Arafsha Lara, Samargandy Shaza A, Alyazidi Anas S
Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia *Email:
Qatar Med J. 2025 Jun 9;2025(2):64. doi: 10.5339/qmj.2025.64. eCollection 2025.
Lung cancer is a leading cause of cancer-related mortality globally, often presenting with diverse and challenging manifestations. This case report discusses an unusual presentation of epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC) initially mimicking tuberculosis (TB), complicated by pituitary involvement.
A 30-year-old female presented with respiratory symptoms and systemic complaints, initially suggestive of miliary TB. Further investigations revealed metastatic lung adenocarcinoma with pituitary metastasis, causing diabetes insipidus, hyperprolactinemia, adrenal insufficiency, and hypothyroidism. Treatment with targeted therapy involving osimertinib resulted in clinical improvement.
This case underscores the diagnostic challenges posed by atypical presentations of lung cancer, which can masquerade as infectious diseases like TB. The presence of pituitary metastasis further complicates the clinical picture, emphasizing the importance of considering rare metastatic sites in the differential diagnosis of lung adenocarcinoma. Timely recognition and appropriate management are crucial for optimizing outcomes in such complex cases, highlighting the need for a multidisciplinary approach in oncological and endocrine care.
肺癌是全球癌症相关死亡的主要原因,常表现出多样且具有挑战性的症状。本病例报告讨论了一例表皮生长因子受体(EGFR)突变的非小细胞肺癌(NSCLC)的不寻常表现,最初类似肺结核(TB),并伴有垂体受累。
一名30岁女性出现呼吸道症状和全身不适,最初提示粟粒性肺结核。进一步检查发现转移性肺腺癌伴垂体转移,导致尿崩症、高催乳素血症、肾上腺功能不全和甲状腺功能减退。使用奥希替尼进行靶向治疗后临床症状改善。
本病例强调了肺癌非典型表现带来的诊断挑战,这些表现可能伪装成如肺结核等传染病。垂体转移的存在使临床情况更加复杂,强调了在肺腺癌鉴别诊断中考虑罕见转移部位的重要性。及时识别和适当管理对于优化此类复杂病例的治疗结果至关重要,突出了肿瘤学和内分泌护理中多学科方法的必要性。