Diagnostic Dilemma: Is the current lung cancer a new primary or a recurrence of a prior epiglottis cancer? (LG01-03)

Patient History:

One year ago, a 72 year old man underwent resection of the epiglottis for invasive squamous cell carcinoma. Recently it was discovered he had a nodule of the right lung. A fine needle biopsy was performed revealing squamous cell carcinoma.

Original Diagnosis:

Despite extensive staining, a relationship between the two cancers could not be determined. The patient’s physician was concerned about selecting the correct course of treatment based on whether the lung lesion was a recurrence or new primary tumor. To get a definitive diagnosis, the patient’s physician requested a tissue analysis be conducted comparing both biopsies.

RedPath Diagnosis:

PathFinderTG results clearly identified the two cancers as independent primary cancers. The lung tumor is not a metastasis of the prior head and neck 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 physician did not feel the patient’s overall health status was good and was concerned about his tolerance for an aggressive treatment plan. If it was a primary lung cancer, the Physician favored a resection using a minimally invasive approach. However, if it was a metastatic head and neck lesion, he would need to consider a surgical resection followed by systemic chemotherapy. With the results of PathFinderTG, the physician selected the resection and the patient was able to avoid aggressive surgery and systemic chemotherapy.