We report the case of a 70-year-old man who was neither treated for tuberculosis nor has had any recent tuberculosis contagion, and with no notable pathological history or chronic smoking. The patient has reported a productive cough for 2 months, with mucous sputum associated with stage III of mMRC dyspnea, without hemoptysis or chest pain. Moreover, for 1 month he had liquid dysphagia associated with regurgitations, in the context of apyrexia and deterioration of the general state.
Clinical examination finds a conscious patient, eupneic at rest, saO2 = 92% at ambient air, with a pleuropulmonary examination without particularities.
The posteroanterior chest roentgenogram showed homogeneous right hilar opacity with peripheral nodular opacity with speculated contours (Figure 1). The thoracic computed tomography (CT) showed a right hilar tumoral process, extended to the posterior segment of the right upper lobe with irregular and spiculated contours, measuring 42 x 32 x 25 mm without contact with the esophagus, associated with a spiculated nodule of the right upper lobe measuring 20 x 19 mm, without lymphadenopathy mediastinal (Figure 2).
A bronchial fibroscopy was made objectifying a budding mucosa of the right upper lobar bronchus whose biopsy concluded from an epidermoid carcinoma.
As part of the exploration of dysphagia, an oesophagoscopy was normal and an achalasia was evoked and confirmed by esophageal manometry.
Due to the significant alteration of the patient, the patient died before the initiation of treatment.