Left sided numbness

Chief Complaint A 69 y-o-f came with the complaint left sided numbness over the face and arm. She is not able to chew food properly on left side or use her left arm to perform routine activities. History History positive for breast cancer and underwent surgery and chemotherapy. Vitals BP-125/80 mmhg, HR-74 bpm, Breathing-17 breaths/min, Temp-98.1 degree F Physical examination Examination shows paresis in left hand. Lab reports wnl. CT & MRI Brain was done which show multiple 1 cm - 1.5 cm nodular lesions in the brain, CT chest shows a 2cm × 2.5cm × 3cm mass in the left lung. Biopsy of the lung mass shows central nervous system metastasis. Treatment How the case should be managed.

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HOLISTIC Approach under care of oncologist&Neurocare

Biopsy of lung lesion shows CNS metastasis.??. Is it a primary in the lung or metastasis in the lung.Hiw ever this is a case of disseminated malignancy. Primary site ?? Lung / secondary in the lung and brain. Ref the case to Oncologist for further management.

Brain lesions -metastasis only.lung lesion primary/ metastasis.

Advanced case of malignancy, metastasis. Chemotherapy, radiotherapy. Oncologist opinion. Physiotherapy too.

Early medical management is advisable. Adv MRI brain and PET scan.

Treatment and prognosis depends upon the primary disease, control the primary disease along with whole brain radiotherapy (if there are multiple metastases in the brain, if focal then SRS) along with systemic chemotherapy

Looks metastasis Advance case of malignancy Req chemo and radiotherapy Oncologist opinion Physiotherapy too

Get brain imaging CT or MRI brain Most probability brain mets

Metastasis with complications. Chemoradiotherapy or palliative therapy and after proper evaluation and assessment by oncologist .

Thanks Dr Pushkar Bhomia

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Chemotherapy + Radiotherapy Physiotherapy Symptomatic treatment Ref to Oncologist

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