%0 Journal Article
%T Excavated pulmonary nodules: an unusual clinical presentation of lung metastasis in two cases
%A Wafa Allam
%A Basma Elkhanoussi
%A Khaoula Alaoui
%A Issam Lalya
%A Hassan Errihani
%J BMC Medical Imaging
%D 2010
%I BioMed Central
%R 10.1186/1471-2342-10-13
%X The first one is 39-year-old man in whom cholecystectomy made the diagnosis of primary non-Hodgkin's lymphoma of the gallbladder. He presented in chest CT scan excavated nodules that had been biopsied and confirmed the diagnosis of non hodgkin lymphoma. He underwent 8 courses of chemotherapy CHOP 21 with complete remission. The second one is an 21 years old man who presented a right leg osteoblastic osteosarcoma with only excavated pulmonary nodules in extension assessment. He had 3 courses of polychemotherapy API (doxorubicin, platinum, and ifosfamide) with partial response. Unfortunately, he died following a septic shock.Review of the literature shows that excavated pulmonary nodules as metastasis are rare but we should consider this diagnosis every time we are in front of a cancer. Chest computed tomography is the best diagnosis imaging that could make this diagnosis. Differential diagnosis between benign and malignant bullous lesions is important because surgical excision affects survival in some malignancies.Although pulmonary nodules are the most common cancer metastasis, a differential diagnosis of a concurrent primary malignancy should always be considered every time we have excavated lesions, even in patients with known malignant disease. Thorough chest evaluation is important, as multiple primary malignancies may occur concomitantly.Metastatic causes of excavated pulmonary nodules are rare but must be considered in patients with a history of neoplastic disease.Excavated metastatic pulmonary lesions are described, but in a country of epidemic tuberculosis, or in front of smokers, it is necessary to raise differential diagnosis. Sometimes, chest scann permitt to elaborate a definite diagnosis, and sometimes, we must resort to a biopsy. We report here two cases of excavated pulmonary metastasis attendant to primary malignancies.A 39 year old male with no significant past medical history, initially presented with a several month history of intermittent pain lo
%U http://www.biomedcentral.com/1471-2342/10/13