Case Overview: A 59-Year-Old Man With ES-SCLC


A thoracic oncologist, Hossein Borghaei, DO, provides an overview of the initial presentation, clinical work-up, treatment, and follow-up of a 59-year-old man with extensive-stage small cell lung cancer.

Hossein Borghaei, DO: Hello, everyone. I’m Hossein Borghaei. I’m a thoracic medical oncologist at Fox Chase Cancer Center in Philadelphia, [Pennsylvania]. Thank you for joining us to discuss a case of a patient with extensive-stage small cell lung cancer and management of this patient population.

Our case is a 59-year-old man who has been diagnosed with small cell lung cancer. His past medical history is significant for hypertension, which is medically controlled. Patient has a 32 pack-year smoking history and does not drink alcohol. On physical exam at the time of initial presentation, the patient has decreased breath sounds in the left lung and evidence of cervical lymph node enlargement. Laboratory evaluation showed that most of the labs are within the normal range, and the patient does have axillary lymph node that’s palpable. A biopsy of the axillary lymph node shows small cell lung cancer.

The patient then undergoes the usual staging studies, such as CT of chest, abdomen, and pelvis. Unfortunately, the CT shows evidence of large mediastinal mass with invasion into the right main and lobar pulmonary arteries and 2 small left pulmonary nodules. Hypermetabolic axillary lymph node was seen on PET [positron emission tomography] scan, and he also had a palpable node that was biopsied. Unfortunately, based on the CT and PET scans, the patient has evidence of liver metastases. A contrast-enhanced MRI of the brain is negative for brain metastases, and the patient has a really good [ECOG] performance status around 0 or 1, so he’s relatively asymptomatic.

Transcript edited for clarity.

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