An incidental finding of lung nodule in patient presenting with posterior chest wall trauma: A case report

Abstract

Lung nodule is considered a common incidental finding in chest CT evaluation. Most cases are benign and derived from a previous infection. However, here we present a case where a patient presenting to the hospital with posterior chest wall trauma had a solitary pulmonary nodule that is consistent with non-small cell lung cancer (NSCLC). We would like to emphasize the importance of evaluation of incidental findings in chest CT evaluation, in this case, trauma cases by presenting this case. An 81-year-old male was referred to the emergency department with altered consciousness and a history of posterior chest trauma. He complained of a productive cough, but no other symptoms were reported. He had a medical history of Alzheimer's dementia, COVID-19, and hypertension. Physical examination revealed a hematoma on the right side of his back and reduced breath sound. Anteroposterior radiograph showed multiple right posterior rib fractures with right pleural effusion. Contrast-enhanced chest CT revealed a low-density solitary pulmonary nodule with multiple lymphadenopathies, with the presumptive diagnosis of incidentaloma. It was confirmed by pleural analysis with the increase of Cyfra 21-1 tumor marker and consistent with non-small cell lung cancer. In CT studies, incidental solitary pulmonary nodules are common, occurring in 8%-51%. Nodules are often discovered incidentally in trauma patients, but they are not always reported or followed up. It is important to note that each may indicate a clinical significance and represents the potential for malignancy which requires additional workup and further evaluation.

Keywords

• Incidental findings
• Lung nodule
• Chest trauma
• NSCLC