Case Presentation: 60 year old female who presented with generalized abdominal pain and distension. Associated featured included unintentional weight loss of 20 lbs, fatigue, nausea, vomiting. She denied melena, hematochezia, diarrhea or pelvic bleeding. Her past medical history was significant for Estrogen Receptor (ER) positive, Progesterone Receptor (PR) positive, human epidermal factor 2 (HER2) negative, [...]

Case Presentation: Case:Patient is a 66yo M with a history of malignant neoplasm of the bladder who presented to Michigan Medicine for 1 month of altered mental status. At the time of presentation, family stated that for the past month the patient began having episodes of “confusion” in which the patient is unable to recognize [...]

Case Presentation: 46 year old male with HTN presented to our facility with frequency, difficulty urinating and dribbling. Imaging revealed urinary retention, multiple 1mm non-obstructing renal calculi, lytic lesions in the axial skeleton, and numerous cysts within the kidneys, compatible with long standing kidney disease. Despite relief of obstruction via bladder catheterization, minimal renal improvement [...]

Case Presentation: A 74-year-old gentleman presented with right upper quadrant pain, nausea, fever, and chills for one-week duration. Initial workup showed simple hepatic cyst and subsequently was discharged with oral antibiotics. The patient returned a week later for persistent right upper quadrant pain and high-grade fevers. No prior history of jaundice, weight loss, intravenous drug [...]

Case Presentation: A 27-year-old man with metastatic gastroesophageal junction adenocarcinoma presents with five weeks of progressively worsening bilateral thigh pain. Admission exam is notable for a normal neurological exam. Labs are notable for CSF with malignant cells. Brain and spine MRI reveal diffuse leptomeningeal carcinomatosis. During his hospitalization, the patient develops dizziness and leg weakness [...]

Case Presentation: The patient is a 43 year old woman with Hashimoto’s thyroiditis, Addison’s disease, and ovarian cysts who presented with days of focal right lower quadrant pain and one day of nausea, vomiting, and fever. She had no diarrhea, hematochezia, dysuria, or urinary frequency/urgency. She had doubled her maintenance glucocorticoid dose as instructed when [...]

Case Presentation: A 76-year-old man with history of diabetes mellitus, atrial fibrillation, colonic adenoma, and recent self-reported bed bug infestation presents with one month of pruritic rash. On interview, he also endorses progressive edema, dyspnea on exertion, orthopnea, as well as 5 days of melena. Admission exam is notable for anasarca and diffuse, tense fluid-filled [...]

Case Presentation: A 51-year-old female presenting with increasing epigastric pain radiating to her back, nausea, and vomiting for five days. Her past medical history is relevant for coronary artery disease and CABG, type 2 diabetes, hypertension, prior tobacco use, and mood disorder. She had visited her primary care doctor the day prior to presentation with [...]

Case Presentation: A 66 year-old woman presents with three weeks of acute onset bilateral lower extremity pain and foot weakness; two weeks of dyspnea, non-productive cough, epistaxis; and one week of oliguria and lower extremity edema. Her past medical history includes COPD, prior heavy tobacco use, and pre-diabetes. Medications and allergies are non-contributable. Her father [...]

Case Presentation: A 27-year-old man with metastatic gastroesophageal junction adenocarcinoma presents with five weeks of worsening thigh pain. Labs are notable for CSF with malignant cells. Brain and spine MRI reveal diffuse leptomeningeal carcinomatosis. His course is complicated by severe pain that requires increasing doses of opioids. During his hospitalization, the patient develops worsening headaches, [...]