Lung cancer seeding along needle track after CT guided transthoracic fine-needle aspiration biopsy - case report

Background: Transthoracic fine needle aspiration biopsy (FNAB) is an important diagnostic method in the evaluation of lung malignancies. The incidence of chest wall implantation metastases after FNAB is extremely rare. However, we report a case of cancer seeding along needle track after a CT-guided transthoracic FNAB. Case report: We diagnosed squamous cell carcinoma of the lung, stage T3N0 in a 71-year old male, ex-smoker, by transthoracic FNAB. A small metastasis was discovered in the left humerus after PET-CT. The patient was treated by chemotherapy and irradiation of bone metastasis. Four months after initial evaluation we repeated CT scan of the thorax. A tumour progression with tumour growth from the primary site was found in the left upper lobe to the pectoral muscle along the needle biopsy track. Conclusions: Although the frequency of chest-wall implantation metastasis after transthoracic FNAB of lung malignancies is very rare, attentive follow up is recommended. Early intervention with resection and irradiation is often curative in previously radically treated patients.