Seth Cohen, MD

A 55-year-old woman with history of hypertension presented to her gynecologist with a chief complaint of nipple retraction.

A 60-year-old woman presented to us with newly diagnosed breast cancer. She had a screening mammogram that revealed loose collections of punctate and linear calcifications on the left breast with ultrasound showing two to three poorly marginated hypoechoic zones. Breast biopsy was consistent with ductal carcinoma in situ with microinvasion. She underwent mastectomy with negative sentinel lymph node biopsy.

A 57-year-old man was referred to the oncology clinic with a 1.5-year history of cough without hemoptysis and progressive dysphagia, resulting in a 65-lb weight loss, approximately one-third of his baseline weight.

A 26-year-old woman with a past medical history significant for congenital heart disease, status-post multiple surgical interventions, congestive heart failure, scoliosis, and diabetes was initially found to have significant hypertension in 1997. CT scan of the abdomen and pelvis with contrast revealed a low density mass in the retrocaval region, thought to be a mass in the right adrenal gland, and a large, heterogeneous liver, suggestive of passive congestion vs. diffuse metastatic disease. A Doppler ultrasound of the renal arteries revealed no evidence of stenosis. A subsequent MRI of the abdomen confirmed the presence of a 3 cm × 2 cm right adrenal mass with moderate increased signal intensity on T2 and STIR images, and iso-intense on T1. Due to her history, this was felt to represent a pheochromocytoma. The liver was increased in size, but there was no evidence of metastatic liver lesions. OctreoScan revealed no evidence of uptake. A 24-hour urine collection for catecholamines was elevated.