Undue delay in the diagnosis of lung cancer due to the clinician's preoccupation with pre-existing tuberculosis.
The authors report the case of a seminomadic older patient who had already received a course of antitubercular treatment and within a few weeks of completion suffered resurgence of symptoms. His treating physician assumed it to be relapse of tuberculosis and hence re-started the patient on antitubercular treatment. Though the mass lesion on CT scan procured by the primary care physician suggested the possibility of a neoplasm, areas of necrosis within the mass led to a 'cavitary appearance', which unfortunately happens to be a feature of tuberculosis. Once the patient presented to the authors, they performed cytological investigations which established that the patient had lung cancer co-existing with tuberculosis, which indeed was the reason for his progressive symptoms in spite of antitubercular treatment.
Department of Radiation Therapy and Oncology, Regional Cancer Center, Shimla, India. swarooptheone@gmail.com
Swaroop
S
Revannasiddaiah
Irappa
I
Madabhavi
Priyanka
P
Thakur
Rajeev Kumar
RK
Seam
D000995:Antitubercular Agents / Q000627:therapeutic use; D018893:Bronchoalveolar Lavage; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000175:diagnosis*; D003371:Cough / Q000209:etiology; D057210:Delayed Diagnosis; D005334:Fever / Q000209:etiology; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000188:drug therapy
D000995:Antitubercular Agents