An atypical presentation of lymphangitis carcinomatosis

Lymphangitis carcinomatosis is a condition characterised by inflammation and malignant infiltration of lymphatic vessels due to metastatic malignancy from a primary location. It usually denotes an end-stage malignancy with poor prognosis. The symptoms are primarily related to the respiratory system but other primary sites have been reported. This case report illustrates a male in his early 50s with no previous history of cancer, presenting with symptoms of unilateral leg ischaemia and respiratory symptoms, for whom his admission led to the discovery of metastasis. Unfortunately, he deteriorated significantly over time due to respiratory failure and passed away. The exact mechanism of lymphangitis carcinomatosis is unclear, but it is presumed that tumour cells are spread within the lymphatic system. Pulmonary lymphangitis carcinomatosis could be one of the first manifestations of an occult primary tumour. This case report aims to highlight the importance of recognising atypical clinical presentations of lymphangitis carcinomatosis to ensure management efforts are made towards the underlying malignancy.