For a patient with a lung tumor that is radiographically consistent with early-stage NSCLC but pathology with characteristics overlapping with upper GI origin, what additional diagnostic procedures would you consider before treating?
For example, there are no abnormalities on CT or PET in the upper GI and the pathology demonstrates strong CK7 staining and mucinous features with negative TTF-1.
Answer from: Radiation Oncologist at Academic Institution
In the absence of imaging findings in a patient with a risk profile consistent with early-stage NSCLC, I would probably just move forward with definitive management as NSCLC with either surgical resection or SBRT as appropriate. The only other thing I would consider is to make sure they are up to da...
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Answer from: Radiation Oncologist at Academic Institution
This could be pulmonary enteric adenocarcinoma (rare lung primary). It may be worth sending the path for outside review.
In addition to the above suggestions and negative PET, it would be prudent to consider more thoroughly assessing the pancreas/liver (diagnostic CT or MRI) and upper/lower e...
Comments
Radiation Oncologist at UCLA | VA Greater Los Angeles Healthcare System
I agree with due diligence by getting more imaging...
I agree with due diligence by getting more imaging...