Pulmonary hypertension: An unusual presentation of alveolar cell carcinoma of the lung

Lung cancer is the leading cause of cancer-related deaths in the USA, with an estimated 178,100 new cases in 1997, accounting for 13% of cancer diagnoses. The incidence rate is declining in men, from a high of 87 per 100,000 in 1984 to 77 in 1993. Recently the rate of increase among women has begun to show; however, since 1987, more women have died of lung cancer, which, for over 40 years, was the major cause of cancer death in women. In 1993, the incidence rate in women was 42 per 100,000¹. The common well- known presentations of lung cancer are often caused by airway obstruction - cough, sputum production, hemoptysis, unresolved pneumonias, etc, and invasion of neighboring and/or distant organs with metastasis. Lung cancer, commonly, is not associated with gas exchange problems. We report a patient with lung cancer of Bronchoalveolar type, whose major clinical presentation resulted from severe hypoxia, hypercapnia leading to pulmonary hypertension, cor pulmonale, right-heart failure and eventually death.