Pulmonary epidermoid carcinoma in a patient with acromegaly: a rare entity

Abstract

A 56-years-old woman was referred to our unit for partially treated acromegaly. She had a high level of insulin growth factor. She did not complain of any pulmonary symptoms and was a non-smoker. Physical examination revealed clinical features of acromegaly. She had a 13 mm pituitary adenoma and was proposed for surgical intervention. Her chest X-ray showed a right paracardiac tumor. Computed tomography scan revealed a large right-sided fowler tumor. Pituitary surgery was cancelled and lobectomy after biopsy with lymph nodes excision was performed through thoracotomy. Histological study of the tumor revealed a medium differentiated epidermoid carcinoma with positive lymph nodes and extension to pleura. She was referred to chemotherapy protocol. Association between carcinoma and acromegaly has previously been reported. Most common tumors are colorectal and thyroid neoplasia. As we see in this case report, we need to consider other carcinomas in acromegalic patients like pulmonary carcinoma, despite their rarity in women.

Keywords: Acromegaly; carcinoma; epidermoid carcinoma; pituitary adenoma; pulmonary neoplasia.

Figure 1

Right sided paracardiac opacity at chest X-ray without pleural effusion

Figure 2

Right medium lobe large tumor at the thorax tomography scan, with speculated margin, in contact with the big lung sulcus and elargment of right inferior lobe

Figure 3

CT scan right ovalar 45x35 mm necrosed tumor with irregular margin, with no mediastinal lymph nodes, and no left parenchymatous anomaly and no pleural reaction