Abstract
BackgroundThe outbreak of coronavirus disease 2019 (COVID-19) started in December 2020, and is a global problem now. There are several sets of established data regarding computed tomography (CT) findings in COVID-19 pneumonia with many differential diagnoses. During the early days of the pandemic, there was little data regarding lung CT features of COVID-19 in a cancer patient. In this paper, we described a rare case of simultaneous presentation of COVID-19 with pulmonary metastasis.Case presentationA Persian patient with a history of chondrosarcoma presented to our clinic during the COVID-19 pandemic with a new-onset cough. He had experienced no recurrence during previous follow-up visits. Chest CT scan revealed numerous bilateral small peripheral and perilymphatic pulmonary nodules, unilateral ground-glass patch, and nodular interlobular septal thickening. Biopsy of the pulmonary nodules established pulmonary metastasis of chondrosarcoma origin, and pharyngeal reverse transcription polymerase chain reaction (RT-PCR) was positive for COVID-19.ConclusionPulmonary metastasis should be considered as a differential diagnosis of COVID-19 features in cancer patients in the pandemic era.
Highlights
BackgroundCoronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first appeared in Wuhan, China, characterized by acute mild to severe respiratory symptoms
The outbreak of coronavirus disease 2019 (COVID-19) started in December 2020, and is a global problem
Pulmonary metastasis should be considered as a differential diagnosis of COVID-19 features in cancer patients in the pandemic era
Summary
Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first appeared in Wuhan, China, characterized by acute mild to severe respiratory symptoms. Examination of vital signs revealed a respiratory rate of 20 breaths/minute, blood pressure of 100/60 mmHg, oral temperature of 36.9 °C, and pulse rate of 120 beats/minute. On lung auscultation, he had bilateral fine rales. Based on two main differential diagnoses of pulmonary metastasis or SARS-CoV-2 infection, he underwent a chest computed tomography (CT) scan with intravenous contrast and SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR). Due to the challenging CT findings, it was difficult to rule out pulmonary metastasis in this case, so several lung biopsies were taken, and the pathology report revealed a recurrence of myxoid sarcoma in the lung. The patient was cared for as a COVID-19-infected case, and subsequently palliative chemotherapy was administered
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