Pretreatment natural history of small cell lung cancer presenting as a solitary pulmonary nodule.

BACKGROUND

Small cell lung cancer (SCLC) occasionally presents as an asymptomatic solitary pulmonary nodule (SPN) on chest radiography. This group of SCLC patients appears to have different tumor growth properties and greater potential for cure than most SCLC patients. Some investigators have hypothesized that SCLC presenting as a SPN represents a biologically unique subset of SCLC.

OBJECTIVE

To provide support for this hypothesis, uncontrolled but infrequently obtainable natural history observations are reported.

DESIGN

A retrospective radiograph review of selected patients with SCLC presenting as a SPN was done.

SETTING

Teaching hospital.

PATIENTS

Three patients with delay in treatment of SCLC were reviewed.

RESULTS

Slow growth of SPNs was documented over a 14, 27, and 40 month period in these patients. No lymph node or systemic metastases were found. Radiographic observations were made retrospectively; delayed treatment of the SPNs was not intentional. SCLC was diagnosed by pulmonary resection in two patients and fine needle aspiration cytology in one patient.

CONCLUSIONS

The hypothesis that SCLC presenting as a SPN is a biologically unique subset of SCLC, with relatively slow growth and potential for cure, is supported by these uncontrolled observations.