2023 North America Conference on Lung Cancer (NACLC) - Posters and Abstracts-PP01.066 Shruti_Gupta_NACLC23

PP01.066 Shruti_Gupta_NACLC23_Abstract

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This case report describes an unusual presentation and delayed diagnosis of multifocal lung adenocarcinoma in a 61-year-old woman with a history of tobacco use disorder and chronic obstructive pulmonary disease (COPD). The patient initially presented to another hospital with acute respiratory failure and was found to have ground-glass opacities and consolidations in the lungs, which were initially thought to be organizing pneumonia. A wedge biopsy showed atypical adenomatous hyperplasia and organizing pneumonia, and the patient was treated with steroids. However, she later presented to a different facility with recurrent respiratory failure, and a re-evaluation of her biopsy slides, imaging, and clinical history suggested a diagnosis of multifocal adenocarcinoma. The patient received chemotherapy but ultimately developed multi-system organ failure and passed away on comfort care.<br /><br />Multifocal adenocarcinoma is a type of lung cancer that is often caught during screening of high-risk patients and treated with resection or local therapy. However, the diagnosis of this condition is often delayed due to its indolent course and non-specific clinical and radiologic presentations. In this case, the evaluation of clinical and pathologic data in a multi-disciplinary setting was crucial in establishing the correct diagnosis. The average 5-year survival rate for multifocal ground-glass/lepidic tumors is 85%, but this patient's disease was symptomatic and treatment-naïve, leading to poor outcomes. The findings of this case highlight the challenges in diagnosing and managing multifocal lung adenocarcinoma and the importance of considering this condition in patients with non-specific lung abnormalities.

Keywords

multifocal lung adenocarcinoma

delayed diagnosis

tobacco use disorder

COPD

organizing pneumonia

biopsy slides

chemotherapy

multi-system organ failure

5-year survival rate

non-specific lung abnormalities