A 63-year-old man is evaluated because of new-onset hemoptysis and a 100-pack-year smoking history. Chest radiograph shows a 4-cm right perihilar mass, and bronchoscopic biopsy and cytologic evaluation of sputum confirm squamous cell carcinoma. There are no significant findings on physical examination, and the patient reports no weight loss.Complete blood count is normal except for a serum alkaline phosphatase level at 110 U/L. CT scans of the chest and abdomen show no mediastinal adenopathy. Results of a positron emission tomography scan are negative, except for the right perihilar mass.In which of the following situations would surgical therapy be offered?

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A solitary brain metastasis in the context of lung cancer can be treated with surgical resection of the primary lung tumor and the brain metastasis, followed by appropriate adjuvant therapy, as it may offer a survival benefit in selected patients. Other options listed (A, B, D) indicate more disseminated disease, which typically precludes surgical intervention as a curative approach.

A 63-Year-Old Man Is Evaluated Because of New-Onset Hemoptysis and a 100-Pack-Year