SYNCHRONUS TUMORS: A RARE COMBINATION

Abstract

TYPE: Late Breaking Abstract TOPIC: Lung Cancer INTRODUCTION: Synchronous tumors refers to cases in which the second primary cancer is diagnosed within 6 months of primary cancer. Carcinoid tumors are rare slow growing tumors arising from the enterochromaffin cells disseminated through out the gastrointestinal and bronchopulmonary systems. Carcinoid tumors are innocuous at time of presentation emphasizing the need for multidisciplinary approach for the diagnosis. CASE PRESENTATION: A 80 year old male patient came with complaints of cough with expectoration on and off for 3 years increased since 1 week with occasional minimal hemoptysis, loose stools, loss of weight and loss of appetite. Chest X-Ray showed ill-defined opacity in the left lower zone. CECT showed two well defined heterogenous enhancing lesion in the superior and lateral basal segment of left lower lobe. Bronchoscopy guided biopsy revealed typical carcinoid. In view of recurrent diarrhea patient underwent endoscopy which revealed poorly differentiated adenocarcinoma. DISCUSSION: Gastrointestinal symptoms along with lung symptoms can be attributed to disseminated carcinoid or carcinoid syndrome. Carcinoid syndrome occurs in fewer than 5% of cases.It presents with symptoms like diarrhea, wheezing, palpitation’s, hypotension. In this case we were attributing the gastric symptoms to carcinoid syndrome. Endoscopy was done in view of diarrhoea which revealed a second malignancy. We lost the patient in view of dual primary within a month. Synchronous tumors with gastric carcinoid have been reported but to our knowledge carcinoid lung with adenocarcinoma of stomach have not been reported. CONCLUSIONS: All symptoms in a tumor patient should not be attributed to paraneoplastic syndromes and metastasis further workup should be done using a multidisciplinary approach. DISCLOSURE: No significant relationships. KEYWORD: Synchronous tumor