|
|||||
|
|
|||||
|
| Primary Site | Probable left upper lobe of lung. | |
| Physical Exam | 01/07/XX |
Tenderness in region of L 4th rib posteriorly. Patient has history of Ca of R breast in 1971 with right radical mastectomy. Recent bony pelvic pain. |
| X-Rays & Scans | 01/07/XX |
Chest X-ray: LUL lesion with partial destruction of left posterior 4th rib; cannot rule out L pleural effusion. |
| 01/15/XX | Bone Scan: Intense uptake throughout the thoracolumbar spine as well as the pelvis and both femurs due to arthritis; tumor activity at L 4th rib. | |
| 01/10/XX | Pelvic sonogram: Negative. | |
| Scopes | 01/18/XX | Thoracoscopy: Approx. 3 cm carcinoma in the LUL; possible malig. pleural effusion (cells swabbed), obvious lytic destruction of the L 4th rib (biopsied) which is direct invasion of the rib from the lung tumor; surgeon states that the tumor is unresectable. |
| Laboratory | 01/07/XX |
CEA: 670 (normal 0 - 3) CA 125: 295 (normal 0 - 35) |
| Operative Findings | None reported. |
|
| Pathological Reports | 01/18/XX
|
Biopsy of L 4th rib: Anaplastic adenocarcinoma (Note: pathologist suggests that histologic picture is more compatible with pulmonary primary than breast.) |
| Treatment | 02/03/XX-02/28/XX |
Radiation: external beam 3500 cGy to left lung delivered in 250 cGy fractions; Palliative radiation to pelvis. |
| 01/21/XX | Chemotherapy: began carboplatin | |
