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      Diagnostic pitfall in a large cell lung cancer with testicular metastasis synchronous malignant pleural mesothelioma patient: A case report

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          Abstract

          Large cell lung cancer metastases to the testis are scarce, although it is the most common malignancy and the most common site of metastases for breast, colorectal and kidney cancers. We hereby report a 28‐year‐old male patient admitted to our hospital with a chief complaint of scrotal enlargement, accompanied by chest pain and progressive dyspnea. The definite diagnosis was malignant pleural mesothelioma with the synchronous occurrence of large cell lung cancer with testicular metastasis. Sophisticated clinical manifestation of symptoms led to a time‐consuming diagnosis, while the patient's condition deteriorated rapidly. Herein, we present this case to share our hard‐learnt experience to increase clinician awareness and contribute to the information in the literature.

          Abstract

          Testicular metastasis as initial manifestation of large cell lung cancer with the synchronous occurrence of malignant pleural mesothelioma, bilateral hydrothorax were increasing, patient's performance kept deteriorating, the diagnosis and treatment were in a dilemma.

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          Most cited references15

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          The Eighth Edition Lung Cancer Stage Classification.

          Stage classification provides a nomenclature about the anatomic extent of a cancer; a consistent language provides the ability to communicate about a specific patient and about cohorts of patients in clinical studies. This paper summarizes the eighth edition of lung cancer stage classification, which is the worldwide standard as of January 1, 2017. This revision is based on a large global database, a sophisticated analysis, extensive internal validation as well as multiple assessments confirming generalizability. Practicing clinicians must be familiar with the stage classification system when managing contemporary patients with lung cancer.
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            Precision Diagnosis and Treatment for Advanced Non–Small-Cell Lung Cancer

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              Prognostic value of pleural effusion in patients with non-small cell lung cancer.

              This study was performed to determine whether pleural effusion in patients with advanced non-small cell lung cancer (NSCLC) has a negative impact on survival. We evaluated 12 prognostic factors in 197 patients with stage IIIB or IV NSCLC. Each factor was dichotomized, and survival curves calculated by the Kaplan-Meier technique were compared using the log-rank test. The Cox proportional hazards regression model was used to confirm the significance of each prognostic factor selected by univariate analysis. We compared the survival times for stage IIIB with pleural effusion with those of stage IIIB without effusion and stage IV. To determine the impact of the cytological results of the effusion on survival, we compared the survival times for cytologically positive and negative effusions. Univariate analysis identified eight significant prognostic factors: pleural effusion, node status, stage, performance status, weight loss, hemoglobin, albumin, and lactate dehydrogenase. Pleural effusion was selected as a prognostic factor in the multivariate analysis, together with stage, performance status, albumin, and node status. Median survival times for stage IIIB without effusion, stage IIIB with effusion, and stage IV were 15.3, 7.5, and 5.5 months, respectively (P < 0.0001). Survival time for stage IIIB with effusion was significantly different from that of stage IIIB without effusion (P = 0.0129) but not from that of stage IV (P = 0.0797). Among patients with effusion, no significant difference in survival time was observed between cytologically positive and negative effusions. We conclude that pleural effusion in advanced NSCLC is a prognostic factor. Survival time for stage IIIB with pleural effusion is more similar to that of stage IV rather than that of stage IIIB without effusion.
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                Author and article information

                Contributors
                cheguowei_hx@aliyun.com
                Journal
                Thorac Cancer
                Thorac Cancer
                10.1111/(ISSN)1759-7714
                TCA
                Thoracic Cancer
                John Wiley & Sons Australia, Ltd (Melbourne )
                1759-7706
                1759-7714
                15 June 2022
                August 2022
                : 13
                : 15 ( doiID: 10.1111/tca.v13.15 )
                : 2253-2256
                Affiliations
                [ 1 ] Day Surgery Center Sichuan University West China Hospital Chengdu People's Republic of China
                [ 2 ] West China School of Medicine Sichuan University West China Hospital Chengdu People's Republic of China
                [ 3 ] Urology Department Sichuan University West China Hospital Chengdu People's Republic of China
                [ 4 ] Department of Thoracic Surgery Sichuan University West China Hospital Chengdu People's Republic of China
                Author notes
                [*] [* ] Correspondence

                Guowei Che, Department of Thoracic Surgery, Sichuan University West China Hospital, Chengdu 610041, People's Republic of China.

                Email: cheguowei_hx@ 123456aliyun.com

                Author information
                https://orcid.org/0000-0002-5602-3792
                https://orcid.org/0000-0002-5779-8274
                Article
                TCA14472
                10.1111/1759-7714.14472
                9346174
                35707844
                cb7712c0-8f8c-4a7d-9f60-709e56147acb
                © 2022 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 28 April 2022
                : 12 April 2022
                : 29 April 2022
                Page count
                Figures: 4, Tables: 0, Pages: 4, Words: 1996
                Funding
                Funded by: National Natural Science Foundation of China , doi 10.13039/501100001809;
                Award ID: 72104161
                Categories
                Case Report
                Case Reports
                Custom metadata
                2.0
                August 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.7 mode:remove_FC converted:03.08.2022

                large cell lung cancer,malignant pleural mesothelioma,testicular metastasis

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