Unusual presentation of an invasive mucinous adenocarcinoma (aka-BAC) as cavitating pneumonia: a case report

Abstract

Mucinous adenocarcinoma, previously termed Broncho-alveolar carcinoma aka “BAC”, has a typical radiographic presentation that includes a solitary lesion, consolidation and diffuse pattern. A 50-year-old female presented with a productive cough, episodic haemoptysis and significant weight loss, with the initial radiographic finding showing an atypical form of cavitating pneumonia mimicking tuberculosis. Chest CT showed a cavitating lesion of the right lower lobe. There was no clinical or radiographic resolution after treatment with antibiotics. An open lung biopsy was performed and was consistent with invasive mucinous adenocarcinoma. Unfortunately, before the introduction of appropriate therapy, respiratory failure led to her demise. To avoid misdiagnosis, clinicians in areas with high TB incidences should be aware of the atypical presentation of mucinous adenocarcinoma as it can mimic infectious processes, as in our case. Early diagnosis avoids delays in initiating proper treatment and resultant poor outcomes.