Ex-smoker's CT scan reveals rare lung cancer mimicking asthma

In an unusual case, a report recently published in The BMJ featured a CT scan of a 54-year-old male, ex-smoker showing a rare type of lung cancer mimicking adult-onset asthma.  

From the patient’s chest CT scan, Abdul Hanif Khan, MD, from the department of medicine at Universiti Putra Malaysia Fakulti Perubatan dan Sains Kesihatan in Malaysia, and colleagues diagnosed the “asthmatic” patient with a mucoepidermoid carcinoma (MEC)—a rare tumor of the trachea which accounts for up to 20 percent of reported primary lung malignancies, according to the report.  

The patient, who was initially referred to tertiary care for poorly controlled asthmatic symptoms such as coughing and wheezing, did not responded to conventional treatment, according to Khan et al. The patient also occasionally coughed up blood and experienced unexplainable weight loss, prompting Khan and colleagues to perform a chest x-ray and CT scan.

The chest x-ray was normal, but the CT scan showed a protruding mass in the patient’s trachea, which caused endobronchial obstruction.  

In response, the physicians performed a bronchoscopic intervention to relieve the obstruction which resulted resolved the patient’s asthmatic symptoms. Histological diagnosis confirmed MEC.  

“This case emphasized the importance of a high index of suspicion in an unusual presentation of a common disease and the pivotal role of bronchoscopic intervention in malignant central airway obstruction,” the researchers concluded.