (MDT) involvement, including radiologists, oncologists, pathologists, thoracic surgeons, and pulmonologists, to accurately define SPLCs and determine the most appropriate lesions to biopsy within the broader clinical context.4  \nIn this report, we describe the case of a woman diagnosed with SPLCs exhibiting two distinct histological types of cancer.  \nCASE REPORT  \nThe patient was a 67-year-old woman with a medical history of hypertension, dyslipidemia, hypothyroidism, a 50 pack-year smoking history, and chronic obstructive pulmonary disease (COPD) . Her family history is significant for cancer, asher father had been diagnosed with both prostate cancer and a brain tumor.  \nInitial Presentation and Imaging. In March 2022, a chest computed tomography (CT) scan performed to monitor stable, bilateral, sub-centimeter pulmonary nodules revealed:  \n• Right upper lobe: 5 x 4 mm nodule  \n• Right lower lobe: 5 mm nodule  \n• Left costophrenic angle: 5 mm nodule  \nThe nodules remained stable over time. Additionally, a spiculated, irregular mass in the right lower lobe was identified, measuring 2.7 x 2.5 cm, without associated lymphadenopathy. Background emphysematous changes were noted. A CT-guided core needle biopsy of the right lower lobe mass yielded negative results for malignancy.  \nLoss to Follow-Up and Recurrence. The patient remained asymptomatic and was lost to follow-up until May 2024, when a chestCTwas performed following an abnormal chest X-ray. This revealed:  \n• Enlargement of the right lower lobe mass to 4.9 x 4.5 cm  \n• Aright perihilar lymph node measuring 3 x 2.2 cm, suggestive of nodal metastasis  \nThe previously identified bilateral pulmonary nodules remained stable. A repeat CT-guided biopsy confirmed invasive, moderately differentiated squamous cell carcinoma. The patient was referred to oncology for further evaluation and consideration of chemoradiation.  \nAdvanced Imaging and Biopsy. A positron emission tomography (PET) scan revealed:  \n• Intense hypermetabolic activity in the","cbCaiqIVkpWOyX78","https://ap.wps.com/l/cbCaiqIVkpWOyX78","pdf",113957,"English","# Introduction\n# Case Report\n## Initial Presentation and Imaging\n## Loss to Follow-Up and Recurrence\n## Advanced Imaging and Biopsy\n## Diagnosis and Management\n# Discussion","[{\"question\":\"What is synchronous primary lung cancer (SPLC) and why is it challenging to diagnose?\",\"answer\":\"SPLC involves two or more anatomically distinct primary cancer regions in the lungs that are not connected by common lymphatic channels. Challenges include obtaining tissue from multiple intrapulmonary lesions, distinguishing molecular and histologic profiles, and limited consensus on management strategies.\"},{\"question\":\"How were the two different lung cancer types identified in this case?\",\"answer\":\"CT revealed a growing right lower lobe mass and PET demonstrated hypermetabolic activity plus metastatic adenopathy. CT-guided biopsy of the mass showed moderately differentiated squamous cell carcinoma, while endobronchial ultrasound-guided biopsy of the right hilar mass showed small cell lung cancer.\"},{\"question\":\"What treatment was selected after staging?\",\"answer\":\"The NSCLC (squamous cell carcinoma) was staged as stage IIA and the SCLC was limited stage with nodal involvement attributed to SCLC. The patient received concurrent chemoradiation with cisplatin and etoposide starting from the second cycle, with plans for adjuvant durvalumab.\"}]","Concurrent Small Cell and Non-Small Cell Lung Cancers: The Diagnostic and Management Challenges of Synchronous Primary Lung Tumors | PDF",1790191797]