Description
An 81 year old male with a history of 2 aortic valve replacements (1989, 2004) and hypertension presented with a 2 month history of intermittent peri-umblical abdominal pain and weight loss. He was medicated with aspirin, bendrofluazide and lisinopril. He was a life long non smoker and of excellent performance status. The physical examination was unremarkable, without any evidence of clubbing or lymphadenopathy. An abdominal x-ray revealed slightly dilated bowel loops. The chest radiograph showed haziness in right lower zone. CT scan of thorax revealed a 3cm mass in the right lower lobe of the lung, highly suggestive of primary bronchogenic carcinoma, without any evidence of mediastinal or axillary lymphadenopathy but with intra-abdominal lymph node enlargement in para aortic region. Flexible fiberoptic bronchoscopy revealed a tumour completely occluding the medial basal segment of right lower lobe. The histology from endobronchial biopsy suggested a non small cell carcinoma of the lung.
