Case Presentation: Early-Stage Non-Small Cell Lung Cancer
Patient Case:
A 48-year-old woman with a significant smoking history of 2 packs per day since age 14 presented with hemoptysis. Initial chest CT identified a 6 mm nodule at the left lung apex.
After experiencing dyspnea, follow-up CT showed growth in the nodule to 12 mm. PET/CT scan indicated an SUV of 2.0 at the nodule site and identified bilateral adrenal masses, suggestive of benign adenomas. Bronchoscopy with endobronchial ultrasound (EBUS) diagnosed papillary and lepidic adenocarcinoma. Benign findings were noted in lymph node stations 4R, 7, 4L, and 11L. The patient underwent left video-assisted thoracoscopic surgery (VATS), converted to thoracotomy due to operative findings, with left upper lobe (LUL) wedge resection.
Pathology confirmed a 1.2 cm tumor with lymphovascular invasion, clear visceral pleural and surgical margins, and 1 positive lymph node at station 5. Pathological staging was pT1bN2M0 (Stage 3A) with a PD-L1 tumor proportion score of 0%. Next-generation sequencing revealed a KRAS G12C mutation.
The patient is undergoing adjuvant doublet chemotherapy with carboplatin and pemetrexed.
