Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2020; 8(11): 2312-2317
Published online Jun 6, 2020. doi: 10.12998/wjcc.v8.i11.2312
Lung cancer from a focal bulla into thin-walled adenocarcinoma with ground glass opacity — an observation for more than 10 years: A case report
Shu-Shi Meng, Shao-Dong Wang, Yuan-Yuan Zhang, Jun Wang
Shu-Shi Meng, Shao-Dong Wang, Jun Wang, Department of Thoracic Surgery, Peking University People’s Hospital, Beijing 100044, China
Yuan-Yuan Zhang, Department of Pathology, Peking University People’s Hospital, Beijing 100044, China
Author contributions: Wang SD and Wang J were the patient’s surgeons and contributed to manuscript drafting; Meng SS reviewed the literature and contributed to manuscript drafting; Zhang YY performed the histopathological analyses; all the authors listed issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Shao-Dong Wang, MD, Doctor, Surgical Oncologist, Department of Thoracic Surgery, Peking University People’s Hospital, No. 11 Xizhimen South Road, Beijing 100044, China. 13651217347@163.com
Received: February 5, 2020
Peer-review started: February 5, 2020
First decision: March 24, 2020
Revised: March 24, 2020
Accepted: April 22, 2020
Article in press: April 22, 2020
Published online: June 6, 2020
Abstract
BACKGROUND

Thin-walled lung cancer manifests as a cystic lesion, mostly adenocarcinoma. It is often misdiagnosed as a benign lesion in clinical practice, thus delaying the diagnosis and surgical treatment. Its natural course is rarely recorded and observed; thus, the pathogenesis and diagnosis need to be clarified and improved.

CASE SUMMARY

A 66-year-old man developed a mass in the upper lobe of the right lung and a small, thin-walled cavity in the lower lobe of the right lung in 2007. The right upper lobe mass was confirmed to be adenocarcinoma after surgery. The cavity diameter increased from 11 mm to 31 mm over 10 years, and a ground glass opacity lesion appeared around the bulla on computed tomography. A second operation confirmed that the lesion was lepidic predominant adenocarcinoma. Here we report a rare case of lung cancer developing from a focal bulla to a thin-walled adenocarcinoma for more than 10 years and confirm that the check-valve mechanism explains the pathogenesis.

CONCLUSION

Solitary thin-walled lung adenocarcinoma is a rare tumor in terms of its clinical manifestations, pathogenesis, and disease progression. The check-valve mechanism can explain the cause of thin-walled lung cancer. Close follow-up and accurate imaging are necessary.

Keywords: Thin-walled lung cancer, Observation, The check-valve mechanism, Case report

Core tip: We describe a rare case of lung adenocarcinoma with gradual enlargement of a thin-walled cavity surrounded by pure ground glass opacity on on computed tomography for more than 10 years. The natural course of the patient's thin-walled lung adenocarcinoma was observed and the check-valve mechanism can explain the cause of thin-walled lung cancer. To avoid misdiagnosis of such diseases close follow-up and accurate imaging are necessary.