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Authors

Irandi P. Pratomo, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia; COVID-19 Task Force – Medical Staff Group of Pulmonology and Respiratory Medicine. Universitas Indonesia Hospital, Depok, Indonesia
Gatut Priyonugroho, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia; COVID-19 Task Force – Medical Staff Group of Pulmonology and Respiratory Medicine. Universitas Indonesia Hospital, Depok, Indonesia
Aris Ramdhani, Department of Surgery, Faculty of Medicine, Universitas Indonesia; Medical Staff Group of Surgery. Universitas Indonesia Hospital, Depok, IndonesiaFollow
Dian Zamroni, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia; Medical Staff Group of Cardiology and Vascular Medicine. Universitas Indonesia Hospital, Depok, Indonesia
Thariqah Salamah, Department of Radiology, Faculty of Medicine, Universitas Indonesia; Medical Staff Group of Radiology. Universitas Indonesia Hospital, Depok, Indonesia
Yayi D.B Susanto, Department of Pathology, Faculty of Medicine, Universitas Indonesia; Medical Staff Group of Pathology. Universitas Indonesia Hospital, Depok, Indonesia
Ramdinal A. Zairinal, Department of Neurology, Faculty of Medicine, Universitas Indonesia; Medical Staff Group of Neurology. Universitas Indonesia Hospital, Depok, Indonesia
Annisa N. Witjaksono, Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia; Medical Staff Group of Ophthalmology. Universitas Indonesia Hospital, Depok, Indonesia
Dita Aditianingsih, Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia; Medical Staff Group of Anaesthesiology and Intensive Care. Universitas Indonesia Hospital, Depok, Indonesia
Jamal Zaini, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia; COVID-19 Task Force – Medical Staff Group of Pulmonology and Respiratory Medicine. Universitas Indonesia Hospital, Depok, Indonesia

Abstract

The Coronavirus disease 2019 (COVID-19) pandemic impacts pulmonary cancer management since it shares similar clinical features and creates fear among patients to visit hospitals due to possible in-hospital disease transmission. We report a patient who presented with a rare case of a pulmonary neuroendocrine tumor with an ocular involvement, which, unfortunately, experienced a delay in diagnostics. The first hospitalization was due to superior vena cava syndrome, pleural and pericardial effusions, and swollen left eye. The patient was diagnosed with pulmonary cancer, released after the symptoms were relieved, and expected to visit a referral hospital for further diagnostics and treatments. The patient returned two weeks later with progressing disease, an ocular metastasis, and a reactive serum IgM/IgG to SARS-CoV-2; serial qPCR tests consistently returned negative. The patient was treated with the best supportive care before succumbing to death. Biopsy showed pulmonary tumor cells consistent with a neuroendocrine tumor. Fear of the pandemic makes patients reluctant to seek help from medical facilities. Pulmonary TBC has similar symptoms to pulmonary cancer, which can pose another challenge in diagnosing pulmonary cancer in TB-endemic countries. Thus, patients often present with advanced-stage pulmonary cancer with rare ocular metastasis, as in this report.

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