Metastatic Small-Cell Lung Cancer

This is a truly amazing case.

The patient presented with a decreased level of consciousness and possibly seizures. While in the Emergency Department the patient developed respiratory distress and had to be intubated.

CT of his chest revealed a large mediastinal mass encroaching on his left mainstem bronchus. On the upper image above (white arrow) note an almost complete collapse of the airway. The transbronchial biopsy revealed a small cell lung cancer.

The patient remained unresponsive. CT Head did not show any acute intracranial pathology.
MRI Brain (see bottom image above) revealed multiple (probably close to a hundred) metastatic lesions in every portion of the brain.

What is interesting about these lesions is the relative paucity of cerebral edema (swelling). The patient was unresponsive primarily due to a subclinical seizure activity that was evident on the electroencephalogram.

Once his seizures were controlled with Keppra the patient “woke up”.

The prognosis for his recovery and survival is extremely poor at this point. The patient will benefit from Hospice care.

This patient presented with respiratory failure and “wheezing”. The image above demonstrates a lung mass (non-small cell lung cancer; white arrow) compressing on the trachea – slit like structure indicated by the black arrow. The patient had to be put on a ventilator. Tracheal stent was subsequently placed as a palliative measure.

74 year old female with a history of emphysema and tobacco abuse presented to the hospital with complaints of increasing shortness of breath and chest discomfort. The patient also noted some redness and swelling around her right breast. A mass could be palpated under her right breast.

CT of the chest was performed and revealed large mass in the right chest. The mass was eroding through the ribs and partially compressing the lung causing post-obstructive pneumonitis. The differential diagnosis included breast cancer or cancer originating from the lung.

CT guided needle biopsy was performed. Pathology report indicated that the patient had squamous cell carcinoma of lung origin.

Treatment options were discussed with the patient. The patient opted for hospice and palliative care.

78 year old male with a history of a metastatic lung cancer came as a trauma patient after he fell at home. CT scan of his head showed multiple metastatic lesions to his skull. The patient is scheduled to undergo chemotherapy.

Lung Cancer on the Chest XR

The patient presented to his PCP complaining of shortness of breath and cough. Chest XR revealed large left-sided lung mass. CT guided mass biopsy confirmed the diagnosis of poorly differentiated adenocarcinoma. Oncology service was consulted.