What are secondary lung tumors?

Updated: Feb 16, 2021
  • Author: Daniel S Schwartz, MD, MBA, FACS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Secondary lung tumors are neoplasms that spread from a primary lesion. The primary tumor can arise within the lung or outside the lung, with the metastases traveling through the bloodstream or lymphatic system or by direct extension to reach their destination. The secondary tumors most typically appear as well-circumscribed, noncalcified nodules. [1]

These secondary cancers are identified by their site of origin. Thus, a colon cancer that metastasizes to the lung is still known as a colon cancer. In children, most lung cancers are secondary. [2]

Metastatic malignant neoplasms are the most common form of secondary lung tumors. Lung metastases are identified in 30-55% of all cancer patients, though prevalence varies according to the type of primary cancer. Benign neoplasms (eg, benign metastasizing leiomyomas) are uncommon exceptions.

In this article, the approach to secondary lung tumors is discussed, with an emphasis on clinical decision-making to determine whether tissue diagnosis would alter clinical management. Also discussed is the multidisciplinary approach to determine when continued systemic chemotherapy for metastatic disease should be accompanied by radiation, surgery, or both.

Almost any cancer has the ability to spread to the lungs, but the tumors that most commonly do so include bladder cancercolon cancerbreast cancerprostate cancer, sarcoma, Wilms tumor, and neuroblastoma. (Primary lung cancers most commonly metastasize to the adrenal glands, liver, brain, and bone.) [1]

Secondary lung tumor is a term that is also used for the malignancies that arise in the lungs as a consequence of therapy for cancer (eg, chemotherapy, radiotherapy, or bone marrow transplant). [3]  This article is not intended to cover the description of such tumors.

Spread to the lungs is usually the marker of an advanced malignant disease, but spread can also occur as an isolated early event. In certain circumstances, surgical resection with curative intent can be performed, with a reported 5-year survival rate of as high as 30-40%, depending on the underlying primary malignancy and the selection criteria for surgery.

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