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PATHOLOGIC QUIZ CASE 1 Luiz F. Perez De Moura, MD, and Royal C. Hayden, Jr., MD, Detroit In April 1963 a 68-year-old woman complained of autophony and blockage in the left ear that started during an upper respiratory infection. Examination showed a left serous otitis media that was treated by myringotomy, self-inflation, and polyethylene tube through the drum. This condition improved until August 1963 when the tube was removed, following which the fluid recurred. At the same time she was seen in the Ophthalmology Department for diminished vision and fogginess for six months, but the examination was negative. One year later, with a complaint of loss of appetite and two weeks constipation, she was admitted to the hospital for possible malignancy. The patient was confused and uncooperative. Psychiatric examination suggested a brain tumor. No localizing signs were noted except lethargy and drifting coma. After being semicomatose for five days, she

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