Successful Use of Photodynamic Therapy in a Patient with Squamous Cell Carcinoma of the Lung and Diffuse Endobronchial Lesions

Field cancerization, a phenomenon in which multiple tumors arise in a carcinogen damaged field could potentially explain the synchronous and metachronous premalignant or malignant lesions surrounding the primary tumor in smokers with aerodigestive malignancies. We report the case of a patient with invasive squamous cell carcinoma (SqCC) of the lung, complicated by multiple synchronous, radiologically silent endobronchial lesions. He underwent successful treatment with stereotactic body radiation therapy (SBRT) followed by adjuvant photodynamic therapy (PDT). We wish to highlight the need for more prospective clinical studies to determine which patient population would be appropriate for early bronchoscopic evaluation and the efficacy of using multimodal therapies like PDT for field cancerization. Further studies could not only give clinicians the opportunity to diagnose radiologically silent endobronchial lesions, but could also lead to using multimodal therapies against field cancerization.