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C. Tasci
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P3.06 - Poster Session/ Screening and Early Detection (ID 220)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 2
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.06-018 - Quick Radiological Course of Lung Cancer Mimicking Pulmonary Tuberculosis (ID 269)
09:30 - 09:30 | Author(s): C. Tasci
- Abstract
Background:
Cavitary lung lesions are primarily due to pulmonary tuberculosis but they also can be associated with other etiologies such as lung malignancies, fungal infections. To exclude tuberculosis with ARB tests when these kind of lesions detected, is a generally accepted clinical approach. Rapid radiological progression in cavitary lesions are usually interpreted as tuberculosis while a slower progression is expected in malignancies.
Methods:
‘not applicable’
Results:
We presented this rare case because of a rapid radiological progression in a patient with lung cancer. Sixty-six year old male was admitted to our clinic with cough, weight loss, fever and fatigue. ARB test was planned and nonspecific antibiotherapy was started because of the cavitary lesions in left upper lobe on CT which was performed in another centre one week before admission to our clinic. ARB test was negative and control CT was planned. CT revealed prominent progression of the lesions. Although tuberculosis was the initial diagnosis because of this rapid progression diagnostic bronchoscopy was performed. Endobronchial lesion in the left upper lobe was detected and pathological examination revealed squamous cell lung cancer.
Conclusion:
Although cavitary lesions can be observed in lung cancer, such a rapid progression as observed in our case suggests infections, especially pulmonary tuberculosis rather than malignancies. We presented this case to be useful for the clinicians in cavitary lung lesion assessment process.
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P3.06-021 - Lung Cancer Presented with Neurological Symptoms and Diagnosed after Brain Surgery (ID 252)
09:30 - 09:30 | Author(s): C. Tasci
- Abstract
Background:
Lung cancer is still one of the the most important and common mortality cause. Although, the presentation and course of the disease differ with the cell type, usually typical symptoms are seen. The most common symptoms include fatigue, weight loss, shortness of breath, and chest pain. These symptoms especially in smoking patients suggest lung cancer first. But in some cases paraneoplastic syndromes and symptoms of other systems caused by diffusing cancer come forward. Such findings are most common in small cell lung cancers (SCLC) among lung cancers. Because early metastasis and paraneoplastic syndromes SCLC can have very different clinical presentations.
Methods:
To emphasize this issue, we present a case of SCLC having only neurological signs.
Results:
60 years old male patient with a history of 70 pack years smoking, admitted to neurology clinic with vertigo, headache, nausea, and changes in consciousness. Because of the tumoral lesion in the left cerebellum seen in brain computed tomography, he was referred to brain surgery. Although, a preoperative thorax tomography revealed a mass lesion in left lung, he was operated for palliation of neurological symptoms and pathological diagnosis. Intraoperative frozen sampling diagnosed as small cell lung cancer. Patient is still followed by our department and radiation oncology.
Conclusion:
We present this case as a reminder of lung malignancies can be met by different presentations.
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P3.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 226)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 2
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.08-030 - Bronchoscopic Diagnosis of Esophageal Carcinoma Mimicking Lung Cancer (ID 257)
09:30 - 09:30 | Author(s): C. Tasci
- Abstract
Background:
Esophageal cancers are usually determined by examining the etiology of symptoms. Diagnosis in people without symptoms is rare and usually incidental. Although the most common symptom of esophageal cancer is dysphagia, in some cases clinical presentation can be different or misleading. Nevertheless, most esophageal cancers do not cause symptoms until they have reached an advanced stage. Here, we present an esophageal cancer case which suggests pulmonary malignancy with the clinical presentation.
Methods:
‘not applicable’
Results:
68-year-old male admitted our clinic with loss of appetite, weight loss and chest pain complaints. He had a smoking history of 30 packs/year. He was using LABA + ICS because of COPD. He told that his complaints had started 6 months before and gradually progressed. Because of the bilateraly suspicious hilar enlargement in chest X-ray, thorax CT examination was performed. In thorax CT, a conglomerate lesion, extending from subcarinal area to the posterior aspect of trachea, was observed. A clear distinction of lymphadenopathy/soft tissue could not be made. Diagnostic EBUS (endobronchial ultrasound) was performed to the patient under general anesthesia. During the process, a lesion protruded into the tracheal lumen with irregular surface was observed and biopsy was taken from this area. Also, EBUS guided biopsies were taken from the soft tissue lesions observed in thorax CT. In PET-CT of the patient, which was performed after this procedure, increased focal FDG uptake (SUWmax: 27.1) in the relevant field was observed without increased uptake elsewhere. Histopathological evaluations of these biopsies have been reported as esophageal squamous cell carcinoma. Subsequently, endoscopy was performed by gastroenterologists. In the course ofˈd(y)o͝oriNG endoscopy process, an ulcerated lesion, 1.5 cm in diameter and obstructing approximately 1/3 of the lumen, was observed on esophageal Z line at 44th cm from the incisors. The results of the biopsies taken from this area were also reported as esophageal squamous cell carcinoma. Thereafter, the patient was referred to Medical Oncology Department for oncologic treatment and follow-up.
Conclusion:
We shared this case in terms of being an informative example for local metastasis of esophageal malignancies presented with pulmonary symptoms which must be considered in differential diagnosis of intrathoracic masses.
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P3.08-031 - Endobronchial Spread of Malignant Melanoma to Lungs, a Case with Original Images (ID 268)
09:30 - 09:30 | Author(s): C. Tasci
- Abstract
Background:
Malignant melanoma, result of malignant transformation of melanocytes, metastasis mainly to regional lymph nodes, skeletal, and nervous systems. However, malignant melanoma can also metastasis to lung either. These metastases usually reach the lungs by tumor emboli to pulmonary arteries. Endobronchial spread of malignant melanoma to lungs diagnosed by bronchoscopy cases have limited number in literature. Here we share a malignant melanoma case spread endobronchially.
Methods:
‘not applicable’
Results:
62 years old male patient known to have malignant melanoma, was accepted to intensive care unit with respiratory distress and was intubated. In first evalution of his HRCT, consolidation and pleural effusion, constitute with large part of left lung’s atelectasis and less pleural effusion and partial atelectasis of neighbor parenchyma in right lung were seen. For both possible endobronchial metastasis causing airway obstruction and tumoral infiltration of parenchyma, bronchoscopy was performed through the endotracheal tube. Airway visualization revealed edema of the left main bronchus, concentrically significantly narrowed upper lobe, but segments were visible. Left lower lobe input was narrowed and segments were not visible. In entrance of left upper lobe there was an endobronchial lesion in brown- black color and slightly bulging form the mucosa like nevus. Transbronchial biopsy was taken from this nevus like formed lesion and left lung upper lobe apicoposterior. Both samples were reported as malignant melanoma by pathologist.
Conclusion:
We shared this case as an example of rare appearance of malignant melanoma with original images. We believe that this case report would be helpfull in terms of clinical practice.
