Situation

A patient who has had a previous pneumonectomy now has a nodule on other side on the CXR. What do you do?

Opinion

Opinion

You need to decide is it another primary or a secondary. A short  interval between pneumonectomy and new nodule would tend to mean secondary. Is the patient fit for any surgical intervention ? Is it wedgeable ?

Perform a CT scan and do a bronchoscopy.

Options include:

Watch

Surgical restage if lesion is new primary, wedgeable, and patient fit for thoracotomy.

Radiotherapy is not an option as it damages the lung and they only have one lung!