Squamous cell carcinoma of the lung with bilateral adrenal metastasis
Presentation
Chest pain, hemoptysis and shortness of breath. Heavy smoker.
Patient Data
Emphysematous changes are seen in both lungs, more prominent in the right upper lobe.
A 100 mm soft tissue density mildly enhancing mass is noted in the central part of the right lung, extending to the right lung hilum and focally infiltrating the adjacent mediastinum. Mild distal pneumonitis is also observed in the right upper and middle lobes. No other mass or nodule is noted in both lung fields.
In addition, several enlarged right paratracheal, subcarinal, and right hilar lymph nodes are present with SAD less than 12 mm.
In imaged portions of the upper abdomen, soft tissue density masses with slightly heterogeneous enhancement are seen in both adrenal glands, indicating metastases.
Case Discussion
This case demonstrates a large right lung mass, pathology-proven squamous cell carcinoma, with bilateral adrenal metastases.
Squamous cell carcinoma is one of the non-small cell carcinomas of the lung, second only to adenocarcinoma of the lung as the most common type of lung cancer.
Clinical presentation and imaging characteristics of lung cancer vary based on tumor location and are mostly not related to histology. Central tumors causing bronchial invasion and obstruction often lead to distal collapse and potential infection. Symptoms may include chronic cough and hemoptysis. Peripheral tumors are usually detected when they are larger and invade the chest wall. Metastasis could be the initial indication of cancer.
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