Initial Manifestation Of Lung Cancer Research Articles

Lung Cancer Revealed by Choroidal Metastasis: About Two Cases

The most common site of ocular metastasis is the choroid. We report two cases of choroidal metastases (CM) revealing lung cancer. The first case is a 66-year-old patient consulting for reduced visual acuity. The fundus reveals a posterior pole choroidal mass. Ultrasound shows a weakly hyperhecogenic choroidal mass. Chest CT revealed the primary lung tumor. The second case is a 62-year-old woman consulting for reduced visual acuity in whom the fundus found a choroidal mass with sero-retinal detachment opposite. Fluorescein angiography, OCT, and ultrasound were in favor of choroidal metastasis. The lung CT scan revealed a lung tumor. Although uncommon, CM can be the initial manifestation of lung cancer. Their diagnosis is based on a range of clinical and paraclinical arguments. The treatment of CM with chemotherapy combined or not with ocular radiotherapy is often effective in disabling eye disorders. The aim of this work is to summarize the current knowledge on choroidal metastases, with an emphasis on epidemiology, diagnosis and treatment.

Paraneoplastic Raynaud's Phenomenon as an Initial Manifestation of Lung Cancer?

Raynaud's phenomenon can be a presenting feature of lung cancer.Evaluation for an underlying malignancy is important if the work-up is negative for autoimmune and vascular aetiology.

P646 Cardiac tamponade as initial manifestation of small cell lung carcinoma

Abstract We report the case of a 69 years old woman, ex-smoker, with a history of hypertension, dyslipidemia, diabetes and right leg partial amputation after childhood osteomyelitis, presented at the emergency department for dyspnoea, posterior thoracic pain and progressive distention of the abdomen. She was tachycardic, slightly hypoxemic but normotensive. Electrocardiography: sinus tachycardia, normal axis, diffuse microvoltage and electric alternans. Chest X-ray showed enlarged cardiac silouhette, bilateral pleural effusion and upper right pulmonary lobe consolidation. Transthoracic echocardiography revealed large pericardial effusion, swinging heart, right atrial and right ventricular colapse, significant respiratory variation of transmitral and transtricuspidian flow, dilated inferior vena cava without respiratory variation, all suggesting cardiac tamponade. Computed tomography showed a mediastinal and pulmonary mass in the upper right pulmonary lobe, invading the posterior right thoracic wall and multiple mediastinal voluminous lymphadenopaty and ascites. She became hypotensive and was transferred to a tertiary hospital for urgent drainage of pericardial effusion. Over 1200 mL of serohematic fluid was evacuated with the removal of the drainage catheter in the following 48 hours. A biopsy was performed through bronchoscopy and small cell carcinoma of the lung was diagnosed. Considering the advanced stage of the carcinoma the option of pallative treatment was pursued. Discussions Chronic accumulation of large amounts of pericardial fluid is well tolerated, especially in patients that have limited physical activity. Ecocardiography allows early detection of cardiac tamponade. Development of cardiac tamponade in the evolution of malignancy confers a poor prognosis. The particularity of the case Cardiac tamponade as initial manifestation of lung cancer is a very rare occurrence and only limited data exist in literature. Conclusion Simultaneous presence of ascites, pleural and pericardial effusion should rise the suspicion of malignancy. Abstract P646 Figure.

P1.16-39 Oncology Emergencies in Patients with Lung Cancer: Experience of One Hospital

Oncological emergencies (OE) are common conditions associated with significant morbidity and mortality. Individuals with malignancy may present with a cancer-related emergency; for many, this will be their initial manifestation of cancer (about 23%). Patients with lung cancer are the type of cancer patient who are most often admitted to emergency departments due to OE. The aim of this study was to characterize the OE like superior vena cava syndrome and metastatic spinal cord compression (MSCC) in patients with lung cancer, at our hospital. a retrospective review was undertaken to assess the number and the outcomes of patients admitted from 2015 to 2018 with lung cancer who had superior vena cava syndrome and MSCC. in this 4-year period there were 455 new patients with the diagnosis of lung cancer, and 31 had an OE: n= 15 (48%) had superior vena cava syndrome and n = 16 (52%) had MSCC. The median age was 66 years old and 90% were man. The histological diagnostics was adenocarcinoma in 48% (n=14), small cell lung cancer in 34% (n=10) and squamous cell carcinoma in 18% (n=4). In 61% (n=19) of the patients the OE was the first manifestation of cancer, and lead to the diagnosis. In the others, the median time between the diagnosis and the emergency was 6 months (0-56 month). Of this, 36% (n=4) were in the first-line chemotherapy, 36% (n=4) in the second-line chemotherapy and 18% (n=2) in the third-line chemotherapy. MSCC was the most frequent OE with 46% (n=16) of the patients, followed by superior vena cava syndrome (43%; n=15). 63% of the patients with MSCC, when the diagnosis was performed had lost the ability to walk; 50% had paraparesis, 25% paraplegia and only one presented with sphincter incontinence. 69% (n=11) of the patients with MSCC were treated with radiotherapy; 44% (n=7) underwent surgery and/or radiotherapy; 13% (n=2) were treated with steroids in combination with radiotherapy. 14 patients who were presented with superior vena cava syndrome (93%) were treated with radiotherapy. After the OE only 13 patients (37%; n=8 (62%) in superior vena cava syndrome and n=5 (38%) in MSCC) initiated or restarted systemic treatment for lung cancer. In this group disease progression was observed in a median time of 2 month after OE (0-31 months). Only 2 patients with MSCC who had lost the ability to walk regain it. 71% (n=21) of patients were dead 3 months after the OE. Only 4 patients (25%) with MSCC and 6 (40%) with superior vena cava syndrome were alive after 3 months of OE. OE causes severe morbidity and compromised survival and can be the initial manifestation of lung cancer. We need to be aware of this situation because the OE have the potential to progress rapidly; therefore, prompt, accurate diagnosis and institution of appropriate treatment are essential to achieve favorable outcomes.

