Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive dyspnea, non-productive cough, and constitutional symptoms including unintentional weight loss and fatigue. Imaging reveals multiple, well-circumscribed, bilateral pulmonary nodules consistent with "cannonball" metastases. No acute hemoptysis or chest pain reported at this time.
Clinical Examination Findings
General: Patient appears cachectic and in mild respiratory distress. HEENT: No cervical lymphadenopathy. Respiratory: Decreased breath sounds bilaterally, dullness to percussion noted in lower lung fields. Cardiovascular: Tachycardic, regular rhythm, no murmurs. Extremities: No peripheral edema or clubbing.
Treatment Protocol
Plan: 1. Oncology referral for systemic therapy evaluation (chemotherapy/immunotherapy/targeted therapy). 2. Palliative care consultation for symptom management. 3. Supplemental oxygen as needed to maintain SpO2 >92%. 4. Staging workup including PET/CT and biopsy of the most accessible nodule for histopathological confirmation.