A 75-year-old man with a history of resected colon carcinoma presented
to his primary care physician because of a new onset of coughing, The
patient had expectorated a small piece of solid tissue; pathologic ex
amination of the tissue found it to be consistent with metastatic colo
n adenocarcinoma. After further work-up, a right upper lobectomy was p
erformed. The surgical specimen removed during the lobectomy showed a
tumor that was histologically identical to the patient's prior colonic
primary tumor.