Small Cell Lung Cancer in a Young, Non-Smoker Patient

Abstract

Introduction: A single lung nodule (SPN) is defined as a solitary lung opacification less than 3 cm in size. In particular, small cell lung cancer (SCLC) affects more patients, older and heavy smokers. A contrast-enhanced computed tomography of the chest followed by a f-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and the pathology examinations are the main ones that determine the diagnosis. Case Report: A young patient, 33 years old, a non-smoking male mining engineer, presented to the clinic with a dry cough that started after a viral situation. No other known comorbidities and family history of lung cancer. A routine chest x-ray was ordered, where an apical round opacity in the apex of the right lung was seen. Sputum for mycobacterium tuberculosis was done and came back negative. A chest scan with contrast showed a solitary pulmonary nodule in the apex of the right lung with well-demarcated contours with dimensions 28 x 22 mm. Given that the dimensions of the nodule were large and not specific for benign pathology, a PET/CT was ordered, which confirmed the nodule resulted in an SUV over that 4.5, which was also not specific for lung TB. The histologic examination of the nodule was done then, and the result, unfortunately, was a small cell lung cancer in the right lung. Conclusion: SCLC is found to be a mass lesion in the lungs in most cases. Differential diagnosis between lung tuberculosis (TB) and lung cancer in such cases is an excellent dilemma for pulmonologists and radiologists.