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.
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.
66-year-old female was diagnosed, following persistent cough, with non-operable tumor of her lung with satellite nodules, and chemotherapy was initiated (first Cisplatin and Gemcitabine, and then switched to Tarceva). Response evaluation following the fourth cycle of chemotherapy showed either stability or an initiation of tumor response, but bone scintigraphy that was performed 6 months later revealed an area of increased uptake in the left hemithorax which could be suggestive of a secondary bone lesion.
66-year-old female was diagnosed, following persistent cough, with lung tumour 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.
30-year-old female was noted to have two right lobe of thyroid gland nodules on a neck ultrasound. A diagnosis of incidental finding of thyroid gland nodule in the setting of normal thyroid gland function was established. In the expert's opinion, the clinical presentation is consistent with a "cold" thyroid gland nodule. He recommends an ultrasound-guided fine needle biopsy, because the results of the cytology can guide the treatment and dictate the extent of surgery.
66-year-old female was diagnosed, following persistent cough, with non-operable tumor of her lung with satellite nodules, and chemotherapy was initiated (first Cisplatin and Gemcitabine, and then switched to Tarceva). Response evaluation following the fourth cycle of chemotherapy showed either stability or an initiation of tumor response, but bone scintigraphy that was performed 6 months later revealed an area of increased uptake in the left hemithorax which could be suggestive of a secondary bone lesion.
52-year-old male was diagnosed in 2004 with a carcinoma of the lower rectum and underwent surgical anterior resection of the rectal tumor which was a well differentiated adenocarcinoma. In 2008 he underwent emergency operation for a perforated pyloric ulcer and then a radical resection of a gastric tumor which infiltrated the entire thickness of the gastric wall. It was a G3 diffuse type adenocarcinoma with signet ring cells, at pT3N2 stage.
Adult male with a history of hepatitis C, non-Hodgkin’s lymphoma (NHL) and hepatocellular carcinoma. Patient treated for NHL with CHOP-R 4 years ago. However, post-treatment, he had continued presumed bone marrow suppression. He was diagnosed 2 years later with HCC and underwent TACE with good effect. Since the TACE, the patient has had persistent and worsening hepatic dysfunction with portal hypertension and ascites. Recently, the patient developed encephalopathy and was treated, as described below, with fast return to consciousness.
78-year-old female with history of diabetes, and meningioma complicated by neurologic deficits following surgery, was diagnosed with progressive iodine-refractory metastatic papillary thyroid carcinoma (PTC). Her initial work-up revealed lung metastasis. She underwent a right thyroidectomy and then left thyroidectomy and laryngectomy, and subsequently received I-131 on 8 occasions. She had a drop in thyroglobulin levels to the early treatments, but most recently, thyroglobulin has steadily increased.
51-year-old female with vitamin D deficiency and incompatibility between the PTH and vitamin D levels. She reports that as a child she had numerous cavities in her jaw, and her daughter also had multiple tooth fillings. She wonders whether the reason could be genetic abnormality.
