Summary Staging 2000 Exercises, Case 6 Notes

Physical Exam

01/08/2001

Left sided chest pain and chest tightness; labored inhalations.

X-Rays and Scans

01/08/2001

CXR: Approx. 5 cm lesion in right lower lobe, mediastinal opacity.

01/13/2001

CT chest: 5 x 5 x 5.5 cm mass at night medial base posteriorly, malignancy is likely

Scopes

01/16/2001

Bronchoscopy with needle aspiration: Fungating mass in RLL, aspirated.

Laboratory

None-contributory

Operative Findings

01/20/2001

Thoracotomy: Extension to mediastinum noted. Biopsy taken; tumor is inoperable.

Pathology Reports

01/16/2001

Aspiration: consistent with carcinoma.

01/20/2001

Biopsy: Poorly differentiated carcinoma, massively necrotic, consistent with small cell morphology.

Treatment

Inoperable.

01/31/2001

Started XRT: 4500 rads to primary tumor, hilum, and mediastinum Chemo: Cisplatin and Etoposide

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