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    P1.24 - Poster Session 1 - Clinical Care (ID 146)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 2
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      P1.24-014 - Metastatic angiosarcoma presenting as haemoptysis and severe pain on the back (ID 1172)

      09:30 - 09:30  |  Author(s): C. Ar

      • Abstract

      Background
      Angiosarcoma is a rare malignant neoplasm of the vascular or lymphatic endothelium that accounts for 2% of all soft-tissue sarcomas.Angiosarcoma in the lung is a rare disorder and is usually attributable to metastasis from primary site such as skin, soft-tissue, heart, breast or liver.We describe a case of pulmonary metastatic angiosarcoma who presented with episodic haemoptysis and severe pain on the back.

      Methods
      A 21-year-old male was admitted with history of recurrent hemoptysis and pain on the his back for two months.There were no other constitutional symtoms.Thoracic and abdominal computed tomograhy scan revealed left hilar lymphadenopathy and bilateral multiple nodules; the spleen was enlarged and shown multipl hypodense lesions.Hilar lymphadenopathy was sampled by real time convex prob EBUS TBNA and CT guided transthoracic fine needle aspiration was performed.Definitive diagnosis couldnt be obtained with both procedures.PET scan revealed the widespread FDG uptake bone marrow, liver and spleen and lung. The patients underwent bone marrow biopsy and histopathological examination of yields reported angiosarcoma.Immunohistochemistry (CD 31 positivity) confirmed the diagnosis of angiosarcoma.

      Results
      The patient showed progressive deterioration and anemia and thrombositopenia and hemoperitoneum owing to spontaneous liver rupture appeared.He was managed with repeated blood transfusions but he died twenty-seventh days after admitted hospital.

      Conclusion
      We presented a rare angiosarcoma case with aggressive clinical course and a fatal prognosis for the patient.

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      P1.24-033 - A rare case: lung cancer and multiple myeloma (ID 2407)

      09:30 - 09:30  |  Author(s): C. Ar

      • Abstract

      Background
      A multiple myeloma (MM) is a malignant disease of plasma cells, which manifests as one or more of lytic bone lesions, monoclonal protein in the blood and/or urine and disease in the bone marrow. The most typical thoracic manifestation of multiple myeloma is bony involvement of the thoracic cage. Other manifestations include pneumonia, intra-parenchymal mass lesions, mediastinal lymphadenopathy, interstitial pattern like reticulonodular shadows and intrapulmonary calcification. The diagnosis of a secondary solid neoplasm in patients with MM is uncommon, and it is debatable whether the MM itself is a risk factor for the incidence of a secondary solid neoplasm.

      Methods
      62 year-old men, former heavy smoker ,treated pulmonary tuberculosis(1977), autologous bone marrow transplantation (BMT) for MM two years ago.He admitted complaints of fever, cough,sputum and nigth sweats for a month. Physical examination was remarkable moderate pallor. Routıne serum biochemistry parameters were within normal limits except hemoglobin (6.6 gm/dl),ESR was 84 mm in the first hour.Chest xray and computed tomography (CT )showed multiple, bilateral,various size, well-circumscribed pulmonary nodules, containing calcification solid nodul 2 cm in diameter and periferal consolidatıon ın the rigth upper lob . Previous chest radiographs and CT had revealed the presence bilateral multiple nodules and low uptake18F‑fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) ( suv max:2.4).

      Results
      The patient underwent wedge resectıon rigth upper lobe for evaluating nodules three years ago.Histological examination demonstared weak -granulom formation and nodüles consisting dystrophic calcification ,multifocal hyalinisation and ossification It was considered sequelae of tuberculosis. Follow –up imaging studies increased in size,the number of pulmonary nodules and newly rigth 8th and left 6th rib hypermetabolik uptake in PET.CT -guided transthoracic needle aspiratıon biopsy performed the increasing nodul in the rigth upper lobe diagnosed adenocarcinoma.The patient is still alive and on follow-up.

      Conclusion
      Studies have shown that people who have had allogeneic transplants have a higher risk of second cancer than people who got a different type of stem cell transplant. In this case it is difficult to conclude whether TB sequelae caused lung cancer or the lung cancer simply associated in a patient with previously known pulmonary TB. Initial diagnosis of tuberculosis in such patients often misleads the physician to abandon further work-up resulting in overlooking or delayed diagnosis of the lung neoplasm,thus affecting their outcome