Excavated pulmonary nodules: an unusual clinical presentation of lung metastasis in two cases

BMC Medical Imaging

Case Report

Hassan Errihani¹  Wafa Allam¹  Khaoula Alaoui¹  Basma Elkhanoussi²  Issam Lalya³ 

[1] Department of Medical Oncology, National Institute of Oncology, Avenue Allal Alfassi, Hayriad, 10100, Rabat, Morocco;Pathology Department, National Institute of Oncology, Avenue Allal Alfassi, Aayriad, 10100, Rabat, Morocco;Radiation Department, National Institute of Oncology, Avenue Allal Alfassi, Hayriad, 10100, Rabat, Morocco;

关键词: Osteosarcoma;    Pulmonary Metastasis;    Ifosfamide;    Pulmonary Nodule;    Primary Malignancy;   

DOI  :  10.1186/1471-2342-10-13

 received in 2010-01-14, accepted in 2010-06-24,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundExcavated pulmonary metastasis are rare. We present two cases of excavated pulmonary nodules proved to be metastases from osteosarcoma and gallblader lymphoma.Case presentationThe first one is 39-year-old man in whom cholecystectomy made the diagnosis of primary non-Hodgkin's lymphoma of the gallbladder. He presented in chest CT scan excavated nodules that had been biopsied and confirmed the diagnosis of non hodgkin lymphoma. He underwent 8 courses of chemotherapy CHOP 21 with complete remission. The second one is an 21 years old man who presented a right leg osteoblastic osteosarcoma with only excavated pulmonary nodules in extension assessment. He had 3 courses of polychemotherapy API (doxorubicin, platinum, and ifosfamide) with partial response. Unfortunately, he died following a septic shock.Review of the literature shows that excavated pulmonary nodules as metastasis are rare but we should consider this diagnosis every time we are in front of a cancer. Chest computed tomography is the best diagnosis imaging that could make this diagnosis. Differential diagnosis between benign and malignant bullous lesions is important because surgical excision affects survival in some malignancies.ConclusionsAlthough pulmonary nodules are the most common cancer metastasis, a differential diagnosis of a concurrent primary malignancy should always be considered every time we have excavated lesions, even in patients with known malignant disease. Thorough chest evaluation is important, as multiple primary malignancies may occur concomitantly.

【 授权许可】

CC BY   
© Allam et al; licensee BioMed Central Ltd. 2010