Coexistent Non–Small Cell Carcinoma and Small Cell Carcinoma in a Patient Presenting with Hyponatremia
Despite recent advances in screening methods, lung cancer remains the leading cause of cancer-related deaths worldwide. By the time lung cancer becomes symptomatic and patients seek treatment, it is often too advanced for curative measures. Low-dose computed tomography (CT) screening has been shown...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Pulmonology |
| Online Access: | http://dx.doi.org/10.1155/2018/1718326 |
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| author | Mitchell D. Ross Sreeja Biswas Roy Pradnya D. Patil Jasmine L. Huang Nitika Thawani Ralph Drosten Tanmay S. Panchabhai |
| author_facet | Mitchell D. Ross Sreeja Biswas Roy Pradnya D. Patil Jasmine L. Huang Nitika Thawani Ralph Drosten Tanmay S. Panchabhai |
| author_sort | Mitchell D. Ross |
| collection | DOAJ |
| description | Despite recent advances in screening methods, lung cancer remains the leading cause of cancer-related deaths worldwide. By the time lung cancer becomes symptomatic and patients seek treatment, it is often too advanced for curative measures. Low-dose computed tomography (CT) screening has been shown to reduce mortality in patients at high risk of lung cancer. We present a 66-year-old man with a 50-pack-year smoking history who had a right upper lobe (RUL) pulmonary nodule and left lower lobe (LLL) consolidation on a screening CT. He reported a weight loss of 45 pounds over 3 months, had recently been hospitalized for hyponatremia, and was notably cachectic. A CT of the chest showed a stable LLL mass-like consolidation and a 9×21 mm subsolid lesion in the RUL. Navigational bronchoscopy biopsy of the RUL lesion revealed squamous non–small cell lung cancer (NSCLC). Endobronchial ultrasound-guided transbronchial needle aspiration of the LLL lesion revealed small cell lung cancer (SCLC). The final diagnosis was a right-sided Stage I NSCLC (squamous) and a left-sided limited SCLC. The RUL NSCLC was treated with stereotactic radiation; the LLL SCLC was treated with concurrent chemotherapy and radiation. In patients with multiple lung nodules, a diagnosis of synchronous multiple primary lung cancers (MPLCs) is crucial, as inadvertent upstaging of patients with MPLC (to T3 and/or T4 tumors) can lead to erroneous staging, inaccurate prognosis, and improper treatment. Recent advances in the diagnosis of small pulmonary nodules via navigational bronchoscopy and management of these lesions dramatically affect a patient’s overall prognosis. |
| format | Article |
| id | doaj-art-aa6d36fd26e44d2f95fcd9c5643f1149 |
| institution | Kabale University |
| issn | 2090-6846 2090-6854 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pulmonology |
| spelling | doaj-art-aa6d36fd26e44d2f95fcd9c5643f11492025-02-03T05:46:29ZengWileyCase Reports in Pulmonology2090-68462090-68542018-01-01201810.1155/2018/17183261718326Coexistent Non–Small Cell Carcinoma and Small Cell Carcinoma in a Patient Presenting with HyponatremiaMitchell D. Ross0Sreeja Biswas Roy1Pradnya D. Patil2Jasmine L. Huang3Nitika Thawani4Ralph Drosten5Tanmay S. Panchabhai6Department of Internal Medicine, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USADepartment of Internal Medicine, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USADepartment of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USANorton Thoracic Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USADepartment of Radiation Oncology, University of Arizona Cancer Center, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USADepartment of Radiology, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USANorton Thoracic Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USADespite recent advances in screening methods, lung cancer remains the leading cause of cancer-related deaths worldwide. By the time lung cancer becomes symptomatic and patients seek treatment, it is often too advanced for curative measures. Low-dose computed tomography (CT) screening has been shown to reduce mortality in patients at high risk of lung cancer. We present a 66-year-old man with a 50-pack-year smoking history who had a right upper lobe (RUL) pulmonary nodule and left lower lobe (LLL) consolidation on a screening CT. He reported a weight loss of 45 pounds over 3 months, had recently been hospitalized for hyponatremia, and was notably cachectic. A CT of the chest showed a stable LLL mass-like consolidation and a 9×21 mm subsolid lesion in the RUL. Navigational bronchoscopy biopsy of the RUL lesion revealed squamous non–small cell lung cancer (NSCLC). Endobronchial ultrasound-guided transbronchial needle aspiration of the LLL lesion revealed small cell lung cancer (SCLC). The final diagnosis was a right-sided Stage I NSCLC (squamous) and a left-sided limited SCLC. The RUL NSCLC was treated with stereotactic radiation; the LLL SCLC was treated with concurrent chemotherapy and radiation. In patients with multiple lung nodules, a diagnosis of synchronous multiple primary lung cancers (MPLCs) is crucial, as inadvertent upstaging of patients with MPLC (to T3 and/or T4 tumors) can lead to erroneous staging, inaccurate prognosis, and improper treatment. Recent advances in the diagnosis of small pulmonary nodules via navigational bronchoscopy and management of these lesions dramatically affect a patient’s overall prognosis.http://dx.doi.org/10.1155/2018/1718326 |
| spellingShingle | Mitchell D. Ross Sreeja Biswas Roy Pradnya D. Patil Jasmine L. Huang Nitika Thawani Ralph Drosten Tanmay S. Panchabhai Coexistent Non–Small Cell Carcinoma and Small Cell Carcinoma in a Patient Presenting with Hyponatremia Case Reports in Pulmonology |
| title | Coexistent Non–Small Cell Carcinoma and Small Cell Carcinoma in a Patient Presenting with Hyponatremia |
| title_full | Coexistent Non–Small Cell Carcinoma and Small Cell Carcinoma in a Patient Presenting with Hyponatremia |
| title_fullStr | Coexistent Non–Small Cell Carcinoma and Small Cell Carcinoma in a Patient Presenting with Hyponatremia |
| title_full_unstemmed | Coexistent Non–Small Cell Carcinoma and Small Cell Carcinoma in a Patient Presenting with Hyponatremia |
| title_short | Coexistent Non–Small Cell Carcinoma and Small Cell Carcinoma in a Patient Presenting with Hyponatremia |
| title_sort | coexistent non small cell carcinoma and small cell carcinoma in a patient presenting with hyponatremia |
| url | http://dx.doi.org/10.1155/2018/1718326 |
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