Early-Onset COPD and Lung Cancer: Case Studies Highlighting Diagnostic Challenges in Younger Patients

BACKGROUND The coexistence of lung cancer with COPD has received increasing attention in recent years. These 2 entities are attributed to older age, with a mean age of around 70 years old. Here, we present 3 fatal cases of lung cancer and COPD in uncommonly young patients (45-55 years old). CASE REPORT The first patient, 46-year-old man, reported progressive tiredness, and recurrent sub-febrile states, without recovery despite empiric treatment with 3 antibiotics. He was diagnosed with SCC and referred for chemoradiotherapy, but he died within 6 months. The second patient was 53-year-old women with hemoptysis, tiredness, loss of weight, spine pain, and cough, who was first diagnosed with pneumonia. Her first bronchoscopy was not diagnostic. A second bronchoscopy performed 2 weeks later was successful and she was diagnosed with large-cell carcinoma. She was referred for chemoradiotherapy, but died within 1 month. The third patient was 50-year-old women with chest pain radiating to her left shoulder and hoarseness. She was diagnosed with advanced SCLC, and was referred immediately for chemotherapy with immunotherapy, but did not respond well to treatment and died a few months later. CONCLUSIONS Age seems to be one of the factors that can delay cancer diagnosis. To the best of our knowledge, the literature contains no reports about young patients with coexistence of lung cancer and COPD. We emphasize the importance of these diseases in differential diagnosis in younger patients when reported with systemic symptoms.