Patient, male 66 yrs, chronic smoker with DM (on oral drugs, well controlled) comes with moderate pain upper abdomen and chest of few weeks duration, and general debility. Workup with USS and CT scans shows large multiple SOLs liver, periaortic, paracaval nodes, bilateral lung SOLs with the largest being left parahilar alongwith mediastinal nodes. Bronchoscopy shows slight extrinsic compression left main bronchus, no intraluminal lesion. PET CT exculdes other dissemination. CA 19.9 as well as CEA and CA-125 raised very high.
Specific search for Pancreatic primary negative. No GI symptoms. The markers are confounding the picture of what otherwise appears to be Primary Lung Cancer with dissemination. FNAC liver done, report awaited. Request views on markers.
