Topic: invasive adenocarcinoma of the lungs in a 17 year old adolescent child in a suburban hospital: A case report.
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Primary lung cancer is rare in pediatric patients. Patients generally present with nonspecific and indistinct clinical symptoms, which usually cause a delay in diagnosis. We report a case of adenocarcinoma in a 17 year-old adolescent child who presented with chronic productive cough, difficulty with breathing, haemoptysis, orthopnoea, weight loss, oedema of the lower limbs and knee joints. He was chronically ill looking with obvious bony prominences, grade 4 digital clubbing, and dull percussion notes and reduced breath sounds in the lower right lung zone. The preliminary diagnosis was lung abscess and pulmonary TB but Nucleic Acid Amplification Test (gene Xpert) and microscopy for acid-fast bacilli (AFB) were negative. Chest radiography revealed a solitary nodule in the right mid-lung zone, while chest CT revealed right lobar bronchiectasis. The patient was treated with anti-heart failure drugs, antibiotics, antifungal medications, blood transfusion, and physiotherapy. He also underwent a thoracotomy and right lower lung lobectomy. The edema resolved following the initial treatment, but the cough and difficulty with breathing persisted until the patient underwent right lobectomy. Symptoms resurfaced 3 weeks after lobectomy. Histological results showed invasive adenocarcinoma of the lung; thus, a definitive diagnosis of Invasive Adenocarcinoma of the lung was made. Patients and caregivers were counseled regarding the diagnosis and need for chemotherapy, patient died four months after the establishment of diagnosis.