April 2025 Cancer Rehabilitation Tumor Board-Session Recording

Video Transcription

Video Summary

In this detailed case presentation, Sameh Wu, a cancer rehab fellow, discusses a 52-year-old female patient with papillary thyroid cancer, initially diagnosed in 2021, who underwent a right hemithyroidectomy. She also has a history of thoracic outlet syndrome, seronegative rheumatoid arthritis, and Sjogren's syndrome. Her current symptoms include daily upper neck and thoracic back pain, radicular pain in the right arm, and intermittent vision blackouts, potentially indicating vascular issues like subclavian steal syndrome or cervical radiculopathy. Examination revealed poor posture and limited neck mobility. A CT scan showed an incidental finding of a right cervical rib. The team considered imaging studies, including an MRI and dynamic vascular Doppler ultrasound, to explore possible etiologies such as vascular thoracic outlet syndrome. The discussion later transitioned to a parallel case involving a breast cancer survivor experiencing severe muscle weakness post-treatment, suspected to have autoimmune implications. Participants engaged in a robust discussion on potential underlying causes, including treatment-related neuropathies. They also addressed complex cases highlighting the importance of differentiating between organic and psychosocial factors in symptomatology, emphasizing comprehensive assessment and tailored therapeutic approaches.

Keywords

papillary thyroid cancer

thoracic outlet syndrome

seronegative rheumatoid arthritis

Sjogren's syndrome

subclavian steal syndrome

cervical radiculopathy

cervical rib

vascular Doppler ultrasound

autoimmune implications