Synchronous Multiple Primary Lung Cancers
Synchronous multiple primary lung cancers should be staged independently. The tumor with the highest stage of disease or more serious prognostic implications should be used for tumor registry entry of a single patient and a specific field assigned for the identification of multiple primary lung cancers. Coding may then be expanded to include particular characteristics for each tumor, such as histology, treatment and survival data. If synchronous multiple lung cancers have similar prognoses and staging characteristics, the tumor receiving first treatment should be selected for tumor registry data entry.

Fig. 54a: Posterior-anterior chest radiograph shows bilateral lung cancers. The cancer on the right is in the right lower lobe. Fullness is seen in the right hilum in keeping with hilar metastasis, T2 N1 M0, stage IIA. The cancer in the left upper lobe, T1 N0 M0, stage IA (arrow), is seen to better advantage on the computed tomographic scan. Fig. 54b.