Metastatic lung adenocarcinoma in a 20-year-old patient

Abstract

Lung cancer is rare disease in patients under 25 years of age. It typically occurs in older patients with a history of tobacco use. This case concerns a 20-year-old man with no history of tobacco use who complained of several months of cough and lower back pain and an 11.3-kg weight loss. He was treated for pneumonia after a chest radiograph showed total opacification of the right lung. Computed tomography imaging subsequently revealed a superior right hilar mass and mediastinal lymphadenopathy. Further imaging studies showed diffuse metastatic disease. Mediastinal biopsy showed poorly differentiated epithelioid tumour with desmoplastic stromal reaction, neutrophil infiltration, and squamous differentiation. Tissue immunostaining confirmed a non-small-cell lung cancer. Unfortunately, despite aggressive therapy, the patient's disease progressed, and he died within 9 months. In this paper, we hope to illustrate the unique challenges in diagnosing and treating young patients with metastatic lung cancer.

Keywords: Metastatic lung cancer; non-small-cell lung cancer; young patients.

FIGURE 1

Posteroanterior view of the chest demonstrates complete opacification of the right hemithorax.

FIGURE 2

Computed tomography imaging of the thorax, with contrast, reveals a poorly defined 7×7×8-cm superior hilar mass.

FIGURE 3

Biopsy of the mediastinal mass shows a poorly differentiated carcinoma, non-small-cell type. (Courtesy Kevin Leslie, md, of the Department of Pathology, Mayo Clinic Arizona; with permission)