Lung cancer - left lower lobe (retrocardiac)

Case contributed by Dr Ian Bickle

Presentation

Middle aged smoker of 30 pack years with chronic cough.

Patient Data

Age: 55
Modality: X-ray

Approximately 3cm left retrocardiac mass.

Minor left costophrenic angle pleural thickening.

Modality: Annotated image

Well defined left retrocardiac mass is enclosed with the circle.

Right lung clear.

Modality: CT

Approximtately 3cm left lower lobe mass.

Left costophrenic angle pleural thickening.

Case Discussion

This case is a classic illustrating the huge importance of checking the review areas on a chest x-ray.

This includes the retrocardiac space - when shown or indicated this tumour (lung cancer) is very visible, but easily overlooked by the unaware of if under time pressure.

The film could be used either in an FRCR 2B rapid reporting set or as the start for a viva case moving to CT Chest and subsequent management questions.

Discussion may include:

1.  How one would handle the x-ray of a primary care referral

2.  Recommendation - urgent referall to lung cancer MDT

3. Identifying the radiological stage

4. The role/amenability of CT guided lung biopsy

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Case Information

rID: 34627
Case created: 2nd Mar 2015
Last edited: 30th Jun 2016
System: Chest
Tags: rdgh, rapids
Inclusion in quiz mode: Included

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