Lung Metastasis Case 002

A young patient with a history of malignant melanoma presents with shortness of breath.

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Reveal Answer
  • Ultrasound of the chest shows innumerable, bilateral, small rounded, pleurally based solid nodules.
  • These are typical of multiple pulmonary metastases and in this case would be clinically consistent.
  • The list of likely differential diagnoses in an oncology patient prior to ultrasound would include pulmonary embolism, pneumonia, pleural effusion, and metastases.
  • Assessment of the lung and heart at the bedside will rapidly differentiate these conditions and enable initiation of appropriate management early.
Further Imaging
Pulmonary mets CXR
Pulmonary mets CXR
Pulmonary mets CT
Pulmonary mets CT
Pulmonary mets CT
Pulmonary mets CT

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Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and informatics. Asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | vocortex |

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