| Symptoms
& History
Physical
Findings
Stop
& Think
Lab
and X-Ray
Differential
Diagnosis
The
Disease
Treatment
Conclusions
Quiz
& Evaluation |
|
The
news
about Mr. Helms' preoperative evaluation isn't good.
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Bone scan: Multiple
axial skeletal and long bone hot-spots, consistent with metastatic carcinoma.
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Abdominal CT: Multiple
parenchymal defects of the liver, consistent with metastatic carcinoma.
Marked increase in size of right adrenal gland, consistent with metastatic
cancer.
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Chest CT: Extensive
mediastinal involvement.
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Head CT: Two
left cerebral defects consistent with metastatic carcinoma.
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Pulmonary function studies:
Not
done because evidence of advanced metastatic malignancy makes him a non-surgical
candidate. Had they been done, we would find he has moderately advanced
emphysema, but probably could withstand a pneumonectomy.
Mr.
Helms represents as the average case for this disease. Recall
only 20-30% of people with bronchogenic carcinoma present early
enough for resection.
Follow
up
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