IN EXAMINING a patient with carcinoma of the lung, it is the commonly accepted practice to search for evidence of metastases. If this is found, the condition with rare exceptions is rightly considered inoperable from the standpoint of cure of the disease. An additional factor to be considered is the location of the growth with respect to the trachea and the carina. If either of these structures is involved by the growth, the ordinary type of pneumonectomy could hardly be expected to be sufficient for cure. The neoplasm or its extension may be so situated as to render the growth obviously inoperable. Not infrequently, however, a growth visualized at a considerable distance from the carina extends in the submucosal lymphatics to the trachea and even to the opposite bronchus without producing any gross changes. In the absence of any other evidence of metastasis, such a lesion would ordinarily be considered