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A4097 - Lung Cancer in a Very Young Males
Author Block: N. Lopes1, A. Gregor2, O. Soares2; 1National Hospital Guido Vala dares, Dili, Timor-Leste, 2Hospital National Guido valadares, Dili, Timor-Leste.
INTRODUCTION Lung cancer is the leading cause of death for men and women in the United States.The prevalence of lung cancer in young patients is 9.5%, as reported by Global Cancer statistic in 2006-2010.The presence of cancer of the lungs is rare in adolescent patients, particularly in those under 20 years of age. Hence, we found two cases of lung cancer in a 15 and 17 years old male with different clinical presentation and history. Keywords: Lung cancer, Adenocarcinoma, young age. CASE REPORT First case report, 17 year old male reported to hospital with blood streak hemoptysis, and weight loss. He had an extensive history of tobacco smoking,one pack of cigarettes a day since age 10 years old. CT scan thorax revealed a 5x4x3 cm mass in the periphery of the left lower lobe. Brain CT was normal. A transthoracic needle aspiration was performed and cytology report revealed Adenocarcinoma. Epidermal Growth Factor Receptor (EGFR) mutation test was not performed due to the lack of facilities. Patient was diagnosed with Adenocarcinoma of the left lung, T2AN0M0 (stage IB) and referred to the thoracic surgeon for lower lobectomy. Second case, 15 year old boy presented with short of breath and lost of weight. No history of tobacco use. Chest examination shows bulging, venectation, and stony dullness on the left side.Chest x-ray shows total opacity on the left lung. Thoracocentesis was done, approximately 500 milliliter serohemorrhagic fluid was drawn. Abdominal ultrasound shows no sign of metastases. Transthoracic needle aspiration was performed and cytology revealed adeno carcinoma. EGFR mutation test cannot be performed. Patient was diagnosed as primary adenocarcinoma of the left lung, T4N?M1a stage IVa (effusion) PS 3. DISCUSSION
Cancers can be caused by DNA changes that turn on oncogenes or turn off tumor suppressor genes. Gene changes related to lung cancer are usually acquired during life rather than inherited. The first patient might have acquired gene changes due to exposure of tobacco use. The second patient might have inherited gene mutation but on these two cases further gene investigation should have done. It’s very important for physicians to be more aware that lung cancer can occurs on any stage of age and timely diagnose play a big role of prognosis.