Case Studies

21-year-old female with an acute onset of a unilateral sixth cranial nerve deficit. Brain MRI showed at least a dozen white matter lesions, one of them contrast-enhancing. Sensory evoked potentials showed a bilateral increase in latency. Multiple sclerosis was diagnosed, and the patient was treated...
78-year-old male was diagnosed with metastatic well differentiated neuroendocrine carcinoma with unknown primary. He recently underwent explorative laparotomy that revealed solitary metastasis in the liver, and a hard lesion in the mid-ileum suspicious for the primary carcinoid. A frozen section...
72-year-old male with diagnosis of chronic or permanent atrial fibrillation. In 1995 he suffered a TIA and in 2005 he underwent two unsuccessful attempts of atrial fibrillation ablation. The main treatment strategy for his atrial fibrillation has consisted of rate control and oral anticoagulation....
33-year-old male underwent reinsertion operation + stabilization of the right knee due to complex capsule-ligamentous laxity. In consequence of recent  trauma he started suffering from pathological condition of the knee: swelling with consequent pain and motor activity difficulty. The...
43-year-old male presented with paresthesias in bilateral distal limbs. EMG showed demyelinating neuropathy with motor conduction blocks in ulnar and median nerves. The diagnosis was CIDP with less likely possibility of MMN. His total cholesterol and triglycerides values were elevated and Liponorm...
43-year-old male experienced numbness in both hands. An EMG showed conduction block both on the ulnar and median nerves at the elbow level on both sides, and the clinical examination found sensory loss affecting mainly light touch on both hands. EMG confirmed the presence of nerve conduction blocks...
60-year-old female with previous history of IgG monoclonal gamopathy. An ultrasound of the thyroid showed a 10 mm diameter nodule to the right and a 12 mm diameter nodule to the left with associated colloid accumulations. Another thyroid US was performed and there seems to be enlargement of the...
44-year-old female that presents with Paresthesias and weakness in the right arm and hand, and left trigeminal neuralgia. The patient underwent operation of microvascular decompression of the left cranial nerve. Following the operation she experienced marked improvement of her facial pain and...
39-year-old male with painful symptomatology of the right shoulder joint was diagnosed with Juvenile concentric osteoarthritis of right shoulder with lower osteophytosis. Arthroscopy is recommended in order to assess the shoulder injury and delay the “shoulder arthroprosthesis”...
63-year-old female with clinical ocular history of mild myopia and presbyopia, started seeing floaters in her right eye, which worsened on the next day and were accompanied by photophobia. Examination revealed the existence of posterior vitreous detachment, with no evidence for retinal tear. Three...
41-year-old female who had been attempting to conceive for the past several years. She underwent several failed fertility treatment attempts, and conceived following a clomid /gonadotropin stimulation but it ended with miscarriage.  Following this she underwent five IVF/ intracytoplasmic...
41-year-old female with 2nd infertility and repeated implantation failure was treated with 4 long protocols with no success. The expert suggests to perform diagnostic hysteroscopy, hysterosalpingogram, and thrombophylia workup, to switch from the long protocols to a short one, and try to do double...
39-year-old male suffers of back pain since 1994. In 2006, following recurrent back pain, investigated by MRI that showed advanced degenerative abnormalities, inversion of physiological lordosis (apex at L1-L2), and L4-L5 discopathy. EMG disclosed slight radiculopathy at L5 and the lumbar MRI...
34-old-male had suffered for 8 months from motor function deterioration in the limbs, tongue and palate. He was diagnosed with 1st and 2nd Motor Neuron Disease of the ALS-type. He also underwent accidental fall and traumatic brain injury during his last in-hospital evaluation. The only proven...
38-year-old female suffers from endometriosis and repeated miscarriages. During a 2 years period, she underwent 2 spontaneous miscarriages, both at 7 weeks' gestation. Her investigation included normal anatomic (HSG/hysteroscopy), genetic, biochemical, hormonal and immunological (autoantibodies)...
A known hypertensive female patient whose blood pressure is mostly uncontrolled. The expert recommends to focus on appropriate treatment which should include fixed combination of Angiotensin Receptor Blocker and diuretics together with 24 hour blood pressure monitoring. The expert emphasize that...
