BMJ Case Reports 2013; doi:10.1136/bcr-2012-008453

Malignant aetiology for breathlessness, concealed by a perception of ‘exam-anxiety’

  1. Manoj Kumar Gupta3
  1. 1Department of Radiation Oncology, HealthCare Global-Bangalore Institute of Oncology, Bengaluru, Karnataka, India
  2. 2Department of Radiotherapy, Dr Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India
  3. 3Department of Radiotherapy & Oncology, Regional Cancer Centre, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
  1. Correspondence to Dr Swaroop Revannasiddaiah, swarooptheone{at}


A 14-year-old boy student who had his annual exams (academic examinations) approaching, suffered a documented history of generalised anxiety disorder, which would occasionally exacerbate during periods of perceived stress, such as with exams. Prior to previous exams, he had for many years reported of having faced a temporary cluster of symptoms comprising palpitations, insomnia and breathlessness.

Just two months prior to his most recent exams, he reported to have felt the same symptom-cluster again, including breathlessness. Without any medical consultation, he attributed his symptoms …

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