Ticiana Leal, MD, presents a case of a 61-year-old man with small cell lung cancer.
Case: A 61-Year-Old Man With Small-Cell Lung Cancer
Initial Presentation
A 61-year-old man presented with a cough, fatigue, progressive shortness of breath
PMH: unremarkable
SH: 25-pack year smoking history; social alcohol use
PE: Right lower lobe wheezing on auscultation, axillary lymph node enlargement
Clinical Workup
Labs: WNL
Axillary lymph node biopsy revealed small cell carcinoma
Chest/abdomen/pelvic CT showed a 7.1 cm mediastinal conglomerate mass, with invasion into the right main and lobar pulmonary arteries; 2 small left pulmonary nodules; hypermetabolic axillary lymph node
PET scan showed large focal hypermetabolic activity in the mediastinum and small hypermetabolic activity in the surrounding area
Contrast‐enhanced MRI of the head showed no brain metastases
Stage IV small-cell lung cancer; ECOG PS 0
Treatment
Initiated carboplatin + etoposide + atezolizumab for 4 cycles; followed with atezolizumab as maintenance therapy
Follow-up
7 months after starting treatment he complained of shortness of breath, right upper quadrant pain and back pain
CT showed hematogenous metastases in the liver and right adrenal gland