An emergence of adenocarcinoma in the lung following longstanding systemic sclerosis: a case report

Abstract

Abstract: Systemic sclerosis (SSc) is one of the chronic autoimmune diseases characterized by the infiltration of the excess collagen in various organs especially the skin. It is found associated with more prevalence of internal malignancies particularly the lung carcinoma. Herein we reported a case of adenocarcinoma confining within the lung in a Thai patient who had long-standing SSc. He was a 67-year-old Thai patient presenting with fever and productive cough for two weeks. He had been clinically diagnosed as having SSc based on the evidence  of the sclerodactyly, the telangiectasia at the upper chest wall, multiple pitting scars at many finger tips and the interstitial lung disease and he had been treated with colchicine and azathioprine for 10 years. Besides the sclerodactyly and the telangiectasia, the lymphadenopathy and lung abnormality were not detected on the physical examination. The chest film and the computed tomography of the lung revealed a 2x2.8 cm mass at the left lower lung field. The pathology of the lung mass biopsied via the bronchoscopy was adenocarcinoma. LDH was 1,814 U/L. HIV antigen/antibody was negative. He was definitely diagnosed as having adenocarcinoma of the lung with an underlying long term SSc although he was not a smoker. He did not accept the further investigations and/or any treatment. Our case seemed to support the fact that the prevalence of cancers particularly the adenocarcinoma of the lung was significantly increased among SSc patients more than that of general population.