SHM Converge Scientific Abstract ePoster Gallery-A Rare Presentation of Small Cell Lung Cancer With Concurrent Metastatic Adenocarcinoma

Pdf Summary

This case describes a rare and challenging presentation of dual metastatic malignancies in a 57-year-old man with extensive-stage small cell lung cancer (SCLC). SCLC is an aggressive lung cancer strongly linked to smoking, and it can occasionally coexist with non-small cell components. However, this patient had two distinct cancers: biopsy-proven SCLC in mediastinal lymph nodes and concurrent metastatic moderately differentiated adenocarcinoma in the liver and bone marrow.<br /><br />The patient had already completed four cycles of chemotherapy for known SCLC with liver and bone metastases when he presented with coffee-ground emesis and constipation. Workup showed severe anemia and marked leukocytosis. Endobronchial ultrasound-guided fine-needle aspiration of the #7 node and carina confirmed SCLC with CD56 positivity. In contrast, liver biopsy showed metastatic moderately differentiated adenocarcinoma with necrosis, and bone marrow biopsy also revealed marrow infiltration by the same adenocarcinoma. Chest CT demonstrated bulky mediastinal adenopathy, bibasilar nodular densities, a stable lytic T7 lesion, and multiple hepatic metastases. EGD and colonoscopy did not identify a GI malignancy, though benign polyps and gastritis with Candida were found.<br /><br />This case highlights the diagnostic complexity of determining whether metastatic lesions represent one cancer type or multiple concurrent primaries. It also underscores the difficulty of treatment, since SCLC and adenocarcinoma often require different therapeutic approaches. Management depends on multidisciplinary coordination, with attention to prognosis, symptom control, and early palliative care involvement.

Asset Subtitle

Quyen Nguyen

Meta Tag

Author List Andrea Rodriguez Jimenez, Monica Correa-Alfonzo, Omar Guerrero, Quyen Nguyen, Sai Wan

Category Clinical Vignettes

Concept Small Cell Lung Carcinoma

Concept Metastasis

Concept Smoking

Concept Combined Small Cell Lung Cancer

Concept Adenocarcinoma

Distinguished Non-Finalist

Presenter Organization Lakeland Regional Health

Presenting Author Quyen Nguyen

Track Adult

Keywords

small cell lung cancer

metastatic adenocarcinoma

dual malignancies

liver metastasis

bone marrow infiltration

mediastinal lymph nodes

endobronchial ultrasound

biopsy diagnosis

aggressive lung cancer

palliative care

Small Cell Lung Carcinoma

Metastasis

Smoking

Combined Small Cell Lung Cancer

Adenocarcinoma