Abstract
BackgroundCoexistent lung cancer and pulmonary tuberculosis is an urgent problem of thoracic surgery presenting a challenging task for diagnosis and surgical treatment.Materials and methodsFrom 1990 to 2005, 2218 patients with lung cancer underwent surgical treatment in Department of Thoracic Surgery and Oncology, Institute of Oncology, Vilnius University. In 46 (2.1%) patients coexistence of lung cancer and tuberculosis was found. Central lung cancer was diagnosed in 37 (80.4%) and peripheral – in 9 (19.6%) patients. Epidermoid cancer was diagnosed in 24 (52.2%) patients, adenocarcinoma – in 10 (21.7%) and adenoepidermoid carcinoma – in 12 (26.1%) patients. Stage I cancer was diagnosed in 12 (26.1%), stage II – in 11 (23.9%), and stage IIIA – in 23 (50%) patients.ResultsPneumonectomy was performed in 18 (39.2%), lobectomy in 10 (21.7%), bilobectomy in 10 (21.7%), segmentectomy in 8 (17.4%) patients. Postoperative surgical complications were observed in 9 (19.5%) patients, non-surgical complications occurred in 19 patients (41.3%). Six patients (13.04%) died. Combined treatment was applied to 23 (50%) patients.ConclusionCoexistence of tuberculosis and lung cancer in thoracic surgery is fairly rare. This combination was diagnosed only in 46 cases (2.1%) out of 2218 operated lung cancer patients. Epidermoid carcinoma and stage IIIA disease was diagnosed in 50% of patients. Postoperative surgical complications occurred in 9 patients (19.5%) with lung cancer and tuberculosis. Six patients (13%) died in postoperative period. Surgery is the method of choice in treatment of combination of tuberculosis and lung cancer. Median survival of these patients was 28 ± 2 months.
Highlights
Coexistent lung cancer and pulmonary tuberculosis is an urgent problem of thoracic surgery presenting a challenging task for diagnosis and surgical treatment
At present it is clear that tuberculosis and other chronic lung diseases increase the risk of lung cancer [1,2,3,4]
Diagnosis of coexistence of cancer and tuberculosis was established before surgery in 18 (39.1%) patients in other 28 (60.8%) the diagnosis was established after pathological examination of resected specimens
Summary
Coexistent lung cancer and pulmonary tuberculosis is an urgent problem of thoracic surgery presenting a challenging task for diagnosis and surgical treatment. Coexistence of tuberculosis and lung cancer has remained controversial since the middle of 19th century. Some scientists stated that tuberculosis promotes development of cancer; others assert that tuberculosis and cancer are antagonists. Rokitansky were advocates of latter statement (1854). As the diagnostics of lung diseases improved, scientists began to believe that post tuberculosis sclerotic changes facilitate development of cancer ("cancer in the scar") [1,2]. At present it is clear that tuberculosis and other chronic lung diseases increase the risk of lung cancer [1,2,3,4]
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