Mestatstic adenocarcinoma of the lung

Case contributed by Dr Ian Bickle

Presentation

Right upper quadrant pain. Left sided painless neck mass.

Patient Data

Age: 70
Gender: Male

CT CHEST

10cm spiculated mass left upper lobe. The left upper lobe mass is contiguous with the large soft tissue density lesions in the mediastinum in the aorto-pulmonary window, prevascular and left tracheo-bronchial region with bulk dimensions of 8.5 x 5 cm. 

1.2cm nodule is seen in the left upper lobe.

Precarinal lymphadenopathy, right lower paratracheal node. Right upper anterior mediastinal enlarged lymph nodes, measuring 2.8cm .

2.3cm left supraclavicular node.

Emphysematous change in both lungs.

CT ABDOMEN

Three hypodense lesions seen in the liver, 1.9 cm in segment III, and two 2cm lesions in segment VII.

6.2cm left adrenal mass.

4.4cm lobulated peritoneal mass indenting the anterior border of segment IV of liver and several other smaller peritoneal nodules seen for example medial to the hepatic flexures and in posterior right subdiaphragmatic region.

1.2 cm nodule is seen in left anterior pararenal space. 2.1 cm nodule seen inferomedial to the spleen is indeterminate.

Enlarged lymph nodes seen in the left para-aortic and right common iliac regions, measuring upto1.8 cm .

3.0 x 2.2 cm enhancing nodule is seen in the posterior wall of the urinary bladder, immediately medial to the right vesico-ureteric junction.

No destructive bony lesion.

6cm fusiform infrarenal aortic aneurysm with mural thrombus.

Case Discussion

An example of advanced non-small cell lung cancer at presentation.

Radiological stage: T4, N3, M1c

Ultrasound guided biopsy of a left supraclavicular lymph node was undertaken.

Result:   Metastatic adenocarcinoma of the lung

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Case information

rID: 55315
Case created: 29th Aug 2017
Last edited: 31st Aug 2017
System: Chest
Inclusion in quiz mode: Included

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