Boss Case
Follow a case through a sequence of decisions. Read the history, work through each stage, and finish with the case’s collected teaching points.
What you will practise
- Combine history with imaging findings.
- Make a sequence of reasoned decisions.
- Review the full case rather than only the score.
This week’s case
Each case includes staged questions and an end-of-case debrief.
The Marrow-Packed Patient
A man with heavily pretreated metastatic castration-resistant prostate cancer has a rising PSA, widespread PSMA-avid skeletal disease and a leucoerythroblastic blood film. Diffuse tumour infiltration of the marrow and borderline blood counts had excluded him from a 177Lu-PSMA trial. His team asks whether alpha therapy is defensible - or reckless - in someone whose marrow is already failing.
3 decisions