Salvage Operation for Late Recurrence After Stereotactic Body Radiotherapy for Lung Cancer: Two Patients With No Viable Cancer Cells  Naohiro Taira, MD,

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Salvage Operation for Late Recurrence After Stereotactic Body Radiotherapy for Lung Cancer: Two Patients With No Viable Cancer Cells  Naohiro Taira, MD, Tsutomu Kawabata, MD, PhD, Takaharu Ichi, MD, Kazuaki Kushi, MD, Tomofumi Yohena, MD, PhD, Hidenori Kawasaki, MD, PhD, Kiyoshi Ishikawa, MD, PhD, Seiya Kato, MD, PhD  The Annals of Thoracic Surgery  Volume 97, Issue 6, Pages 2167-2171 (June 2014) DOI: 10.1016/j.athoracsur.2013.07.123 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Chest computed tomography scan in patient 1 at the start of stereotactic body radiotherapy showed a mass sized 9 mm × 8 mm in the left upper lobe. (B) The scan at 3 months after stereotactic body radiotherapy showed the tumor had shrunk. Follow-up scans at (C) 33 months and (D) 36 months showed apparent tumor regrowth. (E) A positron-emission tomography/computed tomography scan showed moderate uptake in the tumor. (SUV = standardized uptake value.) The Annals of Thoracic Surgery 2014 97, 2167-2171DOI: (10.1016/j.athoracsur.2013.07.123) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) The cut surface of the resected lung. (B) The microscopic appearance of the specimen showed fibrotic tissue without viable cancer cells (HE = hematoxylin and eosin stain; original magnification ×100.) The Annals of Thoracic Surgery 2014 97, 2167-2171DOI: (10.1016/j.athoracsur.2013.07.123) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) A chest computed tomography scan in patient 2 at the start of stereotactic body radiotherapy showed a mass in the right upper lobe. (B) A computed tomography scan 4 months after stereotactic body radiotherapy showed tumor shrinkage. However, follow-up scans at (C) 32 months and (D) 38 months revealed apparent tumor regrowth. (E) A positron emission tomography/computed tomography scan showed moderate uptake in the tumor. (SUV = standardized uptake value.) The Annals of Thoracic Surgery 2014 97, 2167-2171DOI: (10.1016/j.athoracsur.2013.07.123) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A) The cut surface of the resected lung. (B) The microscopic appearance of the specimen showed fibrotic tissue without viable cancer cells. (HE = hematoxylin and eosin stain; original magnification ×100.) The Annals of Thoracic Surgery 2014 97, 2167-2171DOI: (10.1016/j.athoracsur.2013.07.123) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions