ACUTE INFLAMMATORY ABDOMEN: AN ATYPICAL PRESENTATION OF PULMONARY SQUAMOUS CARCINOMA (Atena Editora)

Abstract

Objective: To report a case, as well as investigation of propaedeutic, surgical and complementary approaches applied to the management of abdominal pain and atypical findings in a patient diagnosed with pulmonary squamous cell carcinoma.

Case report: A patient from the emergency department of `` Hospital Universitário Alzira Velano`` complains of severe abdominal pain. The anamnesis collected shows severe abdominal pain that started in the mesogastric and posterior region, migrating to the right hypochondrium, right flank and right iliac fossa. History and exams suggestive of appendicitis, indicated the realization of tomography in which it reports an expansive lesion in the upper third of the right hemithorax, with imprecise limits and spiculated contours. In the abdomen, intraperitoneal abscess and free fluid in the cavity were found. Thus, an exploratory laparotomy was designated, in which the presence of intestinal adhesions was observed, accompanied by whitish secretion suggestive of lymph throughout the explored cavity. The lymph node sample and duodenal lesion located in the first portion were biopsied. Bronchoscopy was also performed, which confirmed the presence of a friable, vegetating, whitish endobronchial lesion measuring approximately 5 cm in the posterior segment of the right upper lobe. After these findings, immunohistochemistry was performed to diagnose the lesion in which pulmonary squamous cell carcinoma was found.

Conclusion: Even with a multidisciplinary approach to the patient, it was difficult to define the diagnosis, precluding early treatment before the progression of the carcinoma.