Endobronchial carcinoid is an uncommon pulmonary neoplasm. In this brief report, we present a case of an HIV-infected patient with an incidentally identified endobronchial carcinoid. This case illustrates the importance of a broad differential diagnosis for lung lesions in HIV-infected patients.
S o m e U n u s u a l P a r a n e o p l a s t i c S y n d r o m e s CASE 1. METASTATIC SQUAMOUS CELL ESOPHAGEAL CANCER TO THE THUMBA 56-year-old white male was received in our outpatient clinic because of slight pain and swelling on the thumb of his left hand. The patient reported a history of trauma with a fishhook 3 days earlier but recognized that the finger was already swollen for a week. The symptoms were confined to the distal phalanx of the thumb, and on examination, it had an inflammatory aspect (Fig 1). He had been diagnosed 3 months earlier with squamous cell esophageal carcinoma with metastatic supraclavicular lymph nodes. He was treated with palliative radiotherapy and cisplatin-fluorouracil chemotherapy. A complete regression of the supraclavicular nodes and a resolution of the dysphagia were obtained.A radiograph of the thumb (Fig 2) showed destruction of the distal phalanx with soft-tissue tumor and lytic lesions in the proximal phalanx. A biopsy was performed, revealing metastatic squamous cell carcinoma. Recurrence of the esophageal tumor was detected by endoscopic examination, and it was the only evidence of disease relapse after work-up. The pain was controlled with nonsteroidal analgesics, but the patient developed recurrent dysphagia and started second-line chemotherapy.Bone metastases are frequent in cancer patients; however, acrometastases or metastases to the hand and foot are rare. Acrometastases have been reported in a variety of malignancies, such as breast, lung, gastrointestinal, and genitourinary tract, especially renal cell carcinoma. 1 In some cases, it can be the first manifestation of an occult cancer. 2,3 A biopsy must be performed to confirm the diagnosis because many cases are often mistaken for benign processes, such as infection or inflammatory arthritis.
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