Cannon ball appearance – A rare case of differential diagnosis of lung metastasis

This case study explores a 77-year-old male, a former smoker with a history of penile cancer and multiple cardiovascular issues, presenting with asthenia, anorexia, and weight loss. Incidental findings on a cardiac MRI revealed numerous pulmonary nodules, sparking suspicion of lung metastasis. Despite the absence of respiratory symptoms, diagnostic imaging revealed mediastinal adenopathy, splenomegaly, and bilateral nodular formations. Further investigation, including bronchoscopy, led to the diagnosis of pulmonary tuberculosis, confirmed by microbiological testing. The case underscores the importance of considering tuberculosis in the differential diagnosis of pulmonary nodules, particularly in patients with relevant risk factors such as diabetes mellitus.