Diagnostic Dilemma: A 63 year old woman with two nodules in the right lung: is this metastatic lung cancer or two separate lung tumors? (LG01-02)

Patient History:

A 63 year old woman had an enlarging lung mass of the right upper lobe. Another smaller lung mass was found in the right lower lobe.

Original Diagnosis:

The upper lobe mass shows well-to-poorly differentiated adencarcinoma (5 cm diameter), including areas with bronchioloalveolar features. The right lower lobe shows moderate-to-poorly differentiated adenocarcinoma (3 cm diameter). The pathology evaluation revealed adenocarcinomas, but was indeterminate for metastatic adenocarcinoma of the lung.

RedPath Diagnosis:

The mutational profile matches in three markers on chromosome loci 5q, 10q and 17p. This indicates that both tumors are derived from one cancer and originated in the upper right lobe. This patient definitively has metastatic lung cancer.

Generic sample of PathFinderTG® quantitative test results. NOTE: A diagnostic interpretation of the quantitative test results is provided by the RedPath Pathologist.
Click here for test result explanation

Clinical Impact:

The treatment of metastatic lung tumors is much more aggressive than treatment for individual, non-metastatic tumors. The PathFinderTG results proved metastatic cancer so the patient will likely receive surgery plus radiation and/or chemotherapy. Without the definitive diagnosis, the patient may have been treated with only surgery for the two individual tumors.