Dr. Breu is a Hospitalist and the Director of Resident Education at VA Boston Healthcare System and an Assistant Professor of Medicine at Harvard University in Massachusetts. He supervises the VA Boston Medical Forum chief resident case conferences. All patients or their surrogate decision makers understand and have signed appropriate patient release forms. This article has received an abbreviated peer review. Correspondence: Anthony Breu (anthony. breu@va.gov) * Co-lead authors.
Author disclosures The authors report no actual or potential conflicts of interest with regard to this article.
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This patient had a very atypical initial presentation of small cell lung cancer. Despite the fact that a diagnosis eluded his doctors, they persisted in a thoughtful and exhaustive workup and through this perseverance were able to make the final diagnosis, which serves as an important learning case for us all.
Acknowledgments
We thank the family of this veteran for sharing his story and allowing us to learn from this case for the benefit of our future patients. We also thank Dr. Michelle Hankins, who provided oncologic expertise.