Rationale: Fetal adenocarcinoma of the lung (FLAC) with fetal lung-like morphology is a rare entity of pulmonary adenocarcinoma. Well-differentiated fetal adenocarcinoma (WDFA) belongs to its the low-grade form, which possesses a relatively favorable prognosis. Tuberculosis (TB) is an aggressive infectious disease that has been ranked as one of the top 10 causes of death worldwide. There may be a connection between the 2 and attention should be paid to the differential diagnosis.
Patient concerns: A 28-year-old non-smoking female was admitted with signs of hemoptysis, and she had been coughing up phlegm for 5 years. The patient was previously diagnosed with TB in another hospital, and underwent an anti-TB regimen.
Diagnosis: The co-existence of WDFA and TB was confirmed via histopathological evaluation of postoperative samples.
Interventions: The patient was subjected to a right lower lobectomy together with a wedge resection of the right upper lobe using video-assisted thoracoscopic surgery, with systemic lymphadenectomy.
Outcomes: The patient tolerated the surgical procedure well and underwent an uneventful postoperative course.
Lessons: To our knowledge, no previous reports exist of cases with WDFA accompanied by TB. The present case indicated that a prior diagnosis of TB might predispose to lung cancer regardless of smoking history. It is also essential to distinguish WDFA from TB because of the similarity in clinical features and sites of pathological changes. Patients with WDFA usually have a better prognosis and surgery is the preferred treatment.