i'm part of a multidisciplinary conciliation meeting in Tunisia. We can find some cases of synchronous NSCLC in both lungs. we hadn't before a case like you described, but we wait for biopsy results from both sides to get sure of the origin of bilateral pulmonary masses.

for your question, we should consider it as a SCLC and propose the patient for chemotherapy first. then, if the tumor seems stabilized, a sequential radiation can be discussed, if respiratory function allows it.

Dear Miss Weng,

I have never seen a case with synchronous appearance of NSCLC and SCLC at the same time, but I had seen a male patient many years ago presenting with SCLC (limited disease) in his right upper lobe bronchus. After receiving adjuvant chemotherapy and local Laser coagulation he underwent successful lobectomy. Two years later he developed a squamous cell lung cancer as a second disease in the right lung with contralateral metastases.

The therapy of lung cancer is complex, the new molecular-pathologic diagnostic developments enable however, a much better and individual therapeutic approach for lung cancer patients. Since the therapeutical regimens change every couple of month in the meanwhile, I suggest you to check out the guidelines of the National Comprehensive Cancer Network (NCCN) (https://www.nccn.org/professionals/physician_gls/default.aspx) (you can register for free) and/or the ASCO guidelines (https://www.asco.org/practice-guidelines/quality-guidelines/guidelines/thoracic-cancer)

With regards

I had one case with syncrhonous SCLC and NSCLC.The key point is an accurate staging. If both are early stage cancer, surgery it's a good option.

In my case a performed a Lobectomy for SCLC and a segmentectomy for NSCLC (was a GGO)