Posters

The Large Necrotic Pulmonary Mass: A Case of Squamous Cell Carcinoma of the Lung

Presenting Author

Khairiya Haj-Yahya

Presentation Type

Poster

Discipline Track

Community/Public Health

Abstract Type

Case Report

Abstract

Lung cancer is the most common cause of cancer-related mortality worldwide. Squamous cell lung carcinoma is a slowgrowing type of non-small cell lung cancer that can spread to multiple sites throughout the body in advanced stages. Patient is a 62-year-old male, lifelong smoker with a history of TB, who presented to the ED with right-sided chest pain, radiating to his right arm that began 1 month prior. Patient also reported a dry cough, decreased appetite, and an unspecified amount of weight loss during this time. On physical exam, he was severely cachectic. CXR and follow up CT with contrast, revealed a large complex mass in the right upper lobe measuring 8.8 x 6.9 cm with a patchy dense consolidation adjacent to the mass, bilateral COPD, pulmonary fibrosis, a partially calcified right pleural plaque, and mediastinal lymph node enlargement. Subsequent biopsy revealed necrotic poorly differentiated squamous cell carcinoma which was found to be stage IIIB, locally advanced and inoperable. The patient was uninsured, without permanent housing and was unable to follow up with an oncologist. Combination chemoradiotherapy was arranged about 2 months after the initial visit at which point the tumor was found to be 14 x 9.5 cm. South Texas is home to the nation’s largest population of uninsured persons, of which over 30% live below the federal poverty level. The case is a prime example of how complex social circumstances can pose significant barriers to accessing health care, resulting in an alarming rate of late-stage cancer diagnoses/deaths.

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The Large Necrotic Pulmonary Mass: A Case of Squamous Cell Carcinoma of the Lung

Lung cancer is the most common cause of cancer-related mortality worldwide. Squamous cell lung carcinoma is a slowgrowing type of non-small cell lung cancer that can spread to multiple sites throughout the body in advanced stages. Patient is a 62-year-old male, lifelong smoker with a history of TB, who presented to the ED with right-sided chest pain, radiating to his right arm that began 1 month prior. Patient also reported a dry cough, decreased appetite, and an unspecified amount of weight loss during this time. On physical exam, he was severely cachectic. CXR and follow up CT with contrast, revealed a large complex mass in the right upper lobe measuring 8.8 x 6.9 cm with a patchy dense consolidation adjacent to the mass, bilateral COPD, pulmonary fibrosis, a partially calcified right pleural plaque, and mediastinal lymph node enlargement. Subsequent biopsy revealed necrotic poorly differentiated squamous cell carcinoma which was found to be stage IIIB, locally advanced and inoperable. The patient was uninsured, without permanent housing and was unable to follow up with an oncologist. Combination chemoradiotherapy was arranged about 2 months after the initial visit at which point the tumor was found to be 14 x 9.5 cm. South Texas is home to the nation’s largest population of uninsured persons, of which over 30% live below the federal poverty level. The case is a prime example of how complex social circumstances can pose significant barriers to accessing health care, resulting in an alarming rate of late-stage cancer diagnoses/deaths.

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