Resection of synchronous bilateral multiple lung adenocarcinomas using virtual-assisted lung mapping

BACKGROUND: Virtual-assisted lung mapping (VAL-MAP) is a novel marking technique to assist sub-lobar resection of small hardly palpable lung tumors. Here, we present the first case of synchronous bilateral multiple lung adenocarcinomas that were successfully resected with VAL-MAP navigation. CASE PRESENTATION: A 73-year-old female with multiple nodules (1 in the right upper lobe, 2 in the right lower lobe, 1 in the left upper lobe, and 1 in the left lower lobe) was referred. Complete resection was achieved with left lower lobectomy in combination with sub-lobar resections (wedge resection for a lesion in the left upper lobe, segmentectomy for a lesion in the right upper lobe, and complex segmentectomy for lesions in the right lower lobe) in which resection lines with securing adequate margins were determined with VAL-MAP navigation. CONCLUSIONS: VAL-MAP is useful in sub-lobar resections including complex segmentectomy for multiple lung adenocarcinomas.