Beware of Masqueraders- Atypical Presentation of Bronchogenic Carcinoma

Abstract

A 56-year-old male presented with complaints of cough with expectoration for 3 months duration and fever for 15 days. He had no associated complaints of breathlessness, wheeze, loss of weight and appetite. For the above complaints, he had received two courses of antibiotics before this presentation elsewhere. He is a smoker for 30 years. There is no significant past medical history. There was no evidence of similar illness in the family. On presentation, patient had investigations done outside like chest x-ray that revealed a right upper and mid-zone cavity and CT thorax that revealed a cavity with fluid level with no evidence of lymphadenopathy or bone erosion. On examination, he was tachypnoeic with respiratory rate of 32/min, pulse rate was 90/min and saturation was 95% on room air. He had no clubbing or lymphadenopathy. Respiratory examination revealed expiratory rhonchi and diminished breath sounds in right mammary, infra-axillary and infrascapular areas.