How do you treat a fit patient with a solitary pulmonary nodule (2cm) which is biopsy-proven small cell lung carcinoma?

Clinical stage I SCLC is vey rare but does happen. In the past this was referred to as "VERY" limited disease. We would recommend surgery, either lobectomy or just a wide wedge resection but with nodal evaluation. This patient would need adjuvant chemo with 4 courses of cisplatin (or carboplatin) + etoposide. I would NOT consider thoracic XRT in this setting. Doubt value or logic for PCI, but obviously no data. Finally need to check with pathology to be certain this is SCLC rather than typical or atypical carcinoid. Of course this is just opinion based as there would never be a trials for this rare setting.

I agree with @Dr. First Last. In my experience, these "very" limited SCCLCa are discovered incidentally when an isolated, growing pulmonary nodule has been resected. Agree completely with respect to adjuvant chemoTx.