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Is Headache a Sign of a Larger Problem?

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The radiograph shows a masslike density within the left suprahilar and mediastinal region, most likely consistent with a carcinoma. Given the entire clinical picture, this patient likely has a primary lung carcinoma that metastasized to the brain.  

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Nandan R. Hichkad, PA-C, MMSc

Nandan R. Hichkad, PA-C, MMSc, practices at the Georgia Neurosurgical Institute in Macon.

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Clinician Reviews - 24(2)
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15,23
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radiology review, mass, suprahilar, mediastinal region, carcinoma, lung, brain, metastasized, vasogenic edema, headache, hoarseness, weight loss
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Author and Disclosure Information

Nandan R. Hichkad, PA-C, MMSc

Nandan R. Hichkad, PA-C, MMSc, practices at the Georgia Neurosurgical Institute in Macon.

Author and Disclosure Information

Nandan R. Hichkad, PA-C, MMSc

Nandan R. Hichkad, PA-C, MMSc, practices at the Georgia Neurosurgical Institute in Macon.

Answer

The radiograph shows a masslike density within the left suprahilar and mediastinal region, most likely consistent with a carcinoma. Given the entire clinical picture, this patient likely has a primary lung carcinoma that metastasized to the brain.  

Answer

The radiograph shows a masslike density within the left suprahilar and mediastinal region, most likely consistent with a carcinoma. Given the entire clinical picture, this patient likely has a primary lung carcinoma that metastasized to the brain.  

Issue
Clinician Reviews - 24(2)
Issue
Clinician Reviews - 24(2)
Page Number
15,23
Page Number
15,23
Publications
Publications
Topics
Article Type
Display Headline
Is Headache a Sign of a Larger Problem?
Display Headline
Is Headache a Sign of a Larger Problem?
Legacy Keywords
radiology review, mass, suprahilar, mediastinal region, carcinoma, lung, brain, metastasized, vasogenic edema, headache, hoarseness, weight loss
Legacy Keywords
radiology review, mass, suprahilar, mediastinal region, carcinoma, lung, brain, metastasized, vasogenic edema, headache, hoarseness, weight loss
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Questionnaire Body

A 60-year-old woman presents with a complaint of severe headache, hoarseness, and weight loss, which have worsened in the past few days. Her headache is bifrontal, and at times she rates its severity as 10/10. She is not aware of any medical problems, but she admits she doesn’t have a primary care provider due to lack of insurance. She has a 30-year history of smoking one to one-and-a-half packs of cigarettes per day. Family history is positive for cancer. On examination, you note that she is uncomfortable but in no obvious distress. Her vital signs are normal. She is able to move all four extremities well and is neurovascularly intact. She has no other focal deficits. Noncontrast CT of the head is obtained. It shows a large right frontal lesion with surrounding vasogenic edema. You also order a chest radiograph (shown). What is your impression?
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