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Have had neurologic symptoms of unknown origin. Was smoker. Chest x-ray was normal. Chances of lung cancer?

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Posted on Wed, 28 Aug 2013
Question: I have had neurologic symptoms of unknown origin for 10 months. I am an ex smoker of 5 pack years over 9 actual years. 9 months ago I had a chest ct w contrast. 1 month ago I additionally had chest x XXXXXXX as well as lateral chest X-ray. Could lung cancer have been missed in these scans. I have had chest pain for the last 3 months under my sternum.
doctor
Answered by Dr. Indu Kumar (1 hour later)
Hello XXXXX
Thanks for writing to XXXXXXX

You didn’t mention your age and type of neurological disorder you are suffering from.
Anyway, you need proper clinical examination and thorough investigations.
As X-rays and CT Thorax has already been done in your case, it rules out tumour .
Though you were a smoker, there is no mass in CT Scan. It is relieving.

Some tumours of lungs have neurological symptoms related to para neoplastic syndromes, but you shouldn’t worry about this as CT Scan is normal in your case.

Retro sternal pain may be due to many reasons.It needs to be evaluated.
Retrosternal pain may be due to acid reflux pain or cardiovascular causes. Investigations like routine hemogram, RBS, LFT, RFT, Lipid profile, Ultrasound of abdomen, ECG, ECHO, Upper GI endoscopy should be done.

Treatment should be based on clinical findings and investigations reports.
For neurological problems you can contact your neurologist.

Get well soon.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Indu Kumar (16 minutes later)
I am age 29 and neurologic symptoms include muscle fasciculation headache in back of the head and dizziness. I am chiefly concerned this is not due to paraneoplastic small cell lung cancer. Thank you for your thorough answer
I meant my chief concern is that this is due to paraneoplastic lung cancer. My imaging has been spaced 10 months apart, but my most recent imaging since my chest pain started has been X-ray only. Would symptomatic lung cancer ie chest pain very seldom cough show up on X-ray.

Thanks for your time
doctor
Answered by Dr. Indu Kumar (13 hours later)
Hello XXXXX

Thanks for your query

Only fasciculations, headache and dizziness doesn’t point towards para-neoplastic symptoms. For diagnosing it, thorough neurological examination is needed.

Para-neoplastic syndrome has wide range of symptoms like ataxia, nystagmus, dizziness, difficulty in swallowing, loss of motor coordination, slurred speech etc.

Mostly fasciculation is due to benign causes and EMG test can be done. Avoid taking caffeine as it provokes fasciculation.

Headache and dizziness is also due to many reasons, this needs to be investigated. It may be due to refractive error, hypertension etc. Better you consult your neurologist.

Most common presentation of lung carcinoma is cough. Only fasciculation and headache doesn’t indicate towards lung carcinoma.

If chest X-ray is normal, don’t think about lung carcinoma.

Causes of chest pain needs to be investigated.

Get well soon.

Further queries are most welcome.


Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Indu Kumar

Radiologist

Practicing since :2004

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Have had neurologic symptoms of unknown origin. Was smoker. Chest x-ray was normal. Chances of lung cancer?

Hello XXXXX
Thanks for writing to XXXXXXX

You didn’t mention your age and type of neurological disorder you are suffering from.
Anyway, you need proper clinical examination and thorough investigations.
As X-rays and CT Thorax has already been done in your case, it rules out tumour .
Though you were a smoker, there is no mass in CT Scan. It is relieving.

Some tumours of lungs have neurological symptoms related to para neoplastic syndromes, but you shouldn’t worry about this as CT Scan is normal in your case.

Retro sternal pain may be due to many reasons.It needs to be evaluated.
Retrosternal pain may be due to acid reflux pain or cardiovascular causes. Investigations like routine hemogram, RBS, LFT, RFT, Lipid profile, Ultrasound of abdomen, ECG, ECHO, Upper GI endoscopy should be done.

Treatment should be based on clinical findings and investigations reports.
For neurological problems you can contact your neurologist.

Get well soon.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX