Lung Adenocarcinoma Presenting With a Reduced Solid Component but Increased Overall Nodule Size After Antibiotic Therapy: A Case Report
Abstract
Abstract This report describes a 51-year-old man with a 30-pack-year smoking history whose initial low-dose chest computed tomography (LDCT) revealed a 17 × 16 mm solid nodule in the right lower lobe with lobulation and pleural indentation. Elevated serum tumor marker levels further increased suspicion for lung cancer. One month later, the patient developed a concurrent Mycoplasma pneumoniae infection and was treated with moxifloxacin. Follow-up computed tomography demonstrated a paradoxical radiologic pattern: the solid component appeared to decrease, whereas the overall lesion size increased to 21 × 18 mm. For this apparent radiologic improvement conflicted with the high-risk baseline features, the case was reviewed in a multidisciplinary setting and a percutaneous transthoracic needle biopsy was performed. Histopathological examination confirmed lung adenocarcinoma (LUAD). The patient subsequently underwent uniportal video-assisted thoracoscopic right lower lobectomy, and the final pathologic stage was pT1bN0M0 (stage IA2). No recurrence or metastasis was detected during nearly 2 years of follow-up. This case highlights that a reduction in the solid component of a pulmonary nodule after antibiotic therapy should not be interpreted as evidence of benignity when other malignant features persist or the overall nodule size increases.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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