Biopsy -> scar tissue

Portal Forums Lung/Thoracic Cancer General Lung/Thoracic Cancer Biopsy -> scar tissue

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November 1, 2017 at 6:07 pm  #1293436    


Hello. I am a esophageal cancer patient (2007) who is ten years out with a re-occurrance to my lower left lobe in 2014 (chemo 2014 and surgery Jan 2015) and another spot same area late 2015 (cyberknife). Since then I have a growth that is about 1 1/4 inch by 1 inch in my left side at rib #9 in the plura, which has grown quite a bit since February of 2017. I also currently have a CEA tumor marker that was 60 in February 2017 and was 330 in September 2017. Also, it hurts to lay on my left side, and I had an unexpected weight loss in 2017.

All that being said, I had a biopsy of the growth in October 2017, and everyone expected it to be cancer – esophageal cancer. To everyone’s surprise, it wasn’t! The odd thing was, the biopsy report showed that it was scar tissue, which is weird. I asked if scar tissue would grown to such proportions 2 1/2 years after the original operation (January 2015 to September 2017), and they said it was quite weird.

My question is this: does it make any sense that this is scar tissue of this size that has grown that far out from surgery, or can we assume that the biopsy was flawed in some way?

The plan is to wait until December and see if the growth\scar tissue\tumor has grown and, if it has, to then do another biopsy. But I’m wondering if we should just re-do the biopsy, as scar tissue doesn’t make much sense to me.

Thanks in advance!


November 2, 2017 at 8:15 am  #1293438    
JimC Forum Moderator
JimC Forum Moderator

Hi MrSicily,

The growth that you describe would be considered unusual, as scarring from radiation or surgery tends to stabilize after a few months. There is a previous discussion about scarring vs. cancer growth in this thread, which includes comments from Drs. Hensing, Pennell and West. As they point out, it’s often possible to distinguish one from the other solely on the basis of CT scans, but when there is doubt a biopsy or PET scan (which would show the kind of metabolic activity associated with cancer) could resolve the question.

With a biopsy, it’s possible to miss cancer cells which may be present, especially if the amount of tissue collected is small. Perhaps a discussion with your doctor about performing a PET scan might be helpful.

Finally, although some patients’ lung cancer progression tracks with CEA values, in general it is not a sufficiently reliable marker upon which to base treatment decisions.

Forum moderator

Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then:

November 4, 2017 at 3:53 am  #1293458    


I’ve had this situation myself with lung cancer and just this year in May. They did my CT w/o contrast and then ordered a PET/CT. Mine also showed scar tissue. It’s not that the scar tissue expands anymore but you can stretch it out with different activities. This is what I was told.
I find it odd that you’ve had two recurrences which were zapped, but no chemo. Once it moves out of the original area to other organs, in your case the lungs, it’s considered stage IV and systemic treatment is normally given. Did you have any treatment other than radiation?
I’m sure they’ll keep an eye on it, as nothing in cancer is guaranteed. I have a follow-up scan the 13th then will go to one year scans if all is well.
Take care, Judy

Stage IIIA adeno, dx 7/2010. SRS then chemo carbo/alimta 4x. NED as of 10/2011.
Local recurrence, surgery to remove LRL 8/29/13. 5.2cm involved pleura. Chemo carbo/alimta x3. NED

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