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Case Studies

CASE STUDIES

Dr. Donato Perez Garcia

Bladder

Carcinoma of the bladder. 53 year old male had a history of hematuria with painful urination for one year, with increasing frequency in urination and normal PSA levels. The patient had been taking Flomax to manage the frequent urination. An investigative CT of the abdomen and pelvis was performed 5/2/2007. This scan revealed a “lobular mass involving the posterior wall of the urinary bladder measuring up to 4.1 cm in the largest AP dimension x 4.5 cm (T).

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Breast 1

This is the case of a fifty-three year old female who discovered a mass in her right breast in May of 1985. A mammogram ordered by her treating physician reported findings suspicious for malignancy. An excisional biopsy of the breast mass was done on 6/1/85 revealing an infiltrating ductal adenocarcinoma. Following surgery, the patient was prescribed a course of radiation therapy.

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Breast 2

45 year old female with a history of breast cancer from 2000. The patient was diagnosed with infiltrating ductal Breast Cancer in December of 2000. The patient had a lumpectomy to remove the tumor as well as some lymph nodes. Blood tests were done to follow tumor markers. Another lump was detected in 2003.

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Cervical Cancer

48 year old female with a history of cervical cancer. The patient was originally diagnosed with Squamous Cell Cervical Cancer Stage II-B on 11/28/00. At the time of consult for IPT, the patient had Stage IV cancer, which was diagnosed when lung metastases were found on a CT scan from December 2001.

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Hodgkin’s Lymphoma

This is the case of a forty-five year old male who began experiencing fever and night sweats in November of1984. Over an ensuing period of three and a half months he also developed dyspnea, dizziness, and a sharp pain in the right posterior hemithorax. A weight loss of 12 kg (27 lbs) accompanied the evolution of all these symptoms.

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Lung 1

81 year old male who smoked cigarettes and pipes with history of cancer of the prostate in 1994, the bladder in 2001 and was hospitalized for pneumonia. There was swelling of the right arm and bilateral leg and the patient was short of breath. The patient also had a pacemaker put in, in 1989. 81 year old male who smoked cigarettes and pipes with history of cancer of the prostate in 1994, the bladder in 2001 and was hospitalized for pneumonia. There was swelling of the right arm and bilateral leg and the patient was short of breath. The patient also had a pacemaker put in, in 1989.

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Lung 2

The patient was a 54 year old female with no history of smoking who complained of a chronic cough, shortness of breath and fatigue. There was a family history of lung cancer.

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Lung 3

This 70 year-old gentleman presented to our facility May 23, 2011 with a history of bladder cancer in 2005. Surgical removal of tumors was the only form of management the patient received for this diagnosis. More recently, the patient had CT scans dated February 25 and March 26, 2011 which revealed extensive mediastinal adenopathy, a hypermetabolic mass in the anterior segment of the right upper lobe, and multiple pulmonary nodules. Also present on the March 26 scan was moderately intense tracer uptake involving the medial margin of the left ninth rib. A CT core guided biopsy performed 4/21/2011 concluded a diagnosis of “poorly differentiated carcinoma” which was determined to be, “consistent with primary carcinoma of the lung.” The patient had smoked throughout his life, and while he had reduced his intake, he did not quit despite encouragement to.

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Ovarian

63 year old female with a history of breast cancer in 1981 who complained of pelvic pain and swelling. There is a history of cancer in the family: the mother of the patient had breast and ovarian cancer at the same time of life as the patient did.

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Pancreatic 1

This is the case of a sixty-four year old female who developed scleral icterus in September of 1986. This was followed by the appearance of jaundice and symptoms of nausea and anorexia. In October the patient sought consultation with her physician about these complaints, and an ultrasound examination of the liver and bile ducts was done on October 22. This reported a normal liver parenchyma without evidence of metastasis, the presence of cholelithiasis, and dilatation of the intra and extrahepatic bile ducts due to extrahepatic obstructive jaundice. The differential diagnosis was cancer of the head of the pancreas versus cancer of the ampulla of Vater. On October 27 a CAT scan of the abdomen was done, confirming suspicions of a pancreatic cancer. The patient was apprised of the possible diagnosis and the poor prognosis under her circumstances.

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Pancreatic 2

67 year-old female with a diagnosis of pancreatic cancer, pathologically confirmed on 6/25/02. Biopsy was obtained via ERCP and demonstrated involvement of the superior and mesenteric veins. A temporary stent was placed at this time. Also, metastases to the liver were mentioned as a possibility. Patient was not a candidate for the Whipple procedure. Imaging on CAT scan showed a three cm mass in the head of the pancreas. A permanent bile duct stent was placed on 10/29/02.

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