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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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