Adalimumab-induced interstitial pneumonia with an improvement of pre-existing rheumatoid arthritis-associated lung involvement.

A 78-year-old man with an 18-year history of rheumatoid arthritis (RA) was treated with tumor necrosis factor (TNF)-α inhibitor adalimumab. Chest computed tomography showed a previously detected consolidation. The patient's arthritic symptoms substantially decreased with the initiation of adalimumab, with a simultaneous improvement of the lung lesion. However, additional interstitial pneumonia was found a month after starting adalimumab. This course suggested that adalimumab might be effective against RA-associated lung disease, but may also have caused drug-induced interstitial pneumonia. This is the first report indicating that TNF-α inhibitor shows simultaneously conflicting actions in a patient with RA-related lung disease.

[Pulmonary adenocarcinoma with facial nerve palsy as the first sign of onset due to a metastatic temporal bone tumor].

A 70-year-old woman was admitted because of left facial nerve palsy. Brain magnetic resonance imaging showed a mass lesion with a well-enhanced margin in the left temporal bone. A computed tomographic scan of the chest showed a lung mass in the left lower lobe, which was thereafter diagnosed as adenocarcinoma. An immunohistochemical examination of the tissue specimen obtained from the left temporal bone revealed evidence of metastatic adenocarcinoma from the lung. No other metastatic lesions including separate site of bone were seen. This is a very rare case of lung cancer with facial nerve palsy as the first sign of onset due to a metastatic temporal bone tumor.