Lung metastasis manifested by solitary pure ground-glass opacity: A case report_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

JING Tao , SONG Tieniu , WEI Xiaoping , FENG Haiming , ZHANG Shaobo , WANG Cheng , JIANG Peng ,  LI Bin

1. Department of Thoracic Surgery, Second Hospital of Lanzhou University, Lanzhou, 730000, P. R. China;

Corresponding author：

LI Bin, Email: dr.leebin@outlook.com

Keywords：

Breast cancer; pulmonary metastasis; pure ground-glass opacity; surgery; case report

DOI：

10.7507/1007-4848.202207003

Video：

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Abstract Full text Figures/Tables Video References Cited by

We reported a 32 years female patient in whom lung metastasis from breast cancer was presented as solitary pulmonary pure ground-glass opacity (GGO) lesion. The patient received rational preoperative examinations and surgery though the preoperative diagnosis was not accurate. Because of different therapy strategies and purposes, it is crucial to make distinction of atypical metastases from primary cancers. Thus, for patients with a history of malignancy, possible metastasis should be taken into consideration if new GGO was found on the CT. Besides this, the follow-up interval of CT should be shortened appropriately, preoperative examinations and surgical procedures should be made according to the suggestions of multidisciplinary team.

Citation： JING Tao, SONG Tieniu, WEI Xiaoping, FENG Haiming, ZHANG Shaobo, WANG Cheng, JIANG Peng, LI Bin. Lung metastasis manifested by solitary pure ground-glass opacity: A case report. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(3): 485-488. doi: 10.7507/1007-4848.202207003 Copy

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2.	Seo JB, Im JG, Goo JM, et al. Atypical pulmonary metastases: Spectrum of radiologic findings. Radiographics, 2001, 21(2): 403-417.
3.	Yu H, Liu S, Zhang C, et al. Computed tomography and pathology evaluation of lung ground-glass opacity. Exp Ther Med, 2018, 16(6): 5305-5309.
4.	Woodring JH, Bognar B. CT halo sign in pulmonary metastases from mucinous adenocarcinoma of the pancreas. South Med J, 2001, 94(4): 448-449.
5.	Okita R, Yamashita M, Nakata M, et al. Multiple ground-glass opacity in metastasis of malignant melanoma diagnosed by lung biopsy. Ann Thorac Surg, 2005, 79(1): e1-e2.
6.	Kim SB, Lee S, Koh MJ, et al. Ground-glass opacity in lung metastasis from breast cancer: A case report. Tuberc Respir Dis (Seoul), 2013, 74(1): 32-36.
7.	Nakamura S, Goto T, Nara S, et al. Pure ground glass opacity (GGO) on chest CT: A rare presentation of lung metastasis of malignant phyllodes tumor. Breast Cancer, 2020, 27(6): 1187-1190.
8.	Shigefuku S, Shimada Y, Hagiwara M, et al. Prognostic significance of ground-glass opacity components in 5-year survivors with resected lung adenocarcinoma. Ann Surg Oncol, 2021, 28(1): 148-156.
9.	MacMahon H, Naidich DP, Goo JM, et al. Guidelines for management of incidental pulmonary nodules detected on CT images: From the Fleischner Society 2017. Radiology, 2017, 284(1): 228-243.
10.	张晓菊, 白莉, 金发光, 等. 肺结节诊治中国专家共识(2018年版). 中华结核和呼吸杂志, 2018, 41(10): 763-771.
11.	Zhang Y, Fu F, Chen H. Management of ground-glass opacities in the lung cancer spectrum. Ann Thorac Surg, 2020, 110(6): 1796-1804.
12.	Zhuge L, Huang Y, Wang S, et al. Preoperative brain MRI for clinical stageⅠA lung cancer: Is routine scanning rational? J Cancer Res Clin Oncol, 2019, 145(2): 503-509.
13.	Veronesi G, Travaini LL, Maisonneuve P, et al. Positron emission tomography in the diagnostic work-up of screening-detected lung nodules. Eur Respir J, 2015, 45(2): 501-510.
14.	Li H, Hu H, Wang R, et al. When should ⁹⁹mTc bone scintigraphy be performed in cT1N0 non-small cell lung cancer patients? Medicine (Baltimore), 2015, 94(51): e2309.
15.	Murabito M, Salat A, Mueller MR. Complete resection of isolated lung metastasis from breast carcinoma results in a strong increase in survival. Minerva Chir, 2000, 55(3): 121-127.
16.	Schirren J, Schirren M, Lampl L, et al. Surgery for pulmonary metastases: quo vadis? Eur J Cardiothorac Surg, 2017, 51(3): 408-410.
17.	刘波, 夏晖. 肺转移瘤的外科治疗进展. 中国肺癌杂志, 2019, 22(9): 574-578.
18.	Patrini D, Panagiotopoulos N, Lawrence D, et al. Surgical management of lung metastases. Br J Hosp Med (Lond), 2017, 78(4): 192-198.
19.	Handy JR, Bremner RM, Crocenzi TS, et al. Expert consensus document on pulmonary metastasectomy. Ann Thorac Surg, 2019, 107(2): 631-649.
20.	Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
21.	Mangiameli G, Cioffi U, Alloisio M, et al. Pulmonary metastases: Surgical principles, surgical indications, and innovations. Sergi CM. Metastasis. Brisbane (AU): Exon Publications. 2022.

