Lung metastases of pancreatic adenocarcinoma: Watch for the second train!

• Published in: Revue des maladies respiratoires Vol. 36; no. 6; p. 738
• Main Authors: Ropars, C, Kerjouan, M, Larible, C, Llamas Gutierrez, F, Léderlin, M, De Latour, B, Desrues, B, Jouneau, S
• Format: Journal Article
• Language: English; French
• Published: France 01-06-2019
• Subjects: Adenocarcinoma - complications; Adenocarcinoma - diagnosis; Adenocarcinoma - secondary; Adult; Delayed Diagnosis; Female; Humans; Lung Neoplasms - complications; Lung Neoplasms - diagnosis; Lung Neoplasms - secondary; Pancreatic Neoplasms - complications; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - pathology; Pulmonary Aspergillosis - complications; Multicystic lung disease; Diffuse interstitial pneumonia; Aspergillose; Pancreatic cancer; Aspergillosis; Cavitating nodules; Pneumopathie infiltrante diffuse; Cancer du pancréas; Maladie kystique multiple pulmonaire; Nodules excavés
• ISSN: 1776-2588
• DOI: 10.1016/j.rmr.2019.04.005

Pulmonary metastases due to a pancreatic cancer are difficult to diagnose and demonstrate a wide range of radiological patterns. We report the case of a 37-year-old female patient, without past medical history, with multicystic lung disease in a context of chronic abdominal pain, fatigue and weight loss. After several months of diagnostic delay, pathological examination of surgical lung biopsies led to the diagnosis of secondary deposits of pancreatic cancer. The clinical and radiogical situation deteriorated quickly with the development of alveolar consolidation and Aspergillus superinfection was then diagnosed. This case illustrates the value of an early decision to undertake surgical lung biopsy in the work-up of multicystic lung disease when cancer is suspected. In addition, in the specific context of cancer, faced with clinical and/or radiological deterioration, it is essential to look for infection, particularly aspergillosis.