Medical Case Reports

Bilateral Pathological Fracture of Proximal Femur Revealing a Rare Lung Carcinoma: What the Family Physician Should Know?

Lung cancer is a severe disease often diagnosed a late stage when surgical resection is no longer possible. Adenosquamous carcinoma is a rare subtype of lung carcinoma. It behaves more aggressively than other histologic subtypes of lung cancer with a poor long-term prognosis. We present here the case of a 62-years-old elderly male patient, smoker with chronic obstructive pulmonary disease, consulted initially a family physician for dyspnea, cough and a spontaneous pain of both hips then he was diagnosed as simple exacerbation of his pulmonary disease. Three months later, patient presented a bilateral pathological fracture of proximal femur prompting the patient to undergo surgery. He benefited from bilateral long Gamma intramedullary nail along with biopsy and cementation on the right proximal femur. Based on clinical features, chest x-ray finding, CT scan, histopathological finding and immune-histochemical analysis, a diagnosis of metastatic adenocarcinoma of femur, primary from the lung was made and was transferred to the oncology service for inpatient palliative radiation and chemotherapy. But, at 3 weeks from surgery, patient presented an acute decompensation of his chronic obstructive bronchopneumopathy causing his death.

Author(s):

Naoufal Elghoul, Azzelarab Bennis, Nasser Ibo, Abdeloihab Jaafar and Mohammed Tbouda

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