43-year-old female with history of continued cigarette smoking and complaints of palpitations. A sinus tachycardia of 160 is documented with little physical activity. Pulmonary function studies revealed obstructive ventilatory defects, consistent with the smoking or beta blockers. She has been...
69-year-old male found on colonoscopy to have multiple polyps and a rectal cancer. He underwent preoperative chemoRT, underwent resection and received a single cycle of bolus 5-FU with leucovorin. In early 2007, he had multiple complications and ultimately has a permanent ileostomy. Scans over the...
42-year-old female with chronic renal insufficiency secondary to immune complex mediated glomerulonephropathy, hypertension, Type 2 diabetes mellitus, and hyperlipidemia. The recommended solution for her is kidney transplant.
62-year-old male with extremity radiculopathy and weakness in intrinsic muscles. His diagnosis include stenosis (cervical spine C3-C7), rediculitis, degenerative disc disease and cervical spondylosis with possible myelopathy. Given the patient's age and the appearance of the MRI scan showing...
62-year-old male underwent an MRI scan of the cervical spine. The expert's conclusions from this test are: congenital diffuse cervical spinal stenosis together with disc protrusion and Ligamentum flavum hypertrophy with evidence of myelopathy at the level of C3-4.
62-year-old male complained about sensation of pins and needles in the fingers accompanied by pain and feeling of pressure in the toes. The patient underwent CT and MRT of the cervical spine and conduction studies that showed signs of severe chronic neuropathy, Lordosis, disc hernias with pressure...
7-year-old boy was diagnosed with diffused intra-axial brainstem expansive lesion. The spine MRI scan indicates spread of the patient's tumor down along the spinal cord, in spite of having reduced at the brainstem. The expert agrees that radiation to the spine that the child started receiving is...
7-year-old boy was diagnosed with diffused intra-axial brainstem expansive lesion. He underwent radiation therapy but his physical condition is worrisome. His relatives ask the expert's opinion about experimental therapy consists of combination Antineoplaston and radiation therapy for the treatment...
7-year-old boy presented with general asthenia, hand tremors, anxiety and episodes of diffuse headache. Exam noted facial asymmetry and symptoms progressed to vomiting. The patient had ataxia, dyarthria and facial weakness. CT and MRI revealed a expansile lesion of the brainstem and signs of...
49-year-old male was diagnosed with renal cell carcinoma and underwent left radical nephrectomy. The expert recommended either close observation every few months or participating in an adjuvant vaccine trial or monoclonal antibody therapy trial.
70-year-old-male was diagnosed with colon cancer. After undergoing a right hemicolectomy, hepatic lesions were revealed. Three months after starting chemotherapy a CT revealed recurrent hepatic disease and celiac lymphadenopathy. He underwent directed therapy with radiofrequency ablation and...
49-year-old-male complained of a feeling of oppression behind the sternum, always when there was emotional stress. His coronary CT showed Severe high level stenosis with wall irregularities of the right coronary artery. The treatment options are coronary revascularization procedure versus optimized...
46-year-old-male with symptoms of burning sensation during miction, soreness in perineal region when in seated position and pollakiuria was diagnosed with Prostatic pathology – "prostatodynia", after prostate calcifications and retention microcysts were observed in echography. In...
26-year-old patient was diagnosed with stage 4 melanoma with massive metastatic spreading around the lymph node, and underwent surgical treatment: radical lymphoadenectomy of the right armpit, splenectomy, and resection of two subcutaneous lesions. Chemotherapy is also planned.
28-year old female had a sudden visus decrease. Her brain MRI showed several myelin lesions and she was diagnosed with Inflammatory Demyelinizing Disease. Because of her Hodgkin’s lymphoma history it is recommended to implement preventive therapy only if another episode consistent with MS...
66-year-old female was diagnosed with lung tumour within the right hemithorax with concomitant pulmonary nodules and a measurable enlargement of lymph nodes. FBS was positive for well differentiated neuroendocrine carcinoma and a needle biopsy revealed adenocarcinoma with associated neuroendocrine...
