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Bronchoalveolar carcinoma as an unsuspected cause for worsening shortness of breath in a patient with metastatic breast cancer
  1. Sukhdeep Kaur Nagpal1,
  2. Michael Flynn2,
  3. Claire Ryan1,
  4. Catherine Harper-Wynne1
  1. 1Oncology, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
  2. 2Oncology, Royal Marsden NHS Foundation Trust, London, UK
  1. Correspondence to Dr Sukhdeep Kaur Nagpal, sukhdeep.nagpal{at}


A 70-year-old woman with lung metastases from a breast cancer presented with worsening cough and dyspnoea. She recently had a pleurodesis for a malignant pleural effusion. Chest CT scans demonstrated various radiological changes leading to diagnostic challenges. Differential diagnoses included empyema, pleural disease progression, pulmonary oedema, pneumonitis, lymphangitis and atypical infections. She deteriorated despite a multimodality treatment strategy. Postmortem examination confirmed that lung changes were consistent with a bronchoalveolar carcinoma unrelated to the known metastatic breast cancer. The eventual knowledge of this diagnosis was reassuring to the treating medical team and a comfort to the relatives who witnessed the lack of response to standard treatment.

  • oncology
  • breast cancer
  • malignant disease and immunosuppression
  • respiratory medicine

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  • Contributors SKN, MF, CR and CH-W were responsible for study conception and design, acquisition, analysis and interpretation of data, drafting of manuscript, critical revision and final approval of manuscript to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.