Primary Lung Signet Ring Cell Carcinoma Presenting as a Cavitary Pancoast Tumor in a 32-Year-Old Man

Corvini, Michael; Koorji, Alysha; Sgroe, Erica; Nguyen, Uyen Thao

doi:10.7556/jaoa.2018.086

Cited by 1 publication

(1 citation statement)

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“…CT imaging in two other cases revealed multiple cavitary lesions similar to our present case [ 9 , 10 ]. Another report described CT findings of a single cavitary lesion, later pathologically confirmed as adenocarcinoma [ 11 ]. Two additional cases reported echocardiogram findings suggestive of infective endocarditis; one such case diagnosed NBTE of the mitral valve in a patient with known stage 4 malignancy [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Mucinous Adenocarcinoma of the Lung Presenting as Septic Emboli

DEMARS¹,

Khan²,

LeBel³

et al. 2023

Cureus

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This is a case of a 92-year-old female with multiple hospitalizations for dyspnea on exertion and hypoxemia. Her symptoms were initially thought to be secondary to pneumonia, and on subsequent admission, culture-negative endocarditis. A computed tomography (CT) of the chest was remarkable for numerous bilateral lung nodules of varying size, some of which had a cavitary appearance raising concern for septic emboli. While a transthoracic echo was unremarkable, a transesophageal echo found a small 3 mm echodensity at the tip of the right coronary leaflet of the aortic valve and a possible mobile echodensity on the tricuspid valve leaflet. These findings further supported a clinical diagnosis of endocarditis with septic emboli in the lungs. Initial bronchoscopy yielded an unremarkable biopsy and a bronchial alveolar lavage with the growth of Actinomyces odontolyticus . During a subsequent hospitalization, a repeat bronchoscopy with transbronchial biopsy revealed a final diagnosis of invasive pulmonary mucinous adenocarcinoma. This case highlights a unique presentation of mucinous adenocarcinoma of the lung initially masquerading as septic emboli, resulting in a delay in the final diagnosis.

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