Ep.49 Diplopia As First Symptom Of Lung Cancer

M. Roig, A. Cabrera, C. Domenech
M.I.R. General Practiser, Javea (Alicante), Spain
We present the case of an English man, resident in Javea (Alicante, Spain) 68 years old who consults in our Health centre (Javea) about a problem of double vision and exophthalmos. In the anamnesis and physical exploration we find out that the patient suffer from tiredness and lost of nearly 8 kg in one month. No short of breath. No chest pain. No cough. No fever. His personal antecedents are high blood treated with enalapril and smoker of 20 cigarettes a day. No family antecedents of cancer. The physical exploration is normal but the exophthalmos and double vision. We send the patient to the hospital to make thorax RX (because we suspect an neo lung) and it appears a lung tumour, the anatomy pathology informs on small cells lung cancer. The patient has been recover in pneumologist service, during the time in the hospital has been made other explorations TC cranial, thorax and abdomen TAC. The results were so many metastasis in orbit eye, brain, pericardial metastasis, kidney, brain. The patient has sent to oncology in Hospital Clinico Valencia, starts with chemotherapy and radiotherapy, but according to the terminal state,it has been send to our consult (G.P.) for palliatives care and he dies 6 months later.
Patients are not a symptoms, but a complete person...do not treat symptoms, treat the whole person. Anamnesis and physical exploration is the most important weapon for a General Practice.