Primary Undiagnosed Adenocarcinoma of Lung Presenting as Acute Respiratory Distress Syndrome

Neoplastic pulmonary infiltration is an unusual but recognized cause of acute respiratory distress syndrome (ARDS). However, its occurrence with primary undiagnosed adenocarcinoma of lung has never been reported in previous instance. We herein report a 54-year-old patient who developed ARDS after ten days of respiratory symptoms and died within three weeks from his initial presentation. High-resolution computed tomography (CT) of his chest showed diffuse patchy infiltration and areas of ground-glass attenuation. Adenocarcinoma was diagnosed by open lung biopsy. Although the clinical manifestation of lung cancer is somewhat variable, rapid deterioration with ARDS is uncommon. The reports in which ARDS developed as a result of neoplastic infiltration of the lungs is reviewed briefly. We also stress the fact that neoplasm should be considered as a possible etiology of unexplained ARDS.