Clinical Reasoning: Flaccid Paraparesis Due to Paraneoplastic Syndrome and Depression Due to Frontal Lobe Metastasis from Adenocarcinoma Lung in a Patient with Pulmonary Tuberculosis and Benign Spindle Cell Tumor of Stomach

Middle age man had flaccid paraparesis and depression. Chest radiograph was compatible with old pulmonary tuberculosis. Non-contrast CT scan head was normal. Benign spindle cell tumor was found in gastroscopy done for hematemesis and melaena. Autopsy revealed adenocarcinoma right lung and metastasis at right frontal lobe. Clinical reasoning and challenges in resource poor setting were discussed.