What happened, in summary

A 63-year-old man was being followed for a slowly changing splenic mass when chest imaging also showed a small right-lung nodule. The splenic lesion and lung lesion were ultimately shown to be separate diseases rather than spread from one site to the other.

In June 2022, he underwent a right-lung wedge resection. Frozen-section analysis showed adenocarcinoma, so the operation was extended to a segmentectomy with mediastinal lymph-node dissection. Final review identified Stage I lepidic adenocarcinoma. The surgical margins were negative and all 17 removed lymph nodes were free of cancer.

His postoperative course included a pneumothorax after the chest tube was removed, which resolved with supplemental oxygen. He was discharged on the third postoperative day. The earlier splenic operation and its diagnosis were kept separate from the lung-cancer pathway because that was a different primary tumor.

At 24 months after the lung operation, he remained recurrence-free. Continued surveillance with chest CT every 6 months was planned. The lung-cancer course therefore reflects an early-stage cancer removed surgically with no recurrence documented during the first 2 years of follow-up.