Adeno Lung Cancer and Actinomyces Odontolyticus

Portal Forums Lung/Thoracic Cancer General Lung/Thoracic Cancer Adeno Lung Cancer and Actinomyces Odontolyticus

This topic contains 8 replies, has 3 voices, and was last updated by  jenny2017 1 month, 3 weeks ago.

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February 13, 2017 at 5:54 am  #1290053    

jenny2017

Hello-Thank you for providing such a great service! So grateful to have found this site. I’m 44, former smoker, diagnosed with stage 1a adeno Feb. 2016. Presented with pain in my back, chest, feeling of lump in throat, GERD and general malaise. X-Ray showed spot, Ct scan showed 2 cm spiculated nodule URL. Pet Scan NEGATIVE. Core biopsy positive, MODERATELY DIFFERENTIATED. Went to large cancer institute for 2nd option. They reviewed slides and said yes it’s cancer and you need lobectomy. Path came back WELL DIFFERENTIATED. Had that done at that institute. In hospital had empyema continually on X-Rays so extended stay and chest tube. First CT July 2016, spot on LRL. CT Oct 2016 spot resolved, new one present. Dec. CT new 1.7 cm nodule. Biopsy scheduled 2 weeks out. Biopsy aborted as it shrunk so much. Surgeon thought it was an organizing pneumonitis. Have coughed up minimal blood twice, lump still in throat, GERD still present. After much research and thought I connected it to a root canal that I had years ago by a general dentist. Sure enough the restoration is leaking and needs to be removed. My understanding is Actin. Odont. can mimic lung cancer on CT and clinical presentation. So my question is, can a path report mistake lung cancer for Actin. Odont. as well? And maybe it was an infection all along?

Thank you,
Jenny

February 13, 2017 at 8:19 am  #1290055    
JimC Forum Moderator
JimC Forum Moderator

Hi Jenny,

Welcome to GRACE. I am sorry to hear of your cancer diagnosis and the presence of Actinomyces Odontolyticus as well. It is certainly true that both diseases can coexist in the lung, But although Actinomyces Odontolyticus can be mistaken for lung cancer on scans, the proper way to correctly make the correct diagnosis is through a biopsy of the tissue, as described in this case report: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4644747/ I don’t see any likelihood that two cancer centers would mistake an infection for lung cancer based on a biopsy.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

February 13, 2017 at 8:47 am  #1290056    

jenny2017

Thank you for your quick reply. Yes, I’m aware that occasionally you can have both. I had the biopsy at a local hospital which said it was moderately differentiated. Then looked at again at a major cancer center who performed the surgery then told me it was well differentiated. I’m just wondering if because it’s so rare it could be a false positive based on it going from moderately to well differentiated and because of this publication I read. Can I have my slides transferred for a 3rd opinion to a infectious disease pathologist?

https://www.ncbi.nlm.nih.gov/pubmed/10882279

Thank you!

February 13, 2017 at 9:06 am  #1290057    

jenny2017

I should add I also have a rare condition called Osteogenesis imperfecta which makes me prone to respiratory problems. Thank you.

February 13, 2017 at 9:39 am  #1290059    
JimC Forum Moderator
JimC Forum Moderator

Although I think that the difference between moderately and well differentiated was probably just a difference in the judgment call made by each of the pathologists, I don’t think it can hurt to send the slides to another pathologist, since you certainly don’t want to be treating for lung cancer if it’s not necessary.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

February 13, 2017 at 4:39 pm  #1290062    

cards7up

You had the lobe removed and the pathology showed cancer. Then you have a new growth in a different lobe that keeps shrinking without treatment, this is probably the AO. I would think if they suspect that’s what this might be that they haven’t brought in Infectious Disease yet. How are they treating it? Why not just ask your doctor to have ID to look at your path slides and see what’s going on in the other lobe.
Take care, Judy
http://www.antimicrobe.org/b73.asp


Stage IIIA adeno, dx 7/2010. SRS then chemo carbo/alimta 4x. NED as of 10/2011.
Local recurrence, surgery to remove LRL 8/29/13. 5.2cm involved pleura. Chemo carbo/alimta x3. NED

February 28, 2017 at 10:33 pm  #1290238    

jenny2017

Update: Had a Ct Scan at the Oral Surgeon office because he couldn’t tell anything from the Xray. The root canal is quite infected.

Judy-I’m not being treated at present. I have a PCP who is trying to defer to the Thoracic Surgeon and a Thoracic Surgeon who is trying to defer to the PCP and also recommended an ID Specialist who I can’t get into for several weeks. Surgeon said otherwise, go to the ER.

March 1, 2017 at 7:04 am  #1290239    

cards7up

The thoracic surgeon does surgery he does not diagnose and follow you only before and a follow-up after surgery. This should be followed by your medical oncologist or PCP if it’s not cancer related. You’ve already seen the oral surgeon and now have to wait and see what ID says. Has ID checked your path slides yet?
Take care, Judy


Stage IIIA adeno, dx 7/2010. SRS then chemo carbo/alimta 4x. NED as of 10/2011.
Local recurrence, surgery to remove LRL 8/29/13. 5.2cm involved pleura. Chemo carbo/alimta x3. NED

March 1, 2017 at 7:37 am  #1290240    

jenny2017

Hi Judy,

Thanks for your response. This facility doesn’t have the oncologist follow unless you needed chemo. They have the thoracic surgeon do all the follow up. I think that’s where there’s a big fragmentation. No, I haven’t seen ID yet. Still waiting. Also in the process of trying to switch to a Pulmonologist for continued surveillance of ‘cancer’ after this ID is sorted

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