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Senator McCain and Our Shared Humanity

  Despite our country’s political divisions, I trust we are all praying for Senator McCain as he confronts his glioblastoma diagnosis. Unfortunately, I can guess the anguish Senator McCain and his family are experiencing. My wife Carolyn, a breast cancer surgeon and a breast cancer survivor, was diagnosed with the same malignant brain tumor in […]

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Computed tomography confirmed ultrasound findings, including the presence of a mass at the head of the pancreas and pancreatic ductal dilation.

The Hyperlipidemia Effect: Pseudohyponatremia in Pancreatic Cancer

A patient’s newly discovered malignancy was evidently accompanied by a sodium deficit. The 48-year-old man presented to the Emergency Department for evaluation of abdominal pain and weight loss. He described gradual onset of severe, burning, epigastric pain with radiation to the back. In addition, he reported a 70-lb weight loss over 2 months, yellowing of […]

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The trigeminocardiac reflex pathway diagram. 1) Trigeminal ganglion via sensory fibers of trigeminal nerve. 2) Sensory nucleus of trigeminal nerve. 3) Internuncial fibers. 4) Motor nucleus of the vagus nerve. 5) Efferent vagal nerve to the heart and stomach.

Trigeminocardiac Reflex as the Presentation of Maxillary Sinus Adenocarcinoma

A 54-year-old man with history of tobacco use presented to the Emergency Department with a few-hour history of dizziness and 2-month history of intermittent right jaw pain. His blood pressure was 68/48 mm Hg, heart rate was 55 beats per minute, and oxygen saturation was 85% on room air. Physical examination was notable for a […]

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(A) Cauliflower-like lesion growing in the right nasal vestibule and occluding the naris; (B) papillary architecture with hyperkeratosis of the overlying squamous epithelium; (C) koilocytosis, which is characteristic of active viral replication; and (D) invasive carcinoma beyond the basement membrane (black arrow), consisting of irregular nests of hyperchromatic cells showing squamous differentiation and focal mitotic figures (black asterisks).

Intranasal Condyloma Acuminatum with Malignant Transformation

A 48-year-old man with a growing mass in the right naris and epistaxis for 6 months visited our department in August 2016. He had a history of diabetes mellitus and psoriasis. We observed a cauliflower-like lesion in the right nasal vestibule (Figure A), extending to the septum and nasal floor. Nasopharyngoscopy revealed that the nasopharynx, oropharynx, […]

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(A) This is what the patient's foot looked like during the index admission. The thickened skin denotes retention hyperkeratosis, which is a result of lymphedema. (B) Roughly 2 months after initiation of therapy with Unna boot compression, the patient reported marked improvement in pain and swelling. Hyperkeratosis remained.

Sole-Searing Pain: Classic Kaposi’s Sarcoma

To read this article in its entirety please visit our website. – This article originally appeared in the November 2017 issue of The American Journal of Medicine.

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The patient had dorsal edema and purpura on both hands.

Four Cancers and a Rash: Henoch–Schönlein Purpura

A patient who had a history of 4 primary malignancies developed a rash that is usually seen among children. The 65-year-old man presented with a 2-day history of anasarca, painless skin lesions, and new arthralgias in both hands. He had a previous diagnosis of amyotrophic dermatomyositis, and although he had none of the typical skin […]

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