A 61-year-old postman, presents to his GP with a 6-week history of increasing tiredness, polyuria and polydipsia. He also noticed weight loss over the past 6 months (around 5 kg) and an irritating cough that seems to have coincided with him stopping smoking around 5 months ago. His past medical history includes a partial gastrectomy for a gastric ulcer 26 years ago, which according to him was related to heavy alcohol intake.
He was a heavy smoker (40/day) for 38 years, but stopped 5 months ago due to increasing shortness of breath. Examination: He looks dehydrated Temperature of 36.6°C Blood pressure of 130/75 Pulse 92 beats/min regular Respiratory rate 22 breaths/min A 3.5-cm mass can be felt in the left clavicular fossa Chest examination shows dullness to percussion, reduced breath sounds and vocal fremitus on the left side Abdominal examination is unremarkable. Tests results showed:…
