Mandal Shobha, Pradhan Ravi R, Bethala Mary Grace, Khan Salman, Karki Apurwa
Internal Medicine, Guthrie Robert Packer Hospital, Sayre, USA.
Internal Medicine, Tribhuvan University Institute of Medicine, Kathmandu, NPL.
Cureus. 2020 Aug 31;12(8):e10166. doi: 10.7759/cureus.10166.
Lung cancer is one of the most common malignancies worldwide, and metastasis occurs in more than one-third of cases. Common sites of metastatic disease are the brain, spine, nerve, adrenal glands, bone, liver, and pleura. Peritoneal involvement, however, is rare, and peritoneal involvement found in lung cancer is presumed to be metastatic until proven otherwise. This is due to the fact that primary peritoneal adenocarcinoma is uncommon and difficult to distinguish from the metastatic spread. Here, we report on a case of a 73-year-old woman who presented with ascites. Evaluation of ascitic fluid was consistent with adenocarcinoma. Subsequent CT of the chest revealed a 4.3-cm mass in the lower lobe of the left lung, which was determined to be poorly differentiated squamous cell carcinoma on histopathology. This is a rare case of two synchronous primary cancers: adenocarcinoma and poorly differentiated squamous cell carcinoma. To conclude, physicians should be familiar with an independent presentation of squamous cell carcinoma of the lung and peritoneal carcinomatosis in the same patient, as the outcome of independent tumors is poor in most cases.
肺癌是全球最常见的恶性肿瘤之一，超过三分之一的病例会发生转移。转移性疾病的常见部位包括脑、脊柱、神经、肾上腺、骨、肝和胸膜。然而，腹膜受累情况罕见，肺癌中发现的腹膜受累在未证实另有病因之前均被推测为转移性的。这是因为原发性腹膜腺癌并不常见，且难以与转移扩散相区分。在此，我们报告一例73岁女性患者，该患者出现腹水。腹水检查结果与腺癌相符。随后的胸部CT显示左肺下叶有一个4.3厘米的肿块，组织病理学检查确定为低分化鳞状细胞癌。这是一例罕见的两种同步原发性癌症病例：腺癌和低分化鳞状细胞癌。总之，医生应熟悉同一患者出现肺鳞状细胞癌和腹膜癌病的独立表现，因为大多数情况下独立肿瘤的预后较差。
