[net.med] Answer to Medical Puzzle #4

werner@aecom.UUCP (Craig Werner) (01/11/86)

[Oops, Sorry to those of you who thought you missed this posting because I
forgot to post it when I posted Puzzle #5.]


> 	Since people's skin color varies, to determine the extent of jaundice,
> you examine the whites of the patients eyes.  One eye is almost orange.  The
> other is totally normal-looking, showing no signs of jaundice.  In addition,
> the non-jaundiced eye is not responsive to light.

	There is only one way an eye could escape being jaundiced, and that's
if it's not connected.  Since unconnected eyes don't last too long, the other
possibility is that it's fake -- which it is, and Glass Eyes don't respond to
light.   That was the non-medical part of the puzzle. And congratulations to
mlf@panda (Matt Fichtenbaum), trudel@caip (Jonathan D. Trudel), and 
hollombe@ttidcc (Jerry Hollombe).

	Given a glass eye, then you have to make the medical leap. The most
common reason for removing an Eye surgically is Cancer of the Retina, the
most common metastatic cancer of the retina is Malignant Melanoma, and one of
the favorite sites for distant metastases of malignant melanoma is, you
guessed it, the Liver.

	Most likely diagnosis:  liver metastases of a malignant melanoma
derived from the retina.
	
	I should note that this is a rare but not unheard of condition. John
Wurzelmann has seen two. A friend at another Medical School called me back
two days after I told her this story, to say they had a patient with the
above at their hospital, and a saying amoung the housestaff, "Beware of man
with one jaundiced eye."
-- 

				Craig Werner
				!philabs!aecom!werner
    "Never attribute to malice what can be adequately explained by stupidity."