2023 North America Conference on Lung Cancer (NACLC) - Posters and Abstracts-PP01.66 (Poster) An unusual presentation and delayed diagnosis of multifocal lung adenocarcinoma

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The case presented is about a 61-year-old African American woman with a history of tobacco use disorder, hypertension, hyperlipidemia, and chronic obstructive pulmonary disease (COPD). She presented to the hospital with shortness of breath and was found to have a low oxygen level.<br /><br />Upon examination, the patient was found to have sinus tachycardia, increased work of breathing, and abnormal lung sounds. Initial tests showed acidosis, elevated inflammatory markers, and no evidence of infection. Imaging revealed abnormalities in the lungs consistent with pneumonia.<br /><br />The patient initially received treatment for pneumonia, including antibiotics and steroids, but her symptoms did not improve. Upon re-reviewing the pathology from a previous biopsy, the patient was found to have multifocal adenocarcinoma in-situ instead of pneumonia. Further workup was unable to be done, and the patient was treated with chemotherapy. However, she developed complications and her condition worsened. She eventually passed away.<br /><br />The case highlights the challenges in diagnosing adenocarcinoma, as its symptoms and radiologic findings can be nonspecific. Multidisciplinary discussions and further research are needed to improve diagnostic criteria and identify similar cases earlier. The average 5-year survival for multifocal adenocarcinoma is good if caught early, but recurrence rates can be high if invasive components are present.<br /><br />The case also raises questions about genetic predisposition, the nature of multifocal adenocarcinoma, and the effectiveness of current screening criteria. Further efforts are needed to prevent delays in treatment for similar cases in the future.

Asset Subtitle

Shruti Gupta

Keywords

African American

tobacco use disorder

hypertension

hyperlipidemia

chronic obstructive pulmonary disease

shortness of breath

multifocal adenocarcinoma in-situ

biopsy

chemotherapy

delays in treatment