Intraepithelial Carcinomatic Tissue Case Study

Breasts: no masses, no nipple retraction, no discharge. Heart: S1 and S2, no gallops, rubs, or murmurs appreciated. Abdomen is scaphoid, soft and non-tender with positive bubble sounds. Pelvic/ Rectal: deferred as patient has recently visited her GYN for a routine Pap smear. Neurologic exam reveals normal motor strength in all muscle

Meanwhile, the applicant’s attorney has recently designated Dr. Steven Mamigonian, a chiropractor, as a new primary treating physician. Per our discussion, Dr. Mamigonian is not within our Medical Provider Network. I have also issued an objection to applicant’s attorney’s office regarding the MPN issues.

Therefore, for all the foregoing reasons, the ALJ concludes that the Appellant was able to provide verification to substantiate her claim that she had other medical conditions that could qualify her for EMA, therefore; the Appellant’s appeal is SUSTAINED. Subsequently, an appropriate Order will

The radiologist report says, “the appearance is suspicious for malignancy, and further evaluation with PET CT is recommended.” The report on the PET scan states that the cardiophrenic mass had increased FDG uptake; the smaller nodules did not. The accuracy of this type of scan is limited on nodules under one centimeter, which many of them were on this patient. Due to this, it was undetermined if there was metastasis or not. It was also found on the PET scan that one of the patient’s ovaries was enlarged and had some FDG uptake there as well. A pelvic ultrasound was recommended as this was a concern for an ovarian

The carrier’s decision in denying coverage for the requested prescription Harvoni was not appropriate for the treatment of this member’s condition. This member meets criteria for treatment as recommended by the AASLD, the duration is limited and the treatment is expected to be effective for this member. The requested prescription Harvoni is medically necessary for the treatment of this member’s condition. The previous denial is

She reports a history of back pain, ovarian cysts excision, and breast tumor. She denies chest pain, shortness of breath, or palpitations. Patient reports that her immunizations and preventive care are up to

The well being of the patient will be on the factors of the location of the tumor and where the sarcoma has spreads.

“…After carefully reviewing the medical information, we are upholding the original decision to deny the above stated service(s). The denial is based on the Plan provisions. Based on the medical information the criteria for approval were not met.

A review of the records reveals the member to be an adult male with a birth date of 08/28/1964. The member has a diagnosis of prostate cancer. The member’s treating provider, Gregory Haselhuhn, MD has requested an out of plan referral to urologist Herb Riemenschneider for High Intensity Focused Ultrasound (HIFU).

MSKCC radiologist use state of the art imaging technology to detect cancer while the pathologists have unsurpassed experience in using advances methods to accurately diagnose cancer. This type of Innovative technology allows precise diagnosis and staging of the disease. Furthermore, it is easier to determine whether a specific form of treatments is working or not. In this case, physicians can therefore shift the treatment or consider alternative methods of treatment.

Jane is a 45yo, G2 P1001, who was seen for an ultrasound evaluation and consultation. She does have AMA but conceived during embryo transfer with a donor egg that is age 32. The father of the baby is 62. She does smoke vapor nicotine cigarettes. She has not smoked regular cigarettes for the past couple of years. She also does have asthma but is currently asymptomatic. She reportedly has had some seizures in the past but her last one occurred in 2007, about 9-10 years ago and she has not been treated for over 7 years and at this point in time is doing well and therefore medication would not be indicated at this point in time. She does have one previous delivery in 2013 that was by cesarean delivery. Lastly, she does have some issues with chronic back pain following a car accident and injuries in the past. Currently, however, she is only on acetaminophen by report. Overall, on today’s assessment she has no complaints other than she states that she has had some headaches off/on for the past couple of weeks.

A histologically confirmed metastasis in the absence of a detectable primary cancer (after investigation) is termed cancer of unknown primary or CUP (1). CUP comprises 2-6% of all malignancies (1), and is generally divided further based on the site of the metastasis and prognosis (2). Most cases are carcinomas with adenocarcinomas (undifferentiated to well differentiated) accounting for 90%, squamous cell carcinomas (SCC) making up 5% and undifferentiated neoplasm accounting for the remainder (3). In post-mortem studies, the primary tumor was discovered in 73% of patients with the most common site being: lung (27%), pancreas (24%), liver or bile duct (8%), kidney or adrenals (8%), colon or rectum (7%), genital system (7%), and stomach (6%)

• A PET (positron emission tomography) scan may help to show cancer activity in some other parts of the body. This can be helpful for “staging” the cancer (see

We found that 85% of our patients had a tumour SUV ≥ 2.5 which goes with our inclusion critera, where mediastinal lymph node had been positive in the entire studied sample. It should be highlighted that if the primary tumour does not have significant FDG uptake, the mediastinal lymph nodes should not be expected to uptake FDG, even if involved (29).