Solitary Pulmonary Nodule Under the Anonymity of COVID-19 Infection

We report the case of a 32-year-old male patient, a former smoker, with a known history of SARS-COV-2 infection, mild clinical form, condition that required follow-up evaluation. Despite being oligosymptomatic, the patient reports discreet respiratory symptoms, manifested by dry cough and a sensation of chest tightness. CT thoracic scan revealed a pseudo-nodular, diffusely contoured infiltrate of approximately 10 mm, in the apical left upper lobe segment (LUL), sequelae appearance, thought to represent SARS-COV-2 residual changes, with follow-up recommendation. Three months later, reassessment highlighted a slight progression of the lesion, with a spiculated appearance and umbilicated pleura, a context that mandated further respiratory-specific medical investigations, including bronchoscopic examination and positron emission tomography (PET CT). Given the diagnostic suspicion that included a pathology with neoplastic potential, the firm recommendation was to perform a nodular pulmonary biopsy through video-assisted thoracoscopy (VATS). Both the histopathological (HP) and immunohistochemical (IHC) examinations supported the diagnosis of primary pulmonary adenocarcinoma. The therapeutic course was completed by performing a left upper lobectomy with lymphadenectomy. The case is instructive, confirming that SARS-COV-2 infection is a perfect mimic (1), capable of imitating various other conditions.

In this context, the optimal scenario is distinguished, where monitoring after infection contributes to the early and incidental identification of neoplasia, thus suggesting that SARS-COV-2 infection may also offer certain benefits.