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Adenocarcinoma stage 4 b in lung, found in usg, multiple calculi in lumen symptoms. Vomiting with white foam. No pain till now, weak and low appetite kindly suggest possibilities. Patient is on gefitinib tab 25 mg post 9 months .urgent. Sir egfr mutations exon 19 is positive and alk rearrangements are negative patient is bearing headache and back pain.


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