1. Scholten ET, de Jong PA, de Hoop B, et al. Towards a close computed tomography monitoring approach for screen detected subsolid pulmonary nodules? Eur Respir J, 2015, 45(3): 765-773.
2. Seo JB, Im JG, Goo JM, et al. Atypical pulmonary metastases: Spectrum of radiologic findings. Radiographics, 2001, 21(2): 403-417.
3. Yu H, Liu S, Zhang C, et al. Computed tomography and pathology evaluation of lung ground-glass opacity. Exp Ther Med, 2018, 16(6): 5305-5309.
4. Woodring JH, Bognar B. CT halo sign in pulmonary metastases from mucinous adenocarcinoma of the pancreas. South Med J, 2001, 94(4): 448-449.
5. Okita R, Yamashita M, Nakata M, et al. Multiple ground-glass opacity in metastasis of malignant melanoma diagnosed by lung biopsy. Ann Thorac Surg, 2005, 79(1): e1-e2.
6. Kim SB, Lee S, Koh MJ, et al. Ground-glass opacity in lung metastasis from breast cancer: A case report. Tuberc Respir Dis (Seoul), 2013, 74(1): 32-36.
7. Nakamura S, Goto T, Nara S, et al. Pure ground glass opacity (GGO) on chest CT: A rare presentation of lung metastasis of malignant phyllodes tumor. Breast Cancer, 2020, 27(6): 1187-1190.
8. Shigefuku S, Shimada Y, Hagiwara M, et al. Prognostic significance of ground-glass opacity components in 5-year survivors with resected lung adenocarcinoma. Ann Surg Oncol, 2021, 28(1): 148-156.
9. MacMahon H, Naidich DP, Goo JM, et al. Guidelines for management of incidental pulmonary nodules detected on CT images: From the Fleischner Society 2017. Radiology, 2017, 284(1): 228-243.
10. 张晓菊, 白莉, 金发光, 等. 肺结节诊治中国专家共识(2018年版). 中华结核和呼吸杂志, 2018, 41(10): 763-771.
11. Zhang Y, Fu F, Chen H. Management of ground-glass opacities in the lung cancer spectrum. Ann Thorac Surg, 2020, 110(6): 1796-1804.
12. Zhuge L, Huang Y, Wang S, et al. Preoperative brain MRI for clinical stageⅠA lung cancer: Is routine scanning rational? J Cancer Res Clin Oncol, 2019, 145(2): 503-509.
13. Veronesi G, Travaini LL, Maisonneuve P, et al. Positron emission tomography in the diagnostic work-up of screening-detected lung nodules. Eur Respir J, 2015, 45(2): 501-510.
14. Li H, Hu H, Wang R, et al. When should ⁹⁹mTc bone scintigraphy be performed in cT1N0 non-small cell lung cancer patients? Medicine (Baltimore), 2015, 94(51): e2309.
15. Murabito M, Salat A, Mueller MR. Complete resection of isolated lung metastasis from breast carcinoma results in a strong increase in survival. Minerva Chir, 2000, 55(3): 121-127.
16. Schirren J, Schirren M, Lampl L, et al. Surgery for pulmonary metastases: quo vadis? Eur J Cardiothorac Surg, 2017, 51(3): 408-410.
17. 刘波, 夏晖. 肺转移瘤的外科治疗进展. 中国肺癌杂志, 2019, 22(9): 574-578.
18. Patrini D, Panagiotopoulos N, Lawrence D, et al. Surgical management of lung metastases. Br J Hosp Med (Lond), 2017, 78(4): 192-198.
19. Handy JR, Bremner RM, Crocenzi TS, et al. Expert consensus document on pulmonary metastasectomy. Ann Thorac Surg, 2019, 107(2): 631-649.
20. Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
21. Mangiameli G, Cioffi U, Alloisio M, et al. Pulmonary metastases: Surgical principles, surgical indications, and innovations. Sergi CM. Metastasis. Brisbane (AU): Exon Publications. 2022.

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