Abstract
A 78-year-old man with a 30 pack-year smoking history, hypertension, hyperlipidemia, and paroxysmal atrial fibrillation presented with several months of fatigue, nausea, vomiting, cough, and shortness of breath. Chest radiography suggested a right pulmonary mass and cardiomegaly. Subsequent computed tomography of the chest and abdomen revealed the following: a mass measuring 4.8 × 4.0 cm in the right middle lobe of the lung, right and left lower lobe nodules, abnormal perihilar lymph nodes, possible left adrenal metastasis, and a small pericardial effusion. Follow-up bronchoscopy with biopsy confirmed grade II squamous cell carcinoma. The patient was referred to Mayo Clinic for further work-up.
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