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Granulomatosis with polyangiitis (GPA), previously known as Wegener's granulomatosis, is a vasculitis that primarily affects the respiratory tract and kidneys(1). Known as a rare disease, predominantly affects Caucasian adults aged between 45 and 60 years(2). While the specific cause remains unclear, it is believed that environmental factors play a role in triggering the condition in individuals who are genetically predisposed(3). There is a wide range of clinical manifestations, comprising both general nonspecific symptoms(4) and organ-specific symptoms, with lung involvement in nearly 90% of patients(5). The diagnosis relies on clinical and imaging criteria, along with histopathological confirmation(2). Treatment consists of an induction phase, followed by a maintenance phase, utilizing glucocorticoids and immunosuppressants, which has greatly enhanced the prognosis for these patients(6). The objective of this paper is to illustrate the complexity of GPA through the presentation of a clinical case. The patient is a 59-year-old man with a professional background involving exposure to respiratory toxins who presented to the clinic with intermittent mucopurulent cough, episodes of hemoptysis, nonspecific chest pain, bilateral knee pain, weight loss, and excessive nocturnal sweating. The imaging findings indicated significant polymorphic lesions in the lungs, and the diagnosis of GPA was confirmed via transthoracic biopsy. Using a therapeutic strategy of immunosuppression and oral corticosteroid therapy, the patient's clinical condition showed a modest improvement. The particularity of this case lies in the need to revise the treatment strategy for a patient identified as a non-responder to cyclophosphamide, given the imaging, functional and biological decline observed under the initial immunosuppressive therapy. [ABSTRACT FROM AUTHOR]

Lung cancer dominates the current picture of malignancies worldwide, remaining a tragic first place in mortality statistics. Despite the continuous improvements in lung cancer screening, the refinement of surgical techniques, and innovations in oncological treatments, lung cancer remains the main contributor to fatalities among all forms of neoplastic conditions(1,2). Lung adenocarcinoma is not just one of the most common histological types of lung cancer but also one of the deadliest worldwide due to its late diagnosis and high heterogeneity. Smoking tobacco is one of the main risk factors for any lung cancer, including adenocarcinoma, but there are also other factors that can increase the risk, such as family history of lung cancer and professional exposure to noxious agents such as silica, asbestos, radon, heavy metals, and diesel fumes(3). Therefore, through this case series report the authors attempt to present their experience with three cases with a broad range of differences such as past medical history, living and work conditions, and other vicious habits such as smoking. This paper strives to establish the potential faces that lung adenocarcinoma can adopt, disguising itself under the umbrella of many other lung parenchymal syndromes, mimicking non-malignant processes, often displaying features very similar to an infection, and misdiagnosed as pneumonia, thereby delaying the diagnosis. Additionally, we provide a brief synthesis of the best resources available in lung adenocarcinoma-specific literature, including the importance of distinguishing early signs and symptoms, medical imaging, differential diagnosis, and early treatment. [ABSTRACT FROM AUTHOR]