Postoperative EGFR-TKI treatment on residual multiple ground-glass nodules after resection for lung adenocarcinoma: a rare case report and literature review

Abstract

\n Background: Multiple ground-glass nodules (mGGNs) in the lung has been defined as synchronous multiple primary lung cancer (SMPLC), but it is very difficult to differentiat SMPLC from intrapulmonary metastases, and the treatment is still controversial. Target therapy on residual mGGNs after resection for the dominant lesion might be a selectable approach.Case presentation: We report a rare case of lung adenocarcinoma displaying primary EGFR-T790M mutation, in which the patient underwent radical resection of lesions in the left upper lung(LUL), and continued osimertinib treatment for the residual mGGNs in all lobes of the right lung. The mGGNs in the right lung displayed different responses to osimertinib.Conclusions: This case indicated that intropulmonary spread might be coexisted with multicentric origin for mGGNs.