Skeletal Muscle Metastasis Presenting as an Initial Manifestation of Lung Cancer

Skeletal Muscle Metastasis Presenting as an Initial Manifestation of Lung Cancer

Conjunctival metastasis as an initial sign of small cell lung cancer.

Introduction. To report a case of a conjunctival metastasis as the initial manifestation of small cell lung cancer. Methods. Observational case report. Results. A 50-year-old man without known systemic disease developed a conjunctival mass in his right eye. He underwent incisional biopsy of the tumor and systemic evaluation. Histopathologically, the conjunctival mass was a metastatic small cell carcinoma. Further evaluation revealed a primary small cell lung carcinoma with metastasis to liver and bones. The primary and metastatic tumors were treated with chemotherapy. Conclusion. Conjunctival metastasis may be the initial manifestation of lung cancer. It should be considered in the differential diagnosis of a deep conjunctival mass.

Bilateral Choroidal Metastases Revealing an Advanced Non-Small Cell Lung Cancer

Choroidal metastases are metastatic lesions to the choroid layer of the eye. Although infrequent, they may be the initial manifestation of lung cancer. To date, only 10 cases of choroidal metastasis as the first sign of lung carcinoma have been reported. We present a 42-year-old woman with choroidal metastasis as the initial manifestation of an advanced lung carcinoma.

ゲフィチニブが奏効した肺癌脈絡膜転移の1例

ゲフィチニブが奏効した肺癌脈絡膜転移の1例

Muscle metastases as initial manifestation of lung cancer

Muscle metastases as initial manifestation of lung cancer

Métastases gastroduodénales : un mode de révélation exceptionnel du cancer du poumon.Étude de deux cas et revue de la littérature

Introduction. – Diagnosis of gastroduodenal metastases is rare. Primary tumors are essentially melanomas and breast cancer, and exceptionally lung cancer. Exegesis. – We report two patients who have a diagnosis of gastroduodenal metastases as initial manifestation of lung cancer. In one case, the patient died 3 weeks after the diagnosis. In the other case, chemotherapy was performed and complete response was obtained for the gastric metastasis. After a few months, node recurrence was diagnosed and the patient died 8 months after the diagnosis. Conclusion. – We review the endoscopic and non-endoscopic literature and discuss the different histological types and therapeutic strategies concerning these unusual manifestations of lung cancer.

Estado epiléptico no convulsivo como forma de presentación de encefalitis límbica

Limbic encephalitis is an unusual presentation of paraneoplastic syndrome, which includes among its symptoms seizures. We report a case with a rare presentation of limbic encephalitis as initial symptom of small cell lung carcinoma. A 69 year-old woman presented with partial non convulsive status epilepticus and neuropsychiatric disturbances. Chest radiography and computed tomography showed mediastinal lymphadenopathy and lung nodules. Subsequently, small cell lung carcinoma was diagnosed by lymph node biopsy. The cerebrospinal fluid study was normal. The electroencephalography and magnetic resonance imaging (MRI) findings had distinctive features compatible with temporo-limbic dysfunction. The anti-Hu antibodies were negative. The neuropsychiatric symptoms improved significantly after systemic chemotherapy and adjuvant radiotherapy. A serial follow-up MRI of the head showed no evidence of intracranial metastasis three months after the diagnosis of cancer. Limbic encephalitis may be an initial manifestation of lung cancer. Paraneoplastic limbic encephalitis is considered a remote effect of cancer commonly associated with anti-neuronal antibodies (anti-Hu) and small cell lung carcinoma. Status epilepticus could be an early sign of limbic encephalitis. The absence of anti-Hu antibodies does not rule out the presence of an underlying small cell lung carcinoma in patients with a clinical diagnosis of limbic encephalitis. Greater awareness for diagnosis and early treatment of the primary tumor offers the best chance for improvement in patients with lung cancer presenting with limbic encephalitis.

