Published online Dec 16, 2022. doi: 10.12998/wjcc.v10.i35.13006
Peer-review started: August 27, 2022
First decision: November 4, 2022
Revised: November 17, 2022
Accepted: November 23, 2022
Article in press: November 23, 2022
Published online: December 16, 2022
Processing time: 108 Days and 16.7 Hours
Lung cancer is the leading cause of cancer-related death. Early diagnosis is critical to improving a patient’s chance of survival. However, lung cancer associated with cystic airspaces is often misdiagnosed or underdiagnosed due to the absence of clinical symptoms, poor imaging specificity, and high risk of biopsy-related complications.
We report an unusual case of cancer in a 55-year-old man, in which the lesion evolved from a small solitary thin-walled cyst to lung squamous cell carcinoma (SCC) with metastases in both lungs. The SCC manifested as rare clustered cystic lesions, detected on chest computed tomography. There were air-fluid levels, compartments, and bronchial arteries in the cystic lesions. Additionally, there was no clear extrathoracic metastasis. After chemotherapy, the patient achieved a partial response, type I respiratory failure was relieved, and the lung lesions became a clustered thin-walled cyst.
Pulmonary cystic lesions require regular imaging follow-up. Lung SCC should be a diagnostic consideration in cases of thin-walled cysts as well as multiple clustered cystic lesions.
Core Tip: Lung cancer associated with cystic airspaces is often delayed diagnosis. We report a case in which the lesion evolved from a thin-walled cyst to advanced lung squamous cell carcinoma (SCC). The SCC manifested as rare clustered cystic lesions in bilateral lungs. There are air-fluid levels, compartments and bronchial arteries in the cyst. Additionally, there was no obvious extrathoracic metastasis. After chemotherapy, the lesions became clustered thin-walled cysts. Our report highlights SCC should be a diagnostic consideration in thin-walled cyst as well as multiple clustered cystic lesions.