Adenocarcinoma of the lung presenting with idiopathic interstitial pneumonia and various paraneoplastic syndromes: A case report

We report a patient with adenocarcinoma of the lung presenting with idiopathic interstitial pneumonia (IIP) and various paraneoplastic syndromes (PS). A 65-year-old man presented to our clinic with a 1-year history of exertional dispnea, fatigue, weight loss of 5 kilograms, 6 months history of lumbar, neck and joint pain, and 3 months history of dry eyes, dry mouth, dysphagia, hoarseness and headache. He had a history of tuberculous pleurisy 8 months before his admission. Based on clinical data, pulmonary function tests, radiographic and bronchoalveolar lavage findings, the patient was diagnosed as IIP. In order to evaluate the etiology of lumbar pain, the patient underwent thoracolumbal vertebral MRI and multiple metastatic lesions were seen. After re-evaluation of the thorax CT, a transthoracic biopsy was obtained from the subpleural nodular lesion on the right upper lobe anterior segment. The histological diagnosis was adenocarcinoma. Cranial nerve dysfunction, facial pain, hyponatremia and eosinophilia were the accompanying PS.