A 67-year-old woman with no known chronic illnesses presented with bilateral leg swelling, weakness, and fatigue, rapidly progressing to septic shock, acute kidney injury, and deep vein thrombosis. Chest imaging revealed a pulmonary mass, hepatic lesions, and a brain metastasis. Despite broadspectrum antibiotics, cultures remained negative and her condition worsened. A liver biopsy confirmed metastatic nonsmall cell lung adenocarcinoma. The case underscores that occult malignancy can mimic or coexist with sepsis, and failure to improve within 48–72 hours of antimicrobial therapy should prompt early evaluation for cancer, multidisciplinary involvement, and timely goals-of-care discussions..

A pilot study from Venezuelan and U.S. institutions reveals significant metabolic reprogramming of tryptophan, arginine, and glutamine pathways in head and neck carcinoma (HNC) patients. Serum tryptophan and the arginine/putrescine ratio emerged as potential dynamic biomarkers for monitoring treatment response, while the glutamine-to-glutamate shift indicates enhanced glutaminolysis in active tumours. The findings provide a rationale for larger validation studies and offer low-cost analytical tools for resource-limited settings.