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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 328:1836-1841 June 24, 1993 Number 25
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Case 25-1993— A 67-Year-Old Man with Osteolytic Lesions of T11 and T12
Frederick L. Mansfield, and John X. O'Connell

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Presentation of Case

A 67-year-old man was admitted to the hospital because of increasing back pain and osteolytic changes in the 11th and 12th thoracic vertebras.

There was a history of coronary artery disease with multiple subendocardial infarcts, which had led to coronary-artery bypass surgery 19 years earlier.

During the year before admission the patient experienced mild, intermittent low dorsal pain. Ten months before entry an electronic pacemaker was implanted because of the sick sinus syndrome. The alkaline phosphatase was 224 U per liter.

Seven months before admission the patient returned to the hospital because of recurrent anterior chest pain. Medical evaluation yielded . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnoses

Dr. Frederick L. Mansfield's Diagnosis

Pathological Discussion

Anatomical Diagnosis

References



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