First presentation of metastatic lung cancer as groin necrotizing fasciitis

Abstract

Introduction: A B is a 64-year-old female who presented to the emergency department with fever, chill, and a swollen tender lump in the groin. She had a high white cell count of 14.0 × 109/L and a C-reactive protein (CRP) of 190 mg/L. She proceeded to have an urgent computed tomography (CT) scan. Case Report: A B had a past medical history of poorly controlled diabetes (HbA1c = 11%) which she was non-compliant to medication. She also had an 80-pack year smoking history. A CT scan performed showed severe cellulitis with a collection with a suggestion of necrotizing fasciitis. She was taken to theater urgently for debridement. Histological examination of the debrided tissue however showed poorly differentiated adenocarcinoma which was consistent with metastatic lung adenocarcinoma. Conclusion: This is the first case recorded of lung cancer with metastasis to the groin and presenting as a necrotizing soft tissue infection.