A quick-frozen section diagnosis of a lung tumor in a patient with a gastric cancer history

Abstract

Even in the era of genome-based medicine, daily practices of surgeons and pathologists are full of challenges in making the best management in the circumstances where limited information is available. In this anecdotal experience we’d like to present an instructive case of the patient with past history of distal gastrectomy for gastric cancer, who was pointed out having a synchronous tumorous lesion in the lung during the surveillance. Scrutinized pathological report of the past gastric cancer, staging based on the Japanese Classification Systems, was T2 without lymphatic permeation, and the attending pathologist who saw the intraoperative frozen section showing a mucinous adenocarcinoma had been preoccupied with the metastatic gastric adenocarcinoma and answered so to the surgical team during the operation. Partial resection of the lung is suitable for metastatic tumor, therefore no further procedure was performed. Actually, it was not the metastatic case retrospectively and he needed additional appropriate procedure; lobectomy. We expound the complexities of this case in the hindsight and extract a lesson to both surgeons and pathologists.