Lung cancer is number one cause of cancer mortality in United States both in men and women. Lung cancer is uncommon in patients younger than 35 years with no smoking and family history. Malignancy from lung nodule depends on size, growth rate, borders, calcification and location. Appropriate follow up for lung nodules in older patient with risk factors has been well described in literature based on various researches. However there is very limited data regarding follow up and management of lung nodule in younger patient with risk factors. We describe a patient who was 30 year old when he presented with acute appendicitis and incidentally found to have lung nodule of 1.2 cm. It was decided that patient should follow up as an outpatient for lung nodule. As patient was uninsured with poor socioeconomic he never followed up as outpatient. After 2 years patient was diagnosed with stage IV lung adenocarcinoma and died shortly after. Guidelines should be used in the proper clinical context as a tool to help with patient management, though exceptions always exist. Some expert believe lung nodule between 8-30 mm in patient with poor follow-up due to socioeconomic status, psychological issues, or young age should get complete resection of nodule.
Afatinib for an EGFR exon 20 insertion mutation: A case report of progressive stage IV metastatic lung adenocarcinoma with 54 months’ survival