2013/10/25

Case 1: Presentation a the Case Coference


Last time, a sixty-year-old man named Mr. GB was admitted to the neurosurgical ward.
I am the physician in charge of him. Thus, I have to prepare for the presentation at the case conference.
(In the conference room.)

This is a sixty-year-old man. Right- handed. He is allergic to some kind of antibiotics. He has a medical history of diabetes for 5 years. No medical history of cancer. No family medical history. 
He experienced convulsions of his right hand 2 months ago. Since then, he has had right hand motor weakness and very mild aphasia. He has no fever. He visited our hospital yesterday, and was admitted immediately. 
These are the MR images performed six weeks ago. There is a mass in the left frontal lobe and the maximal diameter is 2 cm. The mass is enhanced like a ring and well demarcated. We can see the large area of edema around the mass. On the MR images performed six weeks later, the mass has been growing to 3cm in diameter. Based on these inspections, malignant brain tumors are most suspected. We have to consider the possibility of a high-grade glioma or a metastatic brain tumor. A brain abscess must be considered too.
We are planning further examination by an MR spectroscopy and a PET study. By these examinations, we can distinguish a brain abscess from brain tumors. If the brain abscess was denied, the surgical removal will be planned.

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