Clinical case of systemic sclerosis in the course of lung adenocarcinoma

We present a patient with a 5-year systemic sclerosis with diffuse skin manifestations, capillaroscopic data to confirm diagnosis, elevated levels of ANA-antibodies, Anti-Sox-1, Anti-Ro-52 and Anti-Histone in the course of lung adenocarcinoma (proven by fibrobronchoscopy and biopsy) and brain metastasis in consequence. From the clinical examination, it is established diffuse skin manifestations, weakened vesicular respiration in right site of lung, astheno-adynamic syndrome, shortness of breath with usual physical exertion. From lung function tests, FVC is 58% and FEV1 is 59%. The adenocarcinoma is located on a wide area in the right half of the lung and not indicated for surgical treatment. The patient completed 4 courses of chemotherapy with Alimta + Cisplatin from March 2016 to July 2016, 7 courses of Docetaxel from February 2017 to September 2017, and radiotherapy. One year later complaints of forgetting of words, difficult reading and writing appeared. Computed tomography (CT) shows intracranial tumor formation with heterogeneous structure in left frontal brain half – metastasis after lung adenocarcinoma. Operative removal of tumor formation and postoperative radiotherapy took place and Depakine Chrono 2 times 500 mg daily was prescribed. The treatment for systemic sclerosis was followed by 8 mg Methylprednisolone and 250 mg Cuprenil with good therapeutic effect.Key words: systemic sclerosis (scleroderma), lung cancer, paraneopastic syndrome. (author)