November 22, 2019

Despite developing lung cancer, it is estimated that approximately

Despite tobacco smoking being the strongest risk
factor for developing lung cancer, it is estimated that approximately 25% of
all lung cancers are not associated with tobacco use (Sun et all). Smoking has
a stronger correlation with small cell lung cancer and squamous cell carcinoma,
however, adenocarcinoma seems to be the most common form of lung cancer in
non-smoker and lung cancer in the young. Adenocarcinoma is a histological subset
of non-small lung cancer that is comprised of
epithelial tissue that has a glandular origin or glandular characteristics. Recent research has been able to further define specific ‘driver’
mutations that reoccur in NSCLC subtypes. These driver mutations occur in
cancer cells and are made up of genes encoding for proteins involved in survival
and cell growth. EGFR, HER2, ALK, RET, and ROS1 mutations are found more
commonly in adenocarcinoma of non-smokers. On a positive note, new therapeutic agents
are currently available or are being developed to specifically target these
mutations and have shown to slow down the progression of these cancers.

Another disease to
discuss in this case report is syphilis. Syphilis is caused Treponema pallidum which
is a bacteria that is transmitted through sexual contact or as a congenital infection
from mother to baby. There
are several stages of syphilis. In the primary stage, the patient presents with
a chancre. The secondary stage involves a variable rash and systemic symptoms. There
is also a latent stage where the patient is classically asymptomatic. The late
or tertiary stage occurs within 15 to 30 years of initial infection and is associated
with significant organ damage such as gummatous, cardiovascular,
ophthalmologic, neurologic, or osseous aberrations. An important complication
of tertiary syphilis related to this case is aortitis. Aortitis is a consequence
of vasculitis of the vasa vasorum causing weakening of the wall of the aortic root
that can lead to aortic rupture and possibly death. 

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