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Case Reports in Medicine
Volume 2009, Article ID 276571, 4 pages
http://dx.doi.org/10.1155/2009/276571
Case Report

Aggressive Trimodality Therapy for T1N2M1 Nonsmall Cell Lung Cancer with Synchronous Solitary Brain Metastasis: Case Report and Rationale

1Department of Radiation Oncology, Jefferson Medical College, Kimmel Cancer Center, Thomas Jefferson University, 111 S. 11th Street, Philadelphia, PA 19107, USA
2Department of Radiation Oncology, University of Pennsylvania, 3400 Spruce Street, 2 Donner Building, Philadelphia, PA 19104, USA

Received 6 October 2009; Accepted 28 December 2009

Academic Editor: Robert Pirker

Copyright © 2009 Timothy N. Showalter and Alexander Lin. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aggressive treatment, including resection of both metastasis and primary tumor, has been studied for non-small cell lung cancer patients with synchronous solitary brain metastasis. Involvement of mediastinal lymph nodes is considered a poor prognostic factor and a contraindication to surgical resection of the primary lung tumor after treatment for brain metastasis. Here we present the case of a patient who presented with a Stage IV T1N2M1 non-small cell lung cancer with synchronous solitary brain metastasis. He is alive and without evidence of disease two years after aggressive, multimodality treatment that included craniotomy, whole-brain radiation therapy, thoracic surgery, chemotherapy, and mediastinal radiation therapy.