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A 17-year-old woman of Afro-Caribbean origin presented with a 1 month history of abdominal pain associated with vomiting and weight loss. Symptoms had gradually become more frequent and persistent. She had previously been well and had no previous hospital attendances or illnesses.
Vital signs and physical examination was normal with the exception of tenderness in the epigastrium on palpation.
Initial bloods tests revealed the following abnormalities only; platelets 520, alkaline phosphatase 169, C-reactive protein 73, international normalised ratio 1.3.
An x-ray of her chest was abnormal with bilateral reticular nodular shadowing and CT of her chest, abdomen and pelvis showed multiple ill-defined spiculated nodules …
Correction notice This article has been corrected since it was published Online First. The author order has been updated.
Contributors SM was responsible for the writing and submission of the report; KP provided radiology images and reports; JW provided histology images and reports; CM was in charge of the patient care and oversaw the article.
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.