Woman With Back Pain Unable To Walk

ANSWER

The radiograph demonstrates a fairly large mass on the medial aspect of the left upper lobe. Such findings are usually associated with bronchogenic carcinomas.

Among the documentation from the transferring facility was a copy of a CT scan of the patient’s chest. On that study, the mass is seen; it appears to extend to the posterior chest wall, with extensive involvement and destruction of the ribs and posterior elements of T4 and T5. There is also evidence of some spinal cord compression, which would explain the patient’s presenting complaint.

Subsequent CT-guided biopsy demonstrated the lesion to be a non–small cell carcinoma. Due to the already extensive involvement, surgery was not an option, and the patient was referred for palliative radiation therapy.