An occasion chest X-ray of a 74-year-old female revealed a thickening in her left lung, and the tumor was latter typified as non-small cell lung cancer. Her staging chest CAT scan was consistent with a primary tumor in the lingular sub-segment together with millimetric parenchymal nodules suspected as secondary. She underwent a lingular segmental resection of the left lung. The histological report described a mixed acinar and non-mucinous bronchoalveolar adenocarcinoma of the lung.
66-year-old female underwent a left suboccipital craniotomy for resection of a tentorial meningioma. The postoperative course has been difficult, marked by deterioration associated with posterior temporal and cerebellar edema and hemorrhage. First she seems to be in good general conditions showing only a slight strength deficiency in the left upper limb, but about a month after the surgery she started showing asthenia and melena, and esophageal gastroduodenoscopy revealed a sclerosis of active arterial bleeding from duodenal ulcer.
48-year-old male who had undergone multiple surgical attempts to augment mandibular bone for implant placement ('pins'). The patient received the opinion of a spesialist who spotted severe atrophy in the right mandibular posterolateral area. He reported on the condition of the mucosa with high insertion of frenii in the level of the alveolar ridge. Also the report related to occlusion problem and temporo mandibular dysfunction. In 2007, the patient received a report following a neurophysiological examination of the masseter muscle showing a change in sensation from the lower alveolus.
67 year old male, previously a heavy smoker, suffering for 2 months from weakness, diminished appetite and weight loss. Tests showed a mass in right arm, possibly attached to muscle, and tenderness in right ribs. Chest CT showed a mass in LLL, lung foci, suspected secondary spread and masses in upper abdomen. CT guided biopsy from right lung mass was consistent with non small cell carcinoma with extensive necrosis. SPECT bone scan showed many focal findings in the vertebrae L,D2,7, most of the ribs bilaterally and in the limbs- suspected for secondary pathology.
73-year-old female with history of backache and diagnosis of Adult Scoliosis, fell down getting a back trauma at the level of the left hip and inferior limb. After severe symptomatic worsening X-ray examination was performed. The findings were: asymmetric pelvis, bilateral coxarthrosis, coarse arthrosic and osteophytosic manifestations, discopathies and disc arthrosis. The prescribed therapy included Piroxicam, Tioside, Depalgos, and low-molecular-weight-heparin therapy that was later replaced by NSAIDs by injection
1.5-year-old male suffered from eye swelling. His MRI revealed expansive lesion of left lateral orbital wall origin, with compression on the lateral rectus muscle. Later he was hospitalized due to fever and vomiting in left orbital lesion, suspecting a metastatic neuroblastoma. His eye examination revealed exophthalmus of the eye with exophoria and light dysfunction of the lateral rectus. His biopsies were indicative of stroma-poor neuroblastoma.
1.5-year-old male suffered from eye swelling. His MRI revealed expansive lesion of left lateral orbital wall origin, with compression on the lateral rectus muscle. Later he was hospitalized due to fever and vomiting in left orbital lesion, suspecting a metastatic neuroblastoma. His eye examination revealed exophthalmus of the eye with exophoria and light dysfunction of the lateral rectus. His biopsies were indicative of stroma-poor neuroblastoma.
A 58 years old male. 4 years ago the patient was hospitalized due to acute thrombosis of the right femoral-iliac axis. The patient was treated succesfully with locoregional intra-arterial fibrinolytic therapy. A follow-up arteriography, revealed sub-occlusion of the common iliac, occlusion of the right superficial femoral artery in Hunter’s canal. PTA + stent of the iliac was carried out with excellent final angiographic result.
43-year-old female has suffered a multifragmentary fracture of the distal left humorous that wasn't properly reduced, fixed or healed and evolved into pseudoarthrosis. She still has a severely restricted range of motion and seriously painful symptoms in the left elbow.
67-year-old with multiple co morbities: Heart, renal, vascular, hypertensive. His biopsy showed left lower lobe lung mass that was a TTF-1 Non small cell lung cancer- most likely an adenocarcinoma. Multiple small nodules < than 1cm were noted without certain etiology, together with “masses” in the upper abdomen and left arm. Recommended therapy includes single agent Vinorelbine.
67-year-old with multiple co morbities: Heart, renal, vascular, hypertensive. His biopsy showed left lower lobe lung mass that was a TTF-1 Non small cell lung cancer- most likely an adenocarcinoma. Multiple small nodules < than 1cm were noted without certain etiology, together with “masses” in the upper abdomen and left arm. Recommended therapy includes single agent Vinorelbine.
