USMLE Forum Archives - USMLE Step 3 - Neuro- GTCS & RIng enhancing lesion.
Neuro- GTCS & RIng enhancing lesion.
harry206 - 02-18-10 23:31
A 40-year-old right-handed woman is evaluated in the emergency department for a single generalized tonic–clonic seizure. She was diagnosed with stage 2 breast cancer 3 years ago for which she was treated with lumpectomy followed by breast irradiation and adjuvant chemotherapy. Routine oncologic follow-up 2 months ago was negative. Laboratory studies and chest radiograph showed no evidence of recurrent tumor.
On examination 30 minutes after the seizure, she appears normal. MRI of the head shows a 3.5-cm ring-enhancing lesion in the anterior right frontal lobe with surrounding edema and mild mass effect, consistent with metastatic disease. No other lesions are detected on MRI. CT of the chest and abdomen is negative for tumor. Therapy with phenytoin is begun.
Which of the following is the most appropriate next step in patient management?
harry206 - 02-18-10 23:31
A 40-year-old right-handed woman is evaluated in the emergency department for a single generalized tonic–clonic seizure. She was diagnosed with stage 2 breast cancer 3 years ago for which she was treated with lumpectomy followed by breast irradiation and adjuvant chemotherapy. Routine oncologic follow-up 2 months ago was negative. Laboratory studies and chest radiograph showed no evidence of recurrent tumor.
On examination 30 minutes after the seizure, she appears normal. MRI of the head shows a 3.5-cm ring-enhancing lesion in the anterior right frontal lobe with surrounding edema and mild mass effect, consistent with metastatic disease. No other lesions are detected on MRI. CT of the chest and abdomen is negative for tumor. Therapy with phenytoin is begun.
Which of the following is the most appropriate next step in patient management?
The correct answer and explanation will be available after you answer.
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#2
Re: Neuro- GTCS & RIng enhancing conym5 - 02-19-10 08:48 My answer is: b.
patients with a solitary brain metastasis who undergo treatment by surgical resection, the survival rate after 1 year is approximately doubled...
#15
Re: Neuro- GTCS & RIng enhancing babbu5508 - 07-28-10 05:12 My answer is: b.
MRI of the head shows a 3.5-cm ring-enhancing lesion in the anterior right frontal lobe with surrounding edema and mild mass effect, consistent with metastatic disease....a solitary lesion can always be excised
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