Hereditary multiple exostoses complicated with lung cancer with cough as the first symptom: a case report

Hereditary multiple exostoses (HME) is an autosomal dominant genetic disease. It mainly involves the extremities long bone metaphyseal and flat bone, with the cartilage cap covering the surface. The main clinical symptoms include the compression of the surrounding soft tissue caused by osteophyte hyperplasia, such as pain, dysfunction, and developmental deformity, etc. The cases of HME with lung cancer are rare. We performed a case of cough as the first symptom who had a paternal family history of HME. According to the results of positron emission tomography/computed tomography (PET/CT), pathology and immunohistochemistry, the case was finally diagnosed as right lung adenocarcinoma, T3N2M1a, stage IVA. At present, the patient was given pemetrexed with nedaplatin for 2 cycles and added anlotinib combined with chemotherapy for additional 3 cycles. The recent chest computer tomographic (CT) showed the right lung lesion was slightly smaller than before. When we meet patients of such multiple exostoses with lung occupying lesions, we need to think about many possibilities of the disease from various perspectives, such as primary lung cancer, lung metastasis or bone metastasis.