The honeymoon is over.

Abstract

The importance of a broad differential diagnosis is highlighted by a complex patient case. A young woman returned from her honeymoon complaining of activity-limiting pain. The evaluation revealed multiple constitutional symptoms, a breast mass, a large pelvic mass, pulmonary abnormalities, an external iliac venous thrombosis, and lytic bone lesions. Biopsies from several sites revealed no evidence of neoplasia. Consideration of potential etiologies outside of one's practice specialty may be necessary to make a correct diagnosis.