Uliński Robert, Korczyński Piotr, Domagała-Kulawik Joanna
Doctoral School, Medical University of Warsaw, Warsaw, Poland.
Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland.
Am J Case Rep. 2025 Apr 1;26:e946280. doi: 10.12659/AJCR.946280.
BACKGROUND The coexistence of lung cancer with COPD has received increasing attention in recent years. These 2 entities are attributed to older age, with a mean age of around 70 years old. Here, we present 3 fatal cases of lung cancer and COPD in uncommonly young patients (45-55 years old). CASE REPORT The first patient, 46-year-old man, reported progressive tiredness, and recurrent sub-febrile states, without recovery despite empiric treatment with 3 antibiotics. He was diagnosed with SCC and referred for chemoradiotherapy, but he died within 6 months. The second patient was 53-year-old women with hemoptysis, tiredness, loss of weight, spine pain, and cough, who was first diagnosed with pneumonia. Her first bronchoscopy was not diagnostic. A second bronchoscopy performed 2 weeks later was successful and she was diagnosed with large-cell carcinoma. She was referred for chemoradiotherapy, but died within 1 month. The third patient was 50-year-old women with chest pain radiating to her left shoulder and hoarseness. She was diagnosed with advanced SCLC, and was referred immediately for chemotherapy with immunotherapy, but did not respond well to treatment and died a few months later. CONCLUSIONS Age seems to be one of the factors that can delay cancer diagnosis. To the best of our knowledge, the literature contains no reports about young patients with coexistence of lung cancer and COPD. We emphasize the importance of these diseases in differential diagnosis in younger patients when reported with systemic symptoms.
背景 近年来，肺癌与慢性阻塞性肺疾病（COPD）并存的情况日益受到关注。这两种疾病多见于老年人，平均年龄约为70岁。在此，我们报告3例罕见的年轻患者（45 - 55岁）肺癌合并COPD的致命病例。病例报告 首例患者为一名46岁男性，主诉进行性疲劳和反复低热，尽管使用3种抗生素进行经验性治疗仍未康复。他被诊断为鳞状细胞癌（SCC）并接受放化疗，但在6个月内死亡。第二例患者是一名53岁女性，有咯血、疲劳、体重减轻、脊柱疼痛和咳嗽症状，最初被诊断为肺炎。她的首次支气管镜检查未明确诊断。2周后进行的第二次支气管镜检查确诊为大细胞癌。她接受放化疗，但在1个月内死亡。第三例患者是一名50岁女性，有放射至左肩的胸痛和声音嘶哑症状。她被诊断为晚期小细胞肺癌（SCLC），立即接受化疗联合免疫治疗，但治疗效果不佳，几个月后死亡。结论 年龄似乎是延迟癌症诊断的因素之一。据我们所知，文献中尚无关于年轻患者肺癌合并COPD的报道。我们强调，当年轻患者出现全身症状时，这些疾病在鉴别诊断中的重要性。
