Primary lung cancer in an 18-year-old boy: case report

An autopsy case of an 18-year-old boy with adenocarcinoma of the lung is reported. He experienced dyspnea and hemosputum in July 1988. Chest radiographs showed a diffuse bilateral streaky shadow, bilateral pleural effusion and cardiac enlargement. The diagnosis of adenocarcinoma was made by transbronchial biopsy at another hospital. He visited the National Cancer Center Hospital on October 7, 1988. The diagnosis of lung cancer was strongly suggested by positive immunohistochemical staining for pulmonary surfactant apoprotein in biopsy specimens from supraclavicular lymph nodes. Intensive systemic survey demonstrated no other primary site than the lung. The patient was treated with cisplatin, adriamycin and etoposide and his subjective symptoms such as cough and dyspnea significantly improved over the next three months. Tumor shadows in the lung increased steadily, however after February, 1989. A significant lymphangitic spread of the carcinoma and marked obsteoblastic bone metastases were revealed at autopsy.