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Monday, 14 September 2015

CASE 333: LUNG MASS, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

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Man 52 yo, fever  unknown  origine  for 3 months, blood tests: nothing abnormal detected.
MSCT scan of full body detected  a small nodule on right lung,  size of 1 cm with some  pericarena lymph nodes  enhanced  with  CE and  one subcutaneous mass of 3 cm in the  back of  left  neck  (CT lung images).


Ultrasound of this mass  revealed round border, very hypoechoic, nonvascular filling intramass, no posterior enhancement, no sister mass together ( see 3 US  images and  video clip).




Biopsy was done for this mass and microscopy result was  adenocarcinoma  metastasis  from the lung.


Discussion: Clinical onset is fever unknown origine, CT lung detected small spicular nodule , pericarena nodes and the patient himself detected one subcutaneous mass at posterior of his left neck; biopsy of this mass made diagnosis of metastasis from lung cancer  which is small cell lung cancer.

Conclusion = Small  lung cancer  metastasis to skin  and  paraneoplasic  fever.
Reference: Case in NEJM.

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