Solitary pulmonary nodule in an early adolescent

BMJ Case Rep. 2023 Sep 11;16(9):e256081. doi: 10.1136/bcr-2023-256081.

Abstract

An early adolescent boy presented with 1-week history of left-sided chest pain, localised to the anterior aspect of seventh intercostal space. A chest radiograph revealed a round opacity measuring 2.6×2.4 cm in the left mid zone. A CT scan of the chest confirmed a solitary well-circumscribed pulmonary nodule measuring 2.7×2.4 cm in the central left upper lobe, adjacent to the anterior segmental bronchus. Positron emission tomography scan showed mild to moderate fluorodeoxyglucose uptake (maximum standardized uptake value 5.2) in the nodule. He underwent a video-assisted left upper lobectomy. Histology of the nodule was consistent with sclerosing pneumocytoma, a rare benign lung neoplasm that occurs predominantly in middle-aged women of Asian descent. This case highlights the challenges in diagnosis and management of solitary pulmonary nodules in children, especially those who remain symptomatic or only have minimal symptoms and provides a pragmatic approach to this condition.

Keywords: paediatrics; respiratory medicine; surgical oncology.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Biological Transport
  • Bronchi
  • Chest Pain
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Solitary Pulmonary Nodule* / diagnostic imaging
  • Solitary Pulmonary Nodule* / surgery
  • Thorax