Sample Breast Cancer Consultation

In summary, this is a 66-year-old woman with advanced breast cancer, and refractory brain metastases. She was originally diagnosed with left-sided, early-stage breast cancer in 1993. The tumor was estrogen receptor negative and progesterone receptor negative, and received adjuvant CMF chemotherapy, radiation therapy, and tamoxifen. The tamoxifen was subsequently transitioned to raloxifene.

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Sample Neurosurgery Consultation

Thank you for referring Ms. First name Last name to Partners Online Second Opinions.

This 50 year old patient presents with the following problem: "Susp. Lt. facial nerve neurinoma and rt. Vestibular schwanoma s/p recurrent lt. facialis (8 ys ago, 4 ys ago)"

The following questions are presented by the patient:

Questions:

1. What is your interpretation of the MRI?

I have reviewed the 6/20/11 MRI and agree with the following interpretation: "A 7 x 4 x 7 mm homogeneously enhancing lesion within the right internal auditory canal likely represents a vestibular schwannoma. A 7 x 4 x 4 homogeneously enhancing lesion adjacent and superior to the left geniculate ganglion is identified. The inferior margin of the lesion appears to abut the geniculate ganglion of the left facial nerve. The superior aspect of the lesion appears to abut the temporal lobe dura within the middle cranial fossa.

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Sample Hematology Consultation

53 year old man with a 3 year history of progressive supranuclear palsy who first noted a left arm subcutaneous nodule in the left axilla.

Treatment History:

2/2/11 Left axillary mass incisional biopsy. Pathology: carcinoma with neuroendocrine differentiation (small blue cells); no clear lymph node architecture was identified making it unclear whether this represented a primary tumor or lymph node metastasis.

2/23/11 CT chest, abdomen and pelvis: 12.1 cm left axillary mass; 4 spleen lesions

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