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Mitchell Bernstein, M.D.
JAMA. 1930;95(15):1098-1099. doi:10.1001/jama.1930.27210150004011c.
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The diagnosis of intrathoracic cancer in a patient with a deformed chest obviously offers many difficulties. This is especially true in a patient with thoracic deformity when the subjective symptoms suggest the diagnosis of pulmonary tuberculosis with atypical signs. In addition, the pathologic involvement of several cranial nerves further complicates the clinical picture. However, the diagnosis of possible pulmonary cancer with cerebral metastasis, as occurred in the case herein reported, should not be overlooked.


History.  —E. C., a man, aged 48, was admitted to the service of Dr. Bernard Kohn at the Jewish Hospital, Jan. 29, 1930, because of a chronic productive cough together with weakness, night sweats, slight fever and headache. These symptoms had existed for about four weeks prior to admission.During infancy the patient sustained an injury to the upper spine, the exact nature of which was unknown. This injury supposedly resulted in the


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