Christina from Glasgow joins the TWiPlets to solve the case of the Elderly Gentlemen with Full Body Rash, and to present a new clinical case for listeners to solve.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

Guest: Christina Naula

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• Tony Fauci on TWiV 219 and 641
• Letters read on TWiP 189

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Case Study for TWiP 189

At a clinic in Ghana, woman seen for hernia, large swelling in right upper abdomen that grew steadily in previous year. Exam found to have mass, too high for inguinal hernia. Thought to be in liver. Mother, subsistence farmer, 50s, not unwell, no jaundice, mobile, overweight. Lump was firm, did not appear to be fluid filled, did not reduce under pressure, smooth, over 20 cm. Concern was liver cancer. Due to remoteness of clinic not possible to order tests. One test was done which could deliver the diagnosis.

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Music by Ronald Jenkees