Why might we see such big extreme disease?
1. Fear - late presentation
2. Cultural - judgement or societal, dress permitting it to be hidden
3. Rural location with limited healthcare
4. Cost - cannot afford to access it
5. Mental health/solitary living - simply don't get to access a doctor
6. Endstage disease - treatment failure
7. Patient apathy/conscious choice not to get help
How does it alter radiology
1. Sometimes a big mass is hard to origin establish
2. Harder to identify the involvement of adjacent structures
3. More difficult to intervene.
4. Large number of secondary findings
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