Coexistence of three malignancies: Two different lung cancers synchronous with lymphoma

Abstract

Epithelial tumors synchronous with hematologic malignancies are very rare. The hystopathologic type and stage of synchronous tumors are very important for prognosis. A 77-year-old male patient was diagnosed with lymphoma after an excisional biopsy was taken from the retroauricular region. Positron emission tomography, performed for lymphoma staging, revealed a positive solid nodule (SUVmax: 24.3) in the posterobasal segment of the right lower lobe and a negative subsolid nodule in the anterior segment of the upper lobe. Right lower lobectomy and wedge resection for subsolide nodule in the upper lobe were performed. Histopathological examination revealed mildly differentiated squamous cell carcinoma for the solid nodule and mildly differentiated adenocarcinoma with lepidic pattern for the subsolid nodule. The patient was treated for only lymphoma according to the decision of the tumor board, and his condition is stable for 1 year without any evidence of lung cancer recurrence. This case presents the treatment approach and the fact that triple synchronic malignant cases are rare in the literature. © 2017, Turkish Society for Radiation Oncology.