Chapter 785 - 366: Tumor Within a Tumor, Mysterious Persistent Fever and Chest Pain

Chapter 785: Chapter 366: Tumor Within a Tumor, Mysterious Persistent Fever and Chest Pain

Li Jingsheng carefully examined the patient’s detailed information.

The patient was over fifty years old.

Generally speaking, the older you are, the higher the risk of cancer.

For men over 40, body functions decline significantly, and the risk of cancer increases sharply. This is also why many doctors recommend that men over 45 undergo annual gastrointestinal endoscopies and various screenings for major diseases.

The male patient reported symptoms of coughing and shortness of breath, and sometimes a burning sensation between the chest and back.

The symptoms had lasted for almost three months.

After examination, the attending doctor found the patient had paroxysmal coughing with expectoration of small amounts of white viscous sputum and a low-grade fever of 37.5 degrees.

A persistent low-grade fever is a very bad sign.

Li Jingsheng always felt a bit on edge when encountering such patients.

Because the final diagnosis often turned out poor.

Besides the low-grade fever, the man had another serious issue, losing 4.5 kg in three months.

He also experienced difficulty breathing while eating.

Especially during inhalation, it became particularly difficult, as if someone was choking him.

No wonder Director Lian Tao suspected the man’s esophageal tumor was not benign.

The patient’s pulse was 101 beats per minute, which is considered fast.

In clinical medicine, a heart rate of 98 beats per minute is equivalent to 101 beats in terms of diagnostic criteria. Doctors often diagnose a rapid heart rate.

Rather than dogmatically considering 60–100 beats per minute as normal.

At the same time, the patient’s blood pressure also showed elevated levels.

Systolic pressure was 145 mmHg, and diastolic pressure was 88 mmHg.

This is another borderline blood pressure value.

The textbook definition of hypertension is a systolic pressure exceeding 139 and a diastolic pressure exceeding 90 mmHg.

Although this patient exceeded it by only 6 mmHg, it already falls under the category of mild hypertension.

The ideal blood pressure is 120 systolic and 80 diastolic.

Too high or too low is not a good thing.

The lung sounds examination revealed scattered wheezing sounds.

The heart rhythm was regular.

Li Jingsheng also looked at the patient’s blood routine results; the white blood cell count was as high as 13.4 times ten to the ninth power per liter, significantly above normal.

The liver function of the patient was normal, kidney function showed blood urea nitrogen at 19.7 mmol/L, while other electrolytes, fasting blood glucose, and blood uric acid levels were all normal.

"Was a fiberoptic esophagus check done?"

"Yes! The results should be at the bottom!"

Director Lian Tao replied.

Li Jingsheng checked the endoscopic results, finding a circular mass on the anterior wall at 24 cm from the incisors, roughly three centimeters in diameter. The surface mucosa was smooth, the folds had disappeared, presenting a light red transparency.

The mass could move slightly as the patient swallowed.

The boundary was clear.

This tumor should undoubtedly be an esophageal leiomyoma.

The endoscopy only found this one tumor.

Li Jingsheng did not find direct evidence for a malignant tumor and, like Director Lian Tao, he was also puzzled.

Lost in thought, he couldn’t help but recall the child of Secretary Bei who was recently transferred to the People’s Hospital for rescue.

The cause of that child’s illness was also extremely obscure.

An encapsulated fungus masquerading as a virus had infiltrated the child’s cranial space to wreak havoc.

Could this tumor also be fishy?

"Esophageal leiomyomas don’t usually grow very large, but this tumor’s diameter exceeds three centimeters, and its raised height is unusual for esophageal muscle tumors. Could it be a ’tumor within a tumor’?"

Li Jingsheng could only think of that possibility.

Because, in the early stages of a malignant tumor, the body’s nutrient absorption is not significant, and weight loss is unlikely.

It’s really possible that there is a malignant tumor, either not in the esophagus but elsewhere in the body.

Or it could be a tumor within a tumor.

On the outside, it appears as a benign leiomyoma, but it could harbor a malignant tumor inside.

Though such cases are extremely rare, they are still possible.

Like someone harboring malicious intent while appearing to be a gentleman on the surface.

"A tumor within a tumor?"

Lian Tao’s eyes lit up slightly.

"It’s really possible. I have to communicate with the patient and arrange for a biopsy."

He needed to obtain pathological specimens from inside the tumor for testing.

Normally, samples are taken by scraping off some superficial tissue cells.

"Jingsheng, there are two other cases here, both challenging. Could you help consult on them? I’ll make a quick trip to the ward; I should be back in about half an hour. If you’re thirsty, you can help yourself at the water fountain. There are plenty of snacks in this drawer; feel free to have some."

After saying that, he hurried out.

Having his own office is quite comfortable.

It’s like having a private space.

Ordinary doctors have to share one office, and many don’t even have a fixed spot. 𝒻𝑟ℯℯ

That’s why those who have affairs in hospitals are often department heads or hospital-level leaders. Having a separate office makes it convenient for female subordinates to come in for work reports.

As long as the woman agrees, there aren’t many obstacles.

Li Jingsheng watched Lian Tao hurry towards the inpatient ward and couldn’t help but smile and shake his head, thinking that Lian Tao’s decisive personality must be appreciated by patients.

It also reflects putting patients at the forefront of his mind.

He began to review the other two cases.

The patient was male, 18 years old, and experienced severe pain when swallowing, accompanied by a high fever of 39.7 degrees.

The inquiry information stated that the swallowing pain had persisted for over a month.

But the patient didn’t seek hospital treatment until experiencing breathing difficulties.

After being admitted at the local hospital, they took a chest X-ray, which showed no abnormalities.