Abstract :
Abstract
Background: Lung adenocarcinoma is the kind of non-small cell lung cancer (NSCLC) that is most common. It accounts for around 40% of all instances of lung cancer and is the most prevalent subtype among nonsmokers, despite its strong association with smoking. Adenocarcinomas frequently occur in advanced stages, which has a worse prognosis and fewer treatment choices. Their clinical appearance varies greatly.
Case Illustration: A 69-year-old lady who does not smoke has had a dry cough for a year, which has gotten worse over the past two months. She should see an ENT expert because her cough is accompanied by hoarseness and snoring. A laryngoscope reveals paresis of right vocal cord and a right tracheal mass on CXR. A neck CT reveals a thickened posterior tracheal wall with a suspicion of malignancy and lateral bowing of right vocal cord, but with no abnormality in chest CT. She was then referred to our pulmonology department for tissue sampling using bronchoscopy. Bronchoscopy showed an infiltrative stenoting with a suspicion due to malignancy. A forceps biopsy obtained via bronchoscopy reveals an adeno/adenosquamous carcinoma morphology. Further immunohistochemistry test shows a positive Napsin-A and negative TTF-1 and p40 consistent with adenocarcinoma with wild-type EGFR mutation. She was then treated with systemic chemotherapy as per our local protocol. After 3 series of chemotherapy, she came to our department for a follow-up with significant improvement in her symptoms.
Conclusion: The high number of cases of lung adenocarcinoma, accompanied with subtle clinical presentation which often delay the diagnosis, should prompt clinicians to be more aware for the possibility of the disease even with no obvious abnormality in chest imaging.
Keyword :
Lung adenocarcinoma, Tracheal mass, Lung cancer