Multiple primary lung cancers, the hybrid approach in management: a case report

With improved screening and imaging, multiple primary lung cancers (MPLCs) are being recognized more frequently. Differentiating MPLCs from metastases is crucial for accurate staging and management. Surgery remains the cornerstone of treatment, yet many patients present with comorbidities that preclude bilateral resections. We describe two patients with synchronous MPLCs successfully treated using a hybrid approach—lobectomy for one lesion and stereotactic body radiotherapy (SBRT) for the contralateral lesion. We review the diagnostic reasoning, staging, and decision-making process underlying this individualized strategy.