An occasion chest X-ray of a 74-year-old female revealed a thickening in her left lung, and the tumor was latter typified as non-small cell lung cancer. Her staging chest CAT scan was consistent with a primary tumor in the lingular sub-segment together with millimetric parenchymal nodules suspected...
71-year-old-male had been diagnosed as having multiple myeloma (MM), apparently of the IgA-Lambda type, with renal involvement. The disease course is characterized by "ups and downs responding to anti-MM therapy. During the disease course, several problems and complications developed: Renal...
78-year-old male was diagnosed with Metastatic well differentiated neuroendocrine carcinoma in liver. There is an undefined finding in the cecum that might be the primary tumor, and hepatic metastases that can be surgically respected. The imaging tests support the assumption that the primary tumor...
78 years old male patient diagnosed 6 years ago with poorly differentiated prostate cancer. At present he has metastatic hormone refractory prostate cancer. His current treatment consists of Estracyt and LHRH agonist. It is recommended to consider Chemotherapy as an another treatment option.  
65-year-old male was recently diagnosed with a bladder tumor. He had abdominal imaging which revealed a space occupying lesion involving the left bladder wall as well as a mild degree of left hydronephrosis. During his operation a papillary tumor was resected and a stent was inserted into the left...
Infant female was diagnosed with anisocoria. "cornea of reduced size, anterior chamber nearly absent, anomalous iris marking, miotic pupil" were found in Ophthalmologic examination. Gonioscopy examination revealed posterior embryotoxon in both eyes, and bilateral "fibrous lobes...
60-year-old male was informed by the dentist that his 44th tooth would have to be removed. He would prefer to avoid the avulsion. The expert advises him to lose the tooth for the success of comprehensive prosthetic rehabilitation.  
67-year-old male suffering a constant pain at the bottom of the lower left rib cage for the last two years. The pain is described as not being extreme nor affected by breathing; it is dull and always present. Various imaging scans were unremarkable although diffuse degenerative disk spinal...
5-year-old girl with a suspected diagnosis of stage 1 Wilms' tumor. The child's current presentation was an incidental finding of left abdominal swelling. The reports of the abdominal US, total body CT together with normal values of catecholamine metabolites seem to support the diagnosis of Wilms'...
43-year-old female has suffered a multifragmentary fracture of the distal left humorous that wasn't properly reduced, fixed or healed and evolved into pseudoarthrosis. She still has a severely restricted range of motion and seriously painful symptoms in the left elbow.
66-year-old male was diagnosed with Benign Prostatic Hypertrophy. The expert recommends to try two different medications before considering surgery as an alternative.  
69-year-old female with a diagnosis of Bilateral Colloid Degeneration. Her past Ophthalmological history began about 6 to 8 months ago with symptoms of dark spots and reduction of perception of luminosity in the visual field and complaints of a burning sensation on the sides of both eyes.
4-year-old boy presented with a lesion on his left forearm was diagnosed with small cell malignant neoplasm. It was thought that he had a malignant myoepithelioma but other reports suggested a primitive poorly differentiated neoplasia of neuro-ectodermal origin. He underwent surgery and...
38-year-old man was injured in a road accident and sustained severe cervical spine injury including vertebral fractures, for which he underwent posterior cervical spine fusion. The expert recommends intense rehabilitation.  
The patient is a former premature baby who underwent tracheostomy after 30 days of intubation and laryngotracheoplasty with anterior and posterior costal grafts and implantation of a T-tube. She is now 10 years-old and was diagnosed with Cotton’s grade 4 subglottic stenosis. The restricted...
58-year-old female diagnosed with herniated discs at vertebrae L4-L5. MR scans present signs of degeneration in L4-5, mild degenerative scoliosis, secondary narrowing of the canal and of disc space in L5-S1 level, central and left disc herniation at L4-5 level, and swelling of L4 root.
31-year-old woman suffering from secondary recurrent abortions. During a 2 year period, she underwent 4 miscarriages with a thorough investigation, including genetic, anatomic, immune and thrombophilic testing. Nothing of significance has emerged to justify 4 miscarriages.
1-month-old female with Microtia of the right ear, which is a single finding and not part of a syndrome. Hearing test is recommended.  
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