The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.
A 72-year-old man presents to the clinic with facial and neck swelling that has been ongoing for the past 6 months. Over the past 9 months, he has had an increasing loss of appetite and an unintentional weight loss of 12 lb (5.4 kg). He reports generalized malaise and fatigue. He does not report having night sweats, fever, urinary problems, or abdominal pain. He has no chest pain, dyspnea, cough, joint pain, oral sicca, ocular sicca, or rashes.
His past medical history is notable for hypertension, which has been mildly to moderately uncontrolled over the long-term. He takes 5 mg of amlodipine daily. He has no history of allergies. His father died of colon cancer in his late 80s, and his mother died of natural causes. His siblings and children are generally healthy. He drinks a single unit of alcohol about once monthly but has no history of tobacco use or illicit drug use. The patient is a retired civil engineer.
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Cite this: Neck Swelling, Painless Jaundice, and Unintentional Weight Loss in a 72-Year-Old Man - Medscape - Jun 01, 2023.