Extended resection for unexpected invasion of the left sided lung cancer into the liver: combined lung, diaphragm, and liver resection.

Complete anatomic lung resection remains the best curative option in patients with early-stage lung cancer. In some cases, extended lung resections are required to achieve R0 resection. Although diaphragmatic invasion and resection is a well-known condition in lung cancer, direct invasion of the diaphragm and liver in lung cancer is rare. We report a 66-year-old man with left-sided lung cancer. Preoperative evaluation revealed the risk of diaphragm invasion, but the liver invasion was detected intraoperatively. In addition to left pneumonectomy, left-sided partial liver and diaphragm resection was performed. At 24 months from the operation, the patient is alive without any disease progression. We believe that combined resection including lung, diaphragm, and liver may have survival benefits in selected cases. © Indian Association of Cardiovascular-Thoracic Surgeons 2021.