Abstract
A 75-year-old man, a heavy smoker with a history of exposure to dust, was admitted to our hospital because of right back pain. Since café au lait spots, diffuse pigmentation and multiple neurofibromatosis were observed on the skin, he was considered to have von Recklinghausen's disease. Chest X-ray film showed a tumor shadow in the right S2, and chest CT demonstrated that the tumor involved the chest wall. Histopathological examination of the percutaneous lung biopsy specimen demonstrated large cell carcinoma. Following radiotherapy to the tumor, he underwent right upper lobectomy with chest wall resection. Macroscopic examination of the resected specimen revealed invasion of tumor into the external intercostal muscles, although microscopically all cancerous tissue was replaced by necrotic tissue and no viable tumor cells remained. The patient survived for three years after treatment, and subsequently died of respiratory failure caused by pneumonia.
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