# Bilateral pulmonary cavitary mucinous adenocarcinoma in an immunocompetent patient: a case report and literature review

## TL;DR

A rare case of lung cancer with unusual imaging features in an immunocompetent patient led to a misdiagnosis before confirmation through biopsy.

## Contribution

This case report highlights the rare cavitary presentation of pulmonary mucinous adenocarcinoma and its diagnostic challenges.

## Key findings

- PMA presented with bilateral cavitary changes, mimicking infectious diseases on imaging.
- CT-guided biopsy confirmed the diagnosis after anti-infective treatment failed.
- Atypical imaging features can delay diagnosis and lead to inappropriate treatment.

## Abstract

We report an unusual case of pulmonary mucinous adenocarcinoma (PMA) in a 67-year-old immunocompetent male who presented with atypical imaging features that initially resulted in misdiagnosis. Chest CT revealed bilateral diffuse patchy opacities and consolidation with multiple cavities and nodules, mimicking infectious diseases. After unsuccessful anti-infective treatment, CT-guided lung biopsy confirmed PMA. The presence of multiple cavitary changes represents a rare manifestation of PMA that differs significantly from its characteristic imaging appearance, posing substantial diagnostic challenges. This case highlights the importance of maintaining a high index of clinical suspicion for PMA, even when imaging features are atypical, as such presentations can lead to delayed diagnosis and inappropriate treatment.