Case Number 16
The patient was a 64 year old white female who underwent a right modified
radical mastectomy in July 1969 for a large carcinoma. Her pre-operative
chest x-ray was normal. The patient's lymph nodes were negative for
metastases. In February 1970, seven months after her surgery, the patient
had a repeat chest x-ray which revealed a 2.25 cm density in the right hilum,
a 3 cm density in the left mid lung, and two tiny 0.5 cm lesions in the right
costaphrenic area. All were considered to be metastases.
Because her husband was an invalid who was dying, the patient stated that she
wanted to live long enough to care for him. She was placed on
diethylstilbestrol (DES) 5 mg three times daily. A chest x-ray in November
1970 showed totally normal findings without any evidence of tumors.
In 1973, the patient developed endometrial carcinoma and the DES was
discontinued. Shortly thereafter, a chest x-ray revealed the lung lesions
had reappeared, in the same locations and of the same size as was noted in
1970.
The patient was successfully treated for the endometrial carcinoma but died
of metastatic breast cancer in 1982, thirteen years after the original
diagnosis.