# Diagnostic and Therapeutic Challenges With Synchronous Lung Adenocarcinoma and Cervical Carcinoma: A Case Report

## TL;DR

This case report discusses the challenges of diagnosing and treating a rare case of two cancers occurring simultaneously in an elderly patient.

## Contribution

The paper highlights the complexities of managing synchronous multiple primary cancers with a focus on diagnostic and therapeutic decisions.

## Key findings

- The patient had a complete response in cervical cancer after chemotherapy, but lung cancer persisted.
- Immunohistochemistry confirmed the diagnosis of synchronous lung adenocarcinoma and cervical SCC.
- The case emphasizes the need for careful evaluation of non-regional nodules to avoid misdiagnosis.

## Abstract

Cervical cancer and lung cancer are both very rampant cancers and contribute significantly to the global healthcare burden. We discuss the rare occurrence of synchronous multiple primary cancer (SMPC) in an elderly female patient with squamous cell carcinoma (SCC) cervix and lung adenocarcinoma.

The patient had SCC in cervical biopsy, and poorly differentiated carcinoma was reported in the biopsy of a single lung nodule, which was considered metastatic initially.

She received a palliative intent chemotherapy with paclitaxel and carboplatin. Chemotherapy led to a complete response in the cervix, but the lung lesion persisted. Immunohistochemistry on the lung nodule was done, and it guided us to a SMPC diagnosis with lung adenocarcinoma plus SCC cervix. Subsequently, the patient received stereotactic body radiation therapy for lung adenocarcinoma and chemo-radiation for the SCC cervix, and she is on regular follow-up.

The article highlights the practical difficulties in diagnosing SMPC in real-world situations with various practical and financial constraints. The manuscript discusses challenges in defining an optimal treatment regimen for SMPC due to its infrequency, the significance of clinical acuity, and the need for a high index of suspicion. Clinicians must not presume every non-regional nodule is metastatic, especially in cases with an oligometastatic disease burden.