Pancreatic cancer Masquerading as lung nodules: A Diagnostic Dilemma

Rahul Karna; Anam Javed; Adeel Nasrullah; Atif Raja; Hammad Arshad

doi:10.1016/j.rmcr.2021.101453

Pancreatic cancer Masquerading as lung nodules: A Diagnostic Dilemma

Respir Med Case Rep. 2021 Jun 23:33:101453. doi: 10.1016/j.rmcr.2021.101453. eCollection 2021.

Authors

Rahul Karna¹, Anam Javed¹, Adeel Nasrullah¹, Atif Raja², Hammad Arshad³

Affiliations

¹ Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA, USA.
² Department of Pathology, Allegheny Health Network, Pittsburgh, PA, USA.
³ Departement of Pulmonology and Critical Care, Allegheny Health Network, Pittsburgh, PA, USA.

Abstract

To our knowledge, this is the first report of isolated pulmonary nodules as an initial presentation of underlying pancreatic cancer. We present a case of metastatic pancreatic cancer which manifested as worsening bilateral pulmonary nodules and normal abdominal imaging in a 72-year-old female patient. A navigational bronchoscopy with biopsy of lung nodules was performed which showed poorly differentiated adenocarcinoma. Carcinoembryonic antigen and CA 19-9 levels were elevated so endoscopic ultrasound with fine needle aspiration was done which revealed an underlying occult pancreatic adenocarcinoma. The patient was treated with chemotherapy. Patients with pulmonary metastasis have been shown to confer longer survival as compared to metastatic disease involving other organs. We have briefly reviewed the epidemiology, clinical characteristics and management of such cases in our report.

Keywords: Endoscopic ultrasound; Pancreatic adenocarcinoma; Pulmonary nodules.

Publication types

Case Reports