Case Report


Additional lobectomy for atypical carcinoid diagnosed after S3 segmentectomy

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1 Department of Thoracic Surgery, Yamanashi University, Shimokato, Chuo-shi, Yamanashi, Japan

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Tsuyoshi Uchida

Department of Thoracic Surgery, Yamanashi University, Shimokato 1110, Chuo-shi, Yamanashi,

Japan

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Article ID: 101155Z01TU2020

doi: 10.5348/101155Z01TU2020CR

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How to cite this article

Uchida T, Matsubara H, Muto M, Onuki Y, Matsuoka H, Nakajima H. Additional lobectomy for atypical carcinoid diagnosed after S3 segmentectomy. Int J Case Rep Images 2020;11:101155Z01TU2020.

ABSTRACT


Introduction: Pulmonary segmentectomy is performed for early-stage lung cancer as a limited resection to preserve pulmonary function. However, the criteria for segmentectomy remain controversial. We report a case in which S3 segmentectomy was performed for a very small nodule, and completion lobectomy was required due to the risk of malignant remnants.

Case Report: A 70-year-old woman with asthma was referred to our hospital for a ground-glass lung nodule with a solid component. Computed tomography indicated a 0.4-cm solid nodule in the upper lobe segment 3 (S3). S3 segmentectomy was performed because the position of the nodule rendered wedge resection difficult. After the surgery, the pathological analysis revealed that the tumor was an atypical carcinoid, and metastasis was found in the no. 13u lymph node. Thus, completion lobectomy and mediastinal lymph node dissection were performed. Her postoperative course was good, and she had no tumor recurrence 20 months after the surgery.

Conclusion: This case demonstrates two key points. First, care should be taken when segmentectomy is indicated, even if the tumor is small. Second, lymph node metastasis may be detected in segmentectomy, which might be missed in lobectomy.

Keywords: Additional lobectomy, Atypical carcinoid, Completion lobectomy, Ground-glass nodule, S3 segmentectomy

SUPPORTING INFORMATION


Acknowledgments

We would like to thank Editage (www.editage.com) for English language editing.

Author Contributions

Tsuyoshi Uchida - Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Hirochika Matsubara - Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Mamoru Muto - Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Yuichiro Onuki - Revising it critically for important intellectual content, Final approval of the version to be published

Hiroyasu Matsuoka - Revising it critically for important intellectual content, Final approval of the version to be published

Hiroyuki Nakajima - Revising it critically for important intellectual content, Final approval of the version to be published

Guaranter of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2020 Tsuyoshi Uchida et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.