[Fatigue, general weakness, subcutaneous nodules]

A 58 year old female patient presented with subcutaneous nodules (adenocarcinoma on cytology) and general symptoms as first symptoms of advanced metastasizing cancer of the breast. The patient succumbed to metastatic disease and terminal bronchopneumonia a few months later. The path to diagnosis in a situation with diffusely metastasizing cancer, the differential diagnosis during evaluation and the rationale for the choice of investigations in a patient with far advanced metastasizing cancer but unknown primary site are discussed.