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52-year-old woman of breast cancer
52-year-old woman with a history of breast cancer s/p lumpectomy (with three positive nodes), radiation,
and adjuvant chemotherapy two years ago presents with gradual onset of mid-back pain over two
months. She has recently been tripping occasionally and has new left-sided numbness from the level of
her belly button. She denies fever, night sweats, or weight loss.
1) Summarize the case briefly, including neuroanatomic localization and pathogenesis.
2) What is the most likely diagnosis? Name 1-2 alternative diagnoses, and discuss briefly why these
are less likely.
3) What additional information (history, exam, laboratory or other studies) would you like to obtain?
4) Assuming your most likely diagnosis is correct, how would you manage this patient? How would you
monitor her condition and its treatment? What is the prognosis?
Case 44
52-year-old woman with a history of breast cancer s/p lumpectomy (with three positive nodes), radiation,
and adjuvant chemotherapy two years ago presents with gradual onset of mid-back pain over two
months. She has recently been tripping occasionally and has new left-sided numbness from the level of
her belly button. She denies fever, night sweats, or weight loss.
1) Summarize the case briefly, including neuroanatomic localization and pathogenesis.
2) What is the most likely diagnosis? Name 1-2 alternative diagnoses, and discuss briefly why these
are less likely.
3) What additional information (history, exam, laboratory or other studies) would you like to obtain?
4) Assuming your most likely diagnosis is correct, how would you manage this patient? How would you
monitor her condition and its treatment? What is the prognosis? Click here
52-year-old woman with a history of breast cancer s/p lumpectomy (with three positive nodes), radiation,
and adjuvant chemotherapy two years ago presents with gradual onset of mid-back pain over two
months. She has recently been tripping occasionally and has new left-sided numbness from the level of
her belly button. She denies fever, night sweats, or weight loss.
1) Summarize the case briefly, including neuroanatomic localization and pathogenesis.
2) What is the most likely diagnosis? Name 1-2 alternative diagnoses, and discuss briefly why these
are less likely.
3) What additional information (history, exam, laboratory or other studies) would you like to obtain?
4) Assuming your most likely diagnosis is correct, how would you manage this patient? How would you
monitor her condition and its treatment? What is the prognosis?