Diagnostic and Therapeutic Challenges With Synchronous Lung Adenocarcinoma and Cervical Carcinoma: A Case Report

Cervical cancer and lung cancer are both very rampant cancers and contribute significantly to the global healthcare burden. We discuss the rare occurrence of synchronous multiple primary cancer (SMPC) in an elderly female patient with squamous cell carcinoma (SCC) cervix and lung adenocarcinoma. The patient had SCC in cervical biopsy, and poorly differentiated carcinoma was reported in the biopsy of a single lung nodule, which was considered metastatic initially. She received a palliative intent chemotherapy with paclitaxel and carboplatin. Chemotherapy led to a complete response in the cervix, but the lung lesion persisted. Immunohistochemistry on the lung nodule was done, and it guided us to a SMPC diagnosis with lung adenocarcinoma plus SCC cervix. Subsequently, the patient received stereotactic body radiation therapy for lung adenocarcinoma and chemo-radiation for the SCC cervix, and she is on regular follow-up.  The article highlights the practical difficulties in diagnosing SMPC in real-world situations with various practical and financial constraints. The manuscript discusses challenges in defining an optimal treatment regimen for SMPC due to its infrequency, the significance of clinical acuity, and the need for a high index of suspicion. Clinicians must not presume every non-regional nodule is metastatic, especially in cases with an oligometastatic disease burden.