47-year-old male has injured his right wrist while playing football 30 years ago. He always had some manageable pain while playing tennis. The pain increased during the last 12 months. The wrist CT scan that the expert recommended revealed diastasis between scaphoid and semilunar bone, palmar dislocation, dorsal intercalated segmental instability (DISI), marked radio-scaphoid arthritis and reactive sclerosis of the subchondral bone. This findings conformed the previous diagnosis of post traumatic osteoarthritis of radio-carpal joint brought upon by ligamentous injuries due to trauma.
39-year-old male experienced in 1994 intense lower back pain after lifting weights, with spontaneous resolution. In 2006, he again experienced lower back pain radiating into both thighs. A lumbar MRI showed degenerative changes and EMG test showed L5 nerve root irritation. His physical examination demonstrated increased reflexes and a concern for cervical stenosis was entertained. Further cervical MRI and lumbar studies showed arthritic changes, and the thoracic MRI showed evidence of spinal cord compression. The surgeon suggested posterior thoracic laminectomy.
60-year-old male was diagnosed with a symptomatic metastatic well differentiated rectal neuroendocrine tumor, with multiple liver metastases. This tumor is over-expressing somastatin receptors, which was demonstrated by an otreoscan. He was started on Sandostatin LAR 30 once a month.
73-year-old male with a diagnosis of Parkinson's disease (PD) since 2001. The cause for this consultation is a problem in the left foot that appeared in 2005 and has worsened since. The diagnosis was "a serious pronated flat foot transverse to the left” causing pain radiating up to the thigh and hip and causing recurrent falls with serious injury.
The patient is a 52 year old male, who is suffering from backache and carried out imaging tests of the lumbosacral spine. Plain x-rays showed mild left scoliosis without rotation, sclerosis at the L5S1 facets, marginal osteophytes, and decrease in the height of the L5S1 disc space.
67-year-old male began to complain of chronic pain in the left lower rib cage. The pain is stitch, ever-present, dull and localized at the level of his left last rib, and became slightly worse in the last 2 years. Recent image findings: MRI - "Ovalish hypoechogenic solid formation, Ultra sound - "Suspected intercostal neurinoma at ribs 10, 11 and 12.
43 years old patient without any notable pathologies in anamnesis. After two episodes of severe hematochezia the patient underwent EGD, Colonoscopy, digestive system X-rays with contrast medium and capsule endoscopy camera (digestive system micro camera) without any pathological evidences
47-year-old female who had the onset of persistent vertigo. The first evaluations revealed right beating nystagmus on gaze straight and to the right, unsteady gait with limb ataxia, and positive head thrust to the left. Improvement seemed to be occurring in that gait deviation with eyes closed was no longer present. Vestibular physical therapy exercises were started. On the next evaluations there was paroxysmal positional vertigo from the left ear and minimal neurosensory hearing loss. An audiogram showed minor neurosensory deafness.
66-year-old female was diagnosed with lung tumour within the right hemithorax with concomitant pulmonary nodules and a measurable enlargement of lymph nodes. FBS was positive for well differentiated neuroendocrine carcinoma and a needle biopsy revealed adenocarcinoma with associated neuroendocrine differentiation. The patient was then treated with altogether four courses of induction chemotherapy.
67-year-old male suffering a constant pain at the bottom of the lower left rib cage for the last two years. The pain is described as not being extreme nor affected by breathing; it is dull and always present. Various imaging scans were unremarkable although diffuse degenerative disk spinal abnormalities were noted.
55-year-old male diagnosed with Right side gonalgia due to degenerative meniscopathy. The expert suggests anti-inflammatory medications, physiotherapy and modified daily activity. Arthroscopy should be considered only in case of no symptomatic improvement.
65-year-old male experienced loss of consciousness, and a CT scan showed a left temporal mass which was confirmed by MRI. The patient underwent Stereotacti biopsy of mass, and Histological examination gave a diagnosis of anaplastic astrocytoma. He started chemoradiation with fotemustine (nitrosourea alkylating agent). Repeated MRI showed progression with mass effect, mild uncal herniation and enlarging ventricles. He has stable expressive aphasia and hemisyndrome, lethargy and decreased motivation. His treatment was switched from phenobarbital to levetiracetam.
