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中英临床推理一肺腺癌患者渐步出现
文章来源：视网膜静脉周围炎 发布时间:2019-1-27 18:37:39 点击数： 次
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SECTION1第一部分
A54-year-oldmanpresentedwithpainintheleftchestfor3days.Hismedicalhistorywasremarkableforhyperlipidemiamanagedwithdietandstatin.Hedeniedtobaccosmokingandconsumptionofalcohol.Physicalexaminationwasunrevealing.Thepatientwasdiagnosedwithanadenocarcinomaofthelungharboringanepidermalgrowthfactorreceptor(EGFR)mutationthatmetastasizedtoT2-T4levels.HewastreatedwithradiotherapyanddexamethasonefollowedbyGefitinib.
54岁男性主要症状为左侧胸痛3天，既往有明确的高脂血症病史，正接受饮食控制及服用他汀类药物。无吸烟和饮酒史。体格检查无异常。患者诊断为表皮生长因子受体（EGFR）突变性肺腺癌，已转移至T2-T4椎体。患者接受放疗和地塞米松治疗，继之予以吉非替尼治疗。
Inthesubsequentweeks,thepatientdevelopedflaccidparaparesiswithMedicalResearchCouncil(MRC)gradedstrengthof3/5inmostmusclesofthelowerlimbsandnormalpower(MRCof5/5)intheupperlimbs.Deeptendonreflexesweresymmetricalandgrade1+inthelowerlimbsand2+intheupperlimbs.Plantarresponseswereflexor.SensoryexaminationrevealedimpairedpinprickcaudaltotheT4level.Cranialnerveexaminationwasunremarkable.ThepatientwasdiagnosedwithaT2-T4pathologicfracturecausingspinalcord北京一次治疗白癜风要多少钱北京白癜风治疗效果好的医院
