Swelling and Erythema of the Lower Extremities

Mr. T is a 78-year-old male who initially presented with stage IV oligometastatic non–small cell lung cancer (NSCLC) with adrenal metastasis. He is a retired pharmacist who comes to appointments with his wife. His medical history includes hypertension, emphysema, esophageal reflux, and hyperlipidemia. He initially presented with abdominal pain. Upon workup, a CT image of the chest and abdomen revealed a solitary adrenal metastasis and one lung lesion. He had laparoscopic resection of the adrenal metastasis. However, shortly afterward, he was found to have metastatic disease in the surgical bed and progression of the lung mass.