Endocrine manifestations of lung adenocarcinoma with epidermal growth factor receptor mutation mimicking tuberculosis: A case report and literature review

TL;DR

A case of lung cancer with EGFR mutation mimicked tuberculosis and caused endocrine issues, highlighting diagnostic challenges and the need for multidisciplinary care.

Contribution

Highlights an unusual presentation of EGFR-mutated lung cancer mimicking TB with endocrine complications and pituitary metastasis.

Findings

Lung adenocarcinoma with EGFR mutation presented as miliary TB with pituitary metastasis.

Targeted therapy with osimertinib improved clinical outcomes in this complex case.

Pituitary metastasis caused diabetes insipidus, hyperprolactinemia, adrenal insufficiency, and hypothyroidism.

Abstract

Lung cancer is a leading cause of cancer-related mortality globally, often presenting with diverse and challenging manifestations. This case report discusses an unusual presentation of epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC) initially mimicking tuberculosis (TB), complicated by pituitary involvement.

A 30-year-old female presented with respiratory symptoms and systemic complaints, initially suggestive of miliary TB. Further investigations revealed metastatic lung adenocarcinoma with pituitary metastasis, causing diabetes insipidus, hyperprolactinemia, adrenal insufficiency, and hypothyroidism. Treatment with targeted therapy involving osimertinib resulted in clinical improvement.

This case underscores the diagnostic challenges posed by atypical presentations of lung cancer, which can masquerade as infectious diseases like TB. The presence of pituitary metastasis further complicates the clinical picture, emphasizing the importance of considering rare metastatic sites in the differential diagnosis of lung adenocarcinoma. Timely recognition and appropriate management are crucial for optimizing outcomes in such complex cases, highlighting the need for a multidisciplinary approach in oncological and endocrine care.

Figures