Thursday, January 31, 2008

Housewatch 4.10

It's been such a long time since a new episode of House, M.D., I almost forgot about my resolution to try and explain some of the science and medicine behind the show.

This week, the woman had breast cancer. But it wasn't in her breasts, it happened to be behind her knee. So how did it get there? It wasn't metastasis. Rather, it was a developmental abnormality that left her with some breast tissue that should have been resorbed before she was born.

So, we have to digress into embryology and teratology, which is embryology gone wrong. Many tissues are created, sorted out, grown, trimmed and pruned as an embryo becomes a fetus and then a baby. In the woman's case, a small patch of breast tissue wasn't properly disposed of during development, and it later became cancerous. 35 is young for breast cancer, but they did mention her mother died of it and that the patient had a prophylactic double mastectomy.

Was that really breast milk House extracted from the knee? Yes. Risperidone can stimulate breast tissue to produce milk.

So the women's treatment became a standard course of surgery and chemotherapy.

Finally, it's worth mentioning osteopetrosis (literally, bonestone). It's rare, basically the osteoclasts, which are supposed to clip and remodel bone, are defective. Or carbon anhydrase deficiency can lead to mildly acidic blood, which alters bone metabolism.