Metástase cutânea como primeira manifestação de adenocarcinoma pulmonar

Abstract

associated with a worse prognosis. (6,7) Physicians who deal with this pathology should be on the alert for the possibility of cutaneous metastasis as the initial manifestation of lung cancer. Case reportA 58-year-old waiter who had quit smoking 9 years prior (smoking history, 40 pack-years) was referred for medical oncology consultation because of an epigastric mass. The patient presented with a history of COPD with severe IntroductionAnnually, metastatic disease accounts for over half of the new cases of lung cancer in Europe.(1) In Portugal, the estimated annual incidence is approximately 2,500 cases, and mortality among such cases is nearly 100%, lung cancer being the leading cause of cancer death.(1,2) To date, there has been no evidence of an effective method for population screening, (3) smoking cessation being fundamental to reducing the number of cases. AbstractWe report the case of a 58-year-old male patient who was referred for oncology consultation due to an epigastric mass that had been growing rapidly for three months. Diagnostic investigation revealed that the mass was a metastasis of stage IV lung adenocarcinoma. The patient received five cycles of chemotherapy with cisplatin and gemcitabine as a first-line treatment, which was interrupted due to major adverse events. Although the pulmonary disease stabilized, the cutaneous disease progressed. The patient then received pemetrexed as a secondline chemotherapy, together with concurrent external radiotherapy, which was well tolerated. There was complete remission of the epigastric mass. However, the patient died three months after the treatment. Here, we emphasize the importance of a multidisciplinary approach and of its role in individualizing the treatment.