PMC9623338_01
Chest CT.
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Affiliated Hospital of Xi'an Jiaotong University ( Figure 1 ) showed left hilar space occupying lesions, more central lung cancer, obstructive pneumonia and left lower lobe atelectasis were considered. After admission, blood routine test, liver and kidney function, electrolyte, blood glucose, blood coagulation and infection were checked.
Postoperative pathology (Lung).
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Postoperative pathology ( Figure 2 ): specimens of left lower lobe resection: (left) central adenosquamous carcinoma of the lung (lower) lobe, mainly squamous cell carcinoma, with no invasion of the pleura; No cancer tissue was found in the bronchial stump; Metastatic cancer was found in hilar lymph nodes, and no cancer tissue was found in para bronchial lymph nodes and lymph nodes in groups 5, 7 and 9/11; In addition, 6 groups of lymph nodes were sent as fibrous adipose tissue, and no cancer tissue was found.
Head MRI.
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Enhanced head MRI ( Figure 3 ): cystic space occupying lesion in the right temporal lobe, with significantly enhanced uneven rosette wall, surrounding moderate brain edema area, the midline was compressed and moved to the left about 1.1cm.
Postoperative pathology (head).
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Postoperative pathology ( Figure 4 ): (right temporal part) poorly metastatic carcinoma with massive hemorrhage and necrosis, which combined with immunophenotype conforms to poorly differentiated squamous cell carcinoma.
Echocardiography.
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Cranial MRI,Chest and whole abdominal CT: no recurrence and metastasis were found, and repeated echocardiography: medium echogenic mass in the left atrium (about 1.8cmx2.9cm in size), see  Figure 5 .
Postoperative pathology (Heart)HE x 100.
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Postoperative pathology ( Figure 6 ) suggests (left atrium) malignancy, tending to poorly differentiated adenosquamous carcinomamalignant tumors,.
Chest CT contrast (From left to right:2019.1-2021.6-2022.4).
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Since the operation, the general state is good, and no recurrence ( Figure 7 ).