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4th April 2024
A 67-year-old male with a 40 pack-year history presents to the GP complaining of a persistent cough for the last 3 months, which over the last few days has appeared blood-streaked.
A 67-year-old male with a 40 pack-year history presents to the GP complaining of a persistent cough for the last 3 months, which over the last few days has appeared blood-streaked. He has noticed that his clothes feel looser on him and he feels generally fatigued. He reports having to strain to open his bowels over the last month and increased frequency of urination without any dysuria.
You refer him via the 2-week wait pathway. His chest x-ray and initial investigation results show:
| Result | RR | |
|---|---|---|
| Hb | 99 g/L | 135-180 g/L |
| MCV | 79 fl | 82-100 fl |
| WCC | 4.3 x 10⁹/L | 4.0-11.0 x 10⁹/L |
| AdjCa | 2.91 mmol/L | 2.1-2.6 mmol/L |
| Phosphate | 0.79 mmol/L | 0.8-1.4 mmol/L |
| PTH | 0.9 pmol/L | 0.9-5.4 pmol/L |
| HbA1c | 33 mmol/mol | <42 mmol/mol |
What is the most likely cause of this patient’s symptoms?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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