病人是我朋友，先說一下背景， Pathological closed fracture of right humerus Hx: AF, severe mitral stenosis <1cm on warfarin（plan換心瓣） Pet scan finding: ?multiple myeloma,metastasis are unlikely Blood test: male Tumor makers normal, SPE normal Bone marrow: normal 現在未有diagnosis 原本想做biopsy+ORIF, HA said not fit for GA, private said high risk for GA, not fit for regional block also. One of Private hospital radiologist reject for biopsy. 所以現在似乎所有方法都用盡, 仲有沒有其他機會可以接駁右手加找diagnosis？ 及這種病會否是solitary plasmacytoma? 可否跳過拿biopsy直接確診？ 主要如何醫治？ 換完心瓣可否Fit for GA?
王思齊
醫生回覆
Sir or Madam
Thank you for sending me this desperate and challenging case.
If the patient is agreeable, I can be available to provide an opinion. Please make sure that all the investigation results, including blood reports, X-ray, scan pictures, etc. are available at consultation.
Please liaise with my nurse Ms Ma at TST clinic: 2398 2233.
王思齊醫生(男)
王思齊醫生(男)