title: Cellulitis-like symptoms manifested by bone metastasis of lung cancer in a patient living with human immunodeficiency virus.
abstract: Human immunodeficiency virus (HIV)-infected patients are at a high risk of cancer compared with the general population. As the use of antiretroviral therapy (ART) has increased, non-AIDS-defining cancers have also increased in the past decade. A 61-year-old man with HIV infection on ART developed a painful, erythematous and oedematous lower left leg and an associated fever. He was initially treated with antibiotics for cellulitis but there was no improvement, which warranted further investigation. A translucent lesion was found by X-ray imaging and bone scintigraphy showed bone metastasis from a primary adenocarcinoma of the lung, documented by chest computed tomography and an axillary lymph node biopsy. The patient died three months after the diagnosis despite undergoing chemotherapy. This case demonstrates that physicians should consider metastatic malignancies as a differential diagnoses for diverse skin changes in HIV-infected patients.
authors.affiliation: Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan.
authors.forename: Jumpei
authors.initials: J
authors.lastname: Kashima
authors.affiliation: Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan Division of Oncology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan y-okuma@cick.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okuma
authors.affiliation: Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan.
authors.forename: Kageaki
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Toshima Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation, Tokyo, Japan.
authors.forename: Atushi
authors.initials: A
authors.lastname: Ajisawa
authors.affiliation: Department of Pathology, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan.
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Hishima
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D001706:Biopsy; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000556:secondary; D002481:Cellulitis / Q000175:diagnosis* / Q000209:etiology; D017809:Fatal Outcome; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed
keywords: AIDS; HIV; Non-small cell lung cancer; cellulitis; non-AIDS-defining cancers; skin rash