MEDizzy - A 71-year-old woman with a 40-year smoking history is noted

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Cardiothoracic Surgery

A 71-year-old woman with a 40-year smoking history is noted to have a peripheral nodule in her left upper lobe on chest x-ray. Workup is consistent with small cell lung cancer with ipsilateral mediastinal lymph node involvement but no extrathoracic disease. What is the best treatment option for this patient?

ExplanationD. Small cell lung cancers are treated primarily with chemotherapy and radiation; they are rarely amenable to surgical resection because of extensive disease at presentation. Small cell lung cancer accounts for about 20% of primary lung cancers. Most are centrally located and characterized by an aggressive tendency to metastasize. They spread early to mediastinal lymph nodes and distant sites, most commonly to the bone marrow and the brain.