Conjunctival Metastasis as the Initial Manifestation of Lung Cancer

To report a case of conjunctival metastasis as the initial manifestation of lung cancer. A 55-year-old man without known systemic disease developed a conjunctival mass in his right eye. He underwent excision of the tumor and systemic evaluation. Histopathologically, the mass was a metastatic squamous cell carcinoma. Further evaluation disclosed a primary bronchogenic carcinoma with metastasis to ribs and brain. The primary and secondary tumors were treated with chemotherapy and irradiation. Conjunctival metastasis may be the initial manifestation of lung cancer. It should be considered in the differential diagnosis of a deep conjunctival mass.

Metastasis-induced Acute Pancreatitis as the Initial Manifestation of Bronchogenic Carcinoma

Metastasis-induced pancreatitis (MIAP) is a very rare initial manifestation of lung cancer. A review of one institution's experience and the English language medical literature was conducted to define the incidence, natural history, and optimal treatment of this unusual clinical problem. One of 802 (0.12 percent) lung cancer patients presented with MIAP. Seven additional cases were found in the literature. Small-cell carcinoma was present in six of eight patients. Prognosis is poor. Four patients died within two weeks of hospital admission. In patients with small-cell carcinoma and mild pancreatitis, chemotherapy may favorably influence recovery from pancreatitis. Those with severe pancreatitis tolerate chemotherapy poorly and initial supportive management is advisable. Patients with small-cell histologic features who recover from pancreatitis should receive chemotherapy. Survival beyond six months is possible.

Cardiac tamponade caused by primary lung cancer and the management of pericardial effusion.

Between 1978 and 1990, 51 cases of pericardial effusion secondary to lung cancer were treated at the National Cancer Center Hospital by creating a pericardial window, using the subxiphoid approach, that was connected to a water-sealed drainage system. Most patients had advanced disease, such as distant metastasis (76%), pleural effusion (88%), and clinical Stage N2 or N3 disease (98%). Forty-five patients had cardiac tamponade, and six had no symptoms attributable to pericardial effusion. Cardiac tamponade was the initial manifestation of lung cancer in only 3 patients; it was a late manifestation in 48. Of those specimens that were examined cytologically, 92% had positive findings. The interval from creation of the pericardial window until removal of the drainage tube ranged from 4-135 days (median, 11 days). The interval was significantly longer in patients who previously had received thoracic radiation therapy (P < 0.05). The overall median survival was 80 days, and the 1-year survival rate was 10.5%. Postmortem examination showed that constrictive heart failure caused by pericardial lesions was the major contributory cause of death in 32% of patients. Using multivariate analysis, factors indicating a poor prognosis were: (1) the interval from the diagnosis of lung cancer to pericardial effusion development (P = 0.005) and (2) the absence of prior surgery (P = 0.007). The creation of a pericardial window effectively treated pericardial effusion in 85% of cases. However, the role of intrapericardial instillation of anticancer or sclerosing agents was unclear in this retrospective analysis.

Primary Lung Cancer Complicated with Pneumothorax

Eighteen lung cancer patients with a pneumothorax complication were studied. Pneumothorax appears rarely in lung cancer patients, having been found in 18 out of 5567 (0.32%) at our hospital over a period of ten years. Of the 18 patients, eight had adenocarcinoma, seven epidermoid carcinoma and three alveolar cell carcinoma. Unlike those of previous reports, our results showed pneumothorax not to be found exclusively on the same side as the lung cancer. It was contralateral in five cases. Pneumothorax was the initial manifestation of lung cancer in three cases and occurred as a complication in another 15. Of these 15 patients, 11 were described as developing pneumothorax between one and twelve months after completion of radiation therapy for lung cancer. Another two patients developed pneumothorax following cytotoxic chemotherapy. Pneumothorax occurred prior to any treatment for lung cancer in the remaining two patients. The factors contributing to pneumothorax in the lung cancer patients were the rupture of the necrotic neoplastic tissue into the pleural cavity, the rupture of a subpleural bleb or the formation of interstitial air due to partial bronchial obstruction by the tumor, complications arising from radiation therapy and cytotoxic chemotherapy, or any combination of such factors. Pneumothorax was an ominous sign for the lung cancer patients. Most (12/14) died within six months of the onset of pneumothorax.