276 Acquired rhinophyma as a paraneoplastic manifestation of non-small cell lung cancer case report Erworbenes Rhinophym als paraneoplastische Manifestation eines nicht-kleinzelligen Lungenkarzinoms Zusammenfassung Wir berichten über einen 58 Jah- re alten Mann, der ein Rhinophym entwickelte, das durch ein nicht-kleinzelliges Lungenkarzinom ausgelöst wurde. Unseres Wissens wurde ein Rhinophym bisher noch nicht als ein mit einem nicht-kleinzelligem Lun- genkarzinom assoziertes paraneoplastisches Syndrom beschrieben. Schlüsselwörter: Paraneoplastisches Syndrom, Rhino- phym, Nicht-kleinzelliges Lungenkarzinom, Radioche- motherapie Summary We report a case of a 58-year-old man who developed rhinophyma caused by non-small cell lung cancer. To the best of our knowledge, rhinophyma as paraneoplastic syndrome associated with non-small cell lung cancer has not been previously reported. Keywords: Paraneoplastic syndrome, Rhinophyma, Non-small cell lung cancer, Chemoradiotherapy Introduction Non-small cell lung cancer (NSCLC) is a tumor with a poor prognosis with limited response to chemoradio- therapy and targeted agents. Since the better prognostic expectance for patients with NSCLC strictly depends on the possibility of surgical removal, its early detection is of great importance [1]. Paraneoplastic syndromes asso- ciated with NSCLC are variable [2–5], and of particular clinician’s interest [1]. We report a case of a 58-year-old man who developed rhinophyma caused by NSCLC. To the best of our knowledge, rhinophyma as paraneoplas- tic syndrome associated with NSCLC has not been previ- ously reported. Case presentation A 58-year-old male, under the insulin therapy for diabe- tes, developed rosacea for which he was unsuccessfully treated with antibiotic therapy (Fig. 1). He was admitted to our hospital due to chest pain persisting for 2 months, fever up to 37.4 °C, fatigue, and 7 kg weight loss. Computed tomography (CT) imaging showed paren- chyma iniltration of posterior segment of right upper lung lobe and enlarged pericarinal lymph nodes. he iberbronchoscopy showed no abnormality of bronchial tree and mucosa, but cytological analysis of material gained by catheter aspiration from right upper bron- chus revealed NSCLC. Due to the advanced stage of the disease (stage IIIA), the patient was treated with chemot- herapy (four cycles of gemcitabine/cisplatin) and radio- therapy (40 Gy). During chemoradiotherapy, the withdrawal of rhino- phyma has occurred (Fig. 2), and CT imaging showed regression of the disease from stage IIIA to stage IIB, for which the patient soon underwent right thoracotomy with upper lobectomy and radical lymph node dissec- Wiener klinische Wochenschrift The Central European Journal of Medicine Wien Klin Wochenschr (2012) 124:276–277 DOI 10.1007/s00508-012-0151-z Acquired rhinophyma as a paraneoplastic manifestation of non-small cell lung cancer Neven Rakusic, Denis Baricevic, Nevena Rakusic, Miroslav Samarzija, Marko Jakopovic, Marinka Baricevic N. Rakusic, MD, Ph.D. () · D. Baricevic, MD · M. Samarzija, MD, Ph.D. · M. Jakopovic, MD, Ph.D. Clinic for Lung Diseases Jordanovac, University Clinical Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia e-mail: neven.rakusic@zg.t-com.hr N. Rakusic, MD Clinical Hospital Merkur, Zagreb, Croatia e-mail: nevena.rakusic@gmail.com M. Baricevic, DD, Ph.D. Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia Received: 19 October 2011 / Accepted: 15 January 2012 / Published online: 14 April 2012 © Springer-Verlag Wien 2012