47-year-old male has injured his right wrist while playing football 30 years ago. He always had some manageable pain while playing tennis. The pain increased during the last 12 months, and following this, MRI studies were performed. They revealed wrist Diastasis between scaphoid and semilunar bone in agreement with a lesion of the scapholunate ligament and pronounced radioscaphoid arthrotic manifestations. In the expert's opinion, the patient is suffering from post traumatic osteoarthritis of radio-carpal joint brought upon by ligamentous injuries due to trauma.
27-year-old female with a diagnosis of suspected fibromyalgia. Her history includes long standing widespread musculo – skeletal pain connected to a feeling of general slight illness, as well as a series of accompanying symptoms: frequent migraines, cervicalgia, stomach disorders, chest pain and tachycardia . Therefore, she has carried out various follow-ups that each time detected a different problem for which the relevant therapy was set out.
54-year-old obese male with end stage renal disease due to membranous nephropathy, has received 2 renal transplants in the past and is highly sensitized. He underwent coronary angiography for vessel CAD, and PTCAs and stanting were performed. His current treatment consists of multiple medications including mycophylate according to the instructions of his transplant nephrologist. His cardiologists sees no contraindication to transplantation.
71-year-old-male had been diagnosed as having multiple myeloma (MM), apparently of the IgA-Lambda type, with renal involvement. The disease course is characterized by "ups and downs responding to anti-MM therapy. During the disease course, several problems and complications developed: Renal failure, Bone lesions and Neuropathy.
75-year-old male with multiple complaints related to both his lumbar and cervical spine. He complains of low back pain, cramping and numbness in his thigh muscles, radiating left leg pain to his toes, as well as unsteady gait. He experiences numbness in his shoulders, arms and hands that gets worse over the day. He had a C4-5 fusion and a lumbar procedure at L4-5. The cervical MTI showed degenerative disease worse at C6-7 where there is moderate central and foraminal stenosis.
47-year-old male with superficial malignant melanoma of the trunk. After excision of the lesion, a sentinel lymph node biopsy revealed lymph node involved with multi-focal microscopic subcapsular tumor. Subsequently, a lymphadenectomy was performed and the patient initiated treatment with interferon A. As a consequence, he developed marked lymphedemia of the right leg.
75-year-old male with multiple complaints related to both his lumbar and cervical spine. He complains of low back pain, cramping and numbness in his thigh muscles, radiating left leg pain to his toes, as well as unsteady gait. He experiences numbness in his shoulders, arms and hands that gets worse over the day. He had a C4-5 fusion and a lumbar procedure at L4-5. The cervical MTI showed degenerative disease worse at C6-7 where there is moderate central and foraminal stenosis.
5-year-old girl with a suspected diagnosis of stage 1 Wilms' tumor.
The child's current presentation was an incidental finding of left abdominal swelling. The reports of the abdominal US, total body CT together with normal values of catecholamine metabolites seem to support the diagnosis of Wilms' tumor.
53-year-old male complained of right flank discomfort. Scans revealed solid lesion with necrotic content in the left kidney, and radical nephrectomy with ipsilateral para-aortic lymph node dissection was performed. Pathology diagnosis was a clear cell renal carcinoma. The experts recommends a close routine follow up together with routine opthalmoscopy in order to detect retinal angiomas that can be an affect of VHL gene mutation.
43-year-old female with history of continued cigarette smoking and complaints of palpitations. A sinus tachycardia of 160 is documented with little physical activity. Pulmonary function studies revealed obstructive ventilatory defects, consistent with the smoking or beta blockers. She has been documented to have moderate mitral regurgitation, consistent with prior rheumatic disease. At the present time, she is on Inderal.
75-year-old male with a cutaneous squamous cell carcinoma resected from the right eyebrow in 2003. In 2006, the patient underwent resection of an ipsilateral squamous cell carcinoma in the parotid bed that was presumably a nodal metastasis. He then experienced local relapse treated with resection and adjuvant radiotherapy. There was recurrent disease involving the right cheek excised in 2008. In 2009, another recurrence led to resection with orbital exenteration. Pathology showed squamous cell carcinoma, with perineural invasion, and extension into the orbital muscles.
49-year-old male was diagnosed with renal cell carcinoma and underwent left radical nephrectomy. The expert recommended either close observation every few months or participating in an adjuvant vaccine trial or monoclonal antibody therapy trial.
