A case of lung adenocarcinoma that increased in size over four years despite identification at the initial screening

Abstract

Background. Although there are reports to indicate that lung cancer screening is useful for the early detection of lung cancer, if examinees who require detailed examinations do not undergo secondary screenings, the significance of the examination itself will be lost, no matter how early the lung cancer is detected. Case. A 66-year-old woman underwent a computed tomography scan for lung cancer screening in May 2010, which revealed a ground glass nodule involving a solid component (size, 15 mm) in the right upper lobe. She was followed up, but later chose to discontinue the follow-up. In June 2014, the opacity had increased to 25 mm in size. She was suspected of having lung cancer. She underwent surgery and was diagnosed with lung adenocarcinoma. Postoperative adjuvant chemotherapy was administered. Conclusion. Lung cancer is a refractory cancer that is associated with an extremely poor prognosis; the 5-year survival rate is ≤15%. Our study suggests the necessity for proposing measures against non-compliance with detailed examinations or secondary screenings for patients who are suspected of having lung cancer. Additionally, images that are taken during follow-up examinations for ground glass nodules that are detected by screening should be interpreted, considering the expected progression of pathological findings and the possibility that an opportunity for curative resection might be missed.