Hello there, it's my first time writing on this forum.
My mother who is 54yo, otherwise healthy, was complaining for about 3-4 weeks of random night sweats, fever, and persistent cough. She has a 20 year history of smoking 1.5 ppd.
Initial chest xray revealed enlarged right hilar area. Chest CT revealed multi nodular enlargements in mediastinal, subcarinal and hilar lymph. Initial suspection was lymphoma. Bronchoscopy was clear. Transbronchial biopsy was clear. Whole body MRI and PET/CT confirmed results of multinodular involvement in thoracic area only. Mediastinal biopsy came back as an adenocarcinoma not well differentiated, with an IHC profile that is CD 7 +, all other markers were negative. Her routine blood work is normal (CBC, Electrolyte, liver, renal, thyroid, etc...). Blood cancer markers negative with exception of CEA at 11.1 and CA19.9 at 102.
Given her history of smoking, both oncologists we consulted are treating this is a "hidden" lung primary. Two thoracic surgeons advised against dissecting the involved lymph nodes, given the complexity and multinodular involvement. Every imaging/diagnostic test we did and repeated seems to indicate that the cancer is localized in the mid-to-right thoracic area (para-hilar, mediastinal, carinal, para-tracheal).
It's a very confusing case and to be honest it's giving all the drs a big scratch of the head.
The plan now is to do 2 sessions of induction chemo (cisplatin + Alimta), re-evaluate lymph nodes, most likely proceed with chemoradiation (IMRT or 3D). Has anyone come across any similar cases in real practice? Any ideas or suggestions? I was only able to find litterature on T0N2M0 cases that resemble symptomatically and diagnostically my mom's situation.
Thanks alot and God Bless you all.