Patient History A 42-year-old woman was diagnosed with breast cancer 8 years ago. She underwent the right radical mastectomy. The tumor was infiltrating ductal carcinoma with 2 out of 12 lymph nodes positive She received six cycles of adjuvant 5fluorouracil, epirubicin, and cyclophosphamide. Later radiation therapy was given to her chest wall She was on tamoxifen for 5 years The patient was presented with asthenia.
Examination Physical examination reported hepatomegaly, splenomegaly extending into umbilicus Cancer antigen CA15-3 level was 80UI/mL CT and MRI images showed lung metastases with hypodense nodule in liver Patient's blood count showed Hyperleukocytosis at 355 × 109/L Neutrophil count of 152 × 109/L Hemoglobin level was 10.6 dL Platelet count 264 × 109/L. Bone marrow aspiration confirmed myeloproliferative disorder. Medullary karyotype showed the presence of the translocation…
