How would you approach a biopsy proven NSCLC patient with mediastinum negative disease and contralateral suspicious spiculated PET avid nodule without pathologic diagnosis?  

This is a scenario I have faced before. Sometimes unfortunately in spite of staging studies, the stage a lung cancer patient has might remain a bit unclear. In this situation if this is a functioning patient with good PFTs who is a surgical candidate I would consider treating him like he has 2 ...

The patient either has two primaries or oligometastatic disease and biopsy of the left-sided lesion could be important in distinguishing the two although the whole point may be academic; both lesions need to come out sequentially if the patient is fit. I reserve SBRT for patients unfit for surgery s...