術後28年で検診発見された甲状腺癌孤立性肺転移と早期肺癌が併存した1例

Solitary Pulmonary Metastasis from Follicular Thyroid Carcinoma Resected 28 Years Earlier Coexisting with Early Lung Cancer；Report of a Case

はじめに　CT画像診断の発達により，肺結節陰影やいわゆるすりガラス陰影での早期肺癌が発見される機会が増えているが，術前に診断を確定することが困難な場合も多い．一方，胸腔鏡手術の普及により複数病変を有する症例も手術適応となる傾向にある．われわれは，転移性肺腫瘍と対側肺に原発性肺癌が併存した症例を経験したので報告する．

A 71-year-old woman was referred to our hospital for a round mass shadow in the right lower lung field in mass screening chest X-ray. Computed tomography （CT） of the chest showed a well-defined lobulating mass shadow measuring 2.2 cm in diameter in the lower lobe of the right lung and a ground glass opacity （GGO） in the upper lobe of the left lung．

She underwent video-assisted partial resection of right lower lobe of the lung. The pathological examinations indicated a pulmonary metastasis of follicular thyroid carcinoma. Three months later, video-assisted partial resection of left upper lobe of the lung was performed. Microscopically, 2 lesions of adenocarcinoma in situ were revealed.