Right facial paralysis

A 57 y/o male came with the complaint of numbness in the right side of the face. He also had weight loss for 2 months. Physical examination shows right cervical lymphadenopathy (1.5cm*2.5cm). Further examination shows Right facial paralysis. Laryngeal endoscopy revealed right vocal cord paralysis. Biopsy of the right cervical LN shows small cell bronchogenic carcinoma. What other investigations should be done?

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As lymphnode biopsy revealed bronchogenic carcinoma Adv hrct xray chest BAL After confirmation subject to chemoradiotherapy

Thanx dr Kute Ankush
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PET/CT, MRI brain. I am worried that this patient has brain metastasis due to facial nerve palsy. MRI should be done with urgency and if metastasis is found with vasogenic oedema then the patient should start dexamethasone with urgent oncologist referral. No need for bronchoscopy at this time. This is an extensive-stage disease by definition. Chemotherapy with platinum and etoposide + atezolizumab or durvalumab if the patient can afford it. The disease is usually aggressive with survival ranging from months to 1-2 years.

* PET SCAN STUDY.. * BRONCHOSCOPY.. * ONCOLOGISTS OPINION..

Tnx Dr Shivraj Agarwal sir
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Malignancy. As biopsy revealed. Needs further investigation and evaluation to conclude and line of treatment. Chemotherapy or surgical intervention after conclusion.

Thanks Dr Pushkar Bhomia
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SUGGESTIVE. OF SMALL. CELL BRONCHOGENIC CARCINOMA WITH METASTASES NEEDS 1. MRI... BRAIN 2. PET-CT

P E T Surgery + chemotherapy + Radiotherapy Consult an Oncologist

Adv MRI brain PET scan. Oncologist reference.

Abhyadi qwath BD gilo ghanvati 1BD panchksakar powder HS for 2week (abhaydi qwath : ek glass pani me 2 Chamach abhyadi kadha(bhuka) dalke ubalna he, 1/3 baki rahe tab usko chhanke half teaspoon Higutrigun oil dalke lukewarm pina he.) panchsakar powder 1/4 or 1/3 teaspoon (rat ko sote samay lukewarm pani ke sath powder ka dose itna lena he jisase subah ek ua 2 bar motion aaye.) after that, Ashwgandharishtha 20ml BD gilo ghabvati 1BD for 2 to 3 month

CT chest to look for primary MRI brain to look for brain metastasis PET CT to look for metastasis

Xray chest Ct or pet

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