Tuberc Respir Dis.  2010 May;68(5):290-293.

Prostatic Cancer Presenting as an Isolated Large Lung Mass

• No HS
• Lee JH
• Ahn Y
• Na II
• Kim HR
• Kim CH
• Koh JS
• Lee JC

Abstract

A hidden primary tumor presenting as an isolated lung mass is a diagnostic challenge to physicians because the diagnosis of lung cancer is likely to be made if the histologic findings are not inconsistent with lung cancer. A large lung mass was found incidentally in a 59-year-old man. Although adenocarcinoma was diagnosed by percutaneous needle biopsy, thyroid transcription factor-1 (TTF-1) immunostaining was negative, raising suspicion that there was another primary site. There was no abnormal finding except for the lung mass on a 18FDG-PET/CT scan and the patient did not complain of any discomfort. Finally, prostatic cancer was confirmed through the study of tumor markers and prostate-specific antigen (PSA) immunostaining. Because of the rare presentation of a single lung mass in malignancies that have another primary site, physicians should carefully review all data before making a final diagnosis of lung cancer.

Keyword

Metastasis; Prostatic Neoplasms; Thyroid Transcription Factor 1; Tumor Markers, Biological

MeSH Terms

Adenocarcinoma
Biopsy, Needle
Humans
Lung
Lung Neoplasms
Middle Aged
Neoplasm Metastasis
Nuclear Proteins
Prostate-Specific Antigen
Prostatic Neoplasms
Thyroid Gland
Transcription Factors
Biomarkers, Tumor
Nuclear Proteins
Prostate-Specific Antigen
Transcription Factors

Figure

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  Figure 1 (A) Chest radiograph showed a large lung mass on left upper lung. (B) A lung mass with central necrosis along posterior pleural surface was noted on chest CT. (C) Uneven 18FDG uptake of the lung mass was revealed on PET/CT. (D) Bone scan showed multiple metastatic bony lesions.

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  Figure 2 (A) Adenocarcinoma was diagnosed by percutaneous needle biopsy from lung tumor (H&E stain, ×200). (B) TTF-1 immunostaining of lung tumor was negative (TTF-1 immunostain, ×200). (C) PSA immunostaining of lung tumor tissues was strong positive (PSA immunostain, ×400). (D) Prostatic biopsy showed almost same morphologic features with lung tumor (H&E stain, ×200).

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  Figure 3 (A) The size of huge lung mass was markedly reduced by treatment with a luteinizing hormone-releasing hormone agonist on chest radiograph. (B) Chest CT also showed the shrunken mass with necrosis (arrow).

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