Problem
Mrs. Smith was diagnosed with Stage IV breast cancer 15 months ago. She underwent chemotherapy for several months before a bilateral mastectomy was performed. She then completed six weeks of radiation therapy to the chest wall. Recently, she has been experiencing the inability to manipulate the tongue during chewing and swallowing, as well as difficulty in speech. Further investigation indicated that the left side of her tongue appeared to be paralyzed when asked to protrude her tongue past her lips. An MRI was performed and revealed a lesion present at the base of the skull that was affecting this particular cranial nerve.