Doctors Lounge - Oncology Answers
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Forum Name: Lung Cancer
Question: Solid lung mass
|AnnB - Mon Sep 22, 2008 2:37 pm|
my daughter 20 years old healthy,
has had a few bouts of phenemonia recently, she went to emerg had a chest exray sent home with antibiotics the next evening i got a call fro the emerg dr he wanted her to have catscan the next day, had catscan saw new emerg dr he said the radiologist said she had a mass, emerg dr said he didnt think thats what it was but would refer her to a resperologist, on the way home from ER I called family dr who said he would call me once he had full report of cat scan, dr called said it was a solid mass opposed to cystic the size was 2.8x 2 x2.9. the dr said she had some segmental collaps and the mass was blocking the air way, he also said it could be something caled hematonis and that the radiologist said she should see someone within the week. Its been a week and Im going crazy with worry.
I am waiting on a call to see a different dr who preforms something called a bronscopy. Any help on what this could be would be much appreciated
|AnnB - Wed Oct 01, 2008 7:21 am|
she now has an appointment with a respirologist and a surgen next week, I forgot to mention she also had gained 35 lbs in a few months wich the dr thought was because of the depo (birth control) anyway any thoughts comments would be appreciated thank you
|AnnB - Fri Oct 10, 2008 8:56 pm|
Im just wondering why noone is answering, is this an active form Im desperate for comments or concerns the doctor thinks its a carcinoid tumour and she is schedueled for surgery in a week, any comments would be appreciated thank you
|Dr. Safaa Mahmoud - Fri Dec 05, 2008 3:45 pm|
Sorry for the delay in replying.
Pneumonia do not usually present with a solitary lung mass. It is also unusual to occur in young healthy adult with no underlying cause. It is a serious infection that usually mandates hospitalization and IV antibiotic. Only mild to moderate form of infections can be treated outpatient with adeqaute oral antibiotic therapy.
Stopping medication early or inadequate antibiotic course may cause recurrence of pneumonia as well as complications like lung abscess.
From the brief history you have mentioned, I understood that she has been diagnosed with (pneumonia) for some time that was not resolved on antibiotics then the presence of a persistent mass was discovered while being on antibiotic treatment for pneumonia. I assume also that sputum culture and sensitivity was done and antibiotics are chosen based on the results.
In patients with no history, symptoms, or clinical signs suggestive of malignancy, many physicians would start with a course of antibiotic therapy and follow up their patients with both clinical examination and radiological assessment.
If their symptoms improve with radiological evidence of the resolution of the lung lesion(s), patients continue their treatment and are followed up till complete recovery of both the symptoms and the radiologic findings.
If symptoms or radiologic findings proves persistent or recurrent disease, more investigations are needed like bronchoscope and biopsy.
So, patients with unusual presentations should be excluded for atypical forms on pneumonias, TB, as well as tumours.
Carcinoids tumors are typically an indolent type of neuroendocrine tumours. They develop within the large airways and can cause bronchial obstruction. This would result in atelectasis, recurrent pneumonia, or pulmonary abscess. Radionuclide studies specific for this type of tumours (using somatostatin analogues) are used to diagnose and stage the disease.
These tumours also may secrete neuroendocrine substances in the blood, although uncommon. Patients should be tested and looked for these substances like 5-Hydroxyindoleacetic acid (5-HIAA), ACTH, growth hormone (GH), and other hormones, especially if their symptoms are suggestive.
Symptoms of one of the following makes carcinoid tumour more suspicious like cough, wheezing, blood-tinged sputum, pneumonia that is resistant to antibiotics, recent weight gain, facial flushing or diarrhea.
Physicians can make the diagnosis based on both the bronchoscopy and the radiologic findings.
The primary treatment is surgical resection and is the only curative approach in non metastatic patients.
It is essential to follow up with her doctors to complete her investigations for proper diagnosis and treatment.
Hope you find this information useful.
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