A 50-year-old man presented with a one-month history of rectal bleeding, chronic constipation, weight loss of 10 kg over the last 3 months but no appetite loss. He had arterial hypertension treated with furosemide but otherwise, his past medical history and family history were unremarkable. Physical examination revealed a fit man. His body weight was 100 kg and the body mass index was 31.21 kg/m 2 . His abdomen was soft, with normal bowel sounds, no distension, and no palpable masses.
Routine physical examination of the breast revealed an asymptomatic, painless, well-circumscribed, hard but mobile nodule of 3 cm in diameter below the left nipple. The contralateral breast was normal and there was no evident gynecomastia. Supraclavicular or axillary lymph nodes were not palpable. Laboratory tests: Complete blood count, blood biochemistry and tumor markers (CEA, CA19-9, and CA15-3) were…
