Pulmon, Vol. 15, Issue 1, Jan - Apr 2013 31 Case Report An uncommon presentation of lung cancer - a case report Abin Varghese Thomas*, Arjun P**, Jayaprakash Madhavan#, Leena Devi K R  , Biji K A *DNB Trainee, ** Sr. Consultnat & HOD, Dept. of Respiratory Medicine, #Senior Consultant & Head, Dept of Oncology,  Senior Consultant & Head, Dept. of Pathology, Consultant, Dept. of Pathology, Kerala Institute of Medical Sciences, Trivandrum Correspondence: Dr. Arjun P Sr. Consultant & Head - Dept of Respiratory Medicine Kerala Institute of Medical Sciences, Trivandrum - 695029 dr.p.arjun@gmail.com Abstract: Although bronchogenic carcinoma is one of the commonest malignancies affecting both men and women alike, it is more commonly seen in smokers and has a predilection to affect older people. One subtype of Non small cell lung cancer - adenocarcinoma has been described to occur more frequently in non smokers. It is known to affect women more than men and is very commonly seen in Asians and has a reasonably better prognosis compared to other subtypes of adenocarcinoma. Bronchogenic carcinoma is extremely uncommon in younger age group and herein we present the case of a 25 year old non smoking male who presented with cough of 1 month duration and on evaluation was found to have Non small cell lung cancer. Keywords: Bronchogenic carcinoma, Non small cell lung cancer, young male Introduction Malignant neoplasms of lung are typically seen in smokers, past middle age. Recent studies have shown that one subtype of non small cell cancer namely adenocarcinoma is increasingly being detected and in some case series has been documented to be the commonest type of lung cancer. One subtype of adenocarcinoma is seen to occur more commonly in non smoking Asians and has a gender predilection, affecting women more commonly. This subtype on immunohistochemistry is usually positive for either EGFR or ALK mutations, which makes it more responsive for "targeted therapy" with drugs like tyrosine kinase inhibitors and ALK inhibitors. Bronchogenic carcinoma is uncommon in age less than 40 years and especially so, in non smokers. Herein we report the case of 25 year old non smoking male who presented with cough of 1 month duration and on investigation was found to have non small cell lung cancer. The case is being presented because of its rarity and also to highlight the fact that malignancy can never be overlooked in any age group Case report A 25 year old non smoking male, software engineer by profession, presented to our hospital for evaluation of cough of 1 month duration. Cough was non productive in nature. He denied having fever, weight loss, breathlessness, wheeze or chest pain. He did not have any relevant respiratory illness in the past. Clinical examination revealed a healthy man, not in any kind of distress. General examination did not reveal any abnormality. His vital signs were normal. Clinical examination of the respiratory system revealed a reduced intensity of breath sounds in the left infraxillary and infrascapular area. Other systems were within normal limits. Laboratory investigation revealed normal blood counts, an erythrocyte sedimentation rate of 32 mm/hour, and