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Helpful Brainfarts 1

Nov 24, 2008 - 0 comments
Tags:

ice pack

,

Neck lump



As I am trying to deal with this lump thing behind my incision, I re-read some of the tips from the wonderful members here.
1. ice packs 2. sherbert 3. try to keep head elevated a bit when lying down.

That brings me to my 'brainfart" (am I allowed to say that? I hope so cause I get a lot of them)...........
I can't be laying around all day with ice packs on my neck, so I got my gel-pack out and rolled it around a bit to soften it up; then wrapped it diagonally (sp?) in a light weight kitchen towel and tied it loosely around my neck. I have also used my husbands big red handkerchief (clean of course) and that worked great too.

So now I can go about my business and reduce swelling at same time.
Hopefully I helped some one out here...cause that's what I like to do.
hugs and health to all



Pathology Report UPMC

Oct 27, 2008 - 0 comments
Tags:

pathology report



COMMENT:
Thank you for sharing this most challenging case with us. In our opinion the larger nodule represents an oncocytic follicular variant of papillary carcinoma. The follicles present within this lesion are large in caliber and are lined by cells that are though oncocytic, show nuclear features, namely enlargement clearing elongation, overlap, and membrane irregularities (particularly on slide A4), that are compatible with the below diagnosis.

Additionally we found at least three incidental foci of papillary  thyroid microcarcinoma present on A3 and A5 (your original slides), and A4 (our recut)

FINAL DIAGNOSIS:
Part 1: Thyroid, right lobe, lobectomy (8.3 grams) (OSS S08-7463, 10/21/2008)
     A. Papillary thyroid Carcinoma, oncocytic variant (1.5cm)
     B. Three additional foci of papillary thyroid microcarcinoma (Range : less than 0.1 cm to 0.1cm)
     C: No angiolymphatic invasion present, all foci confined to thyroid.
     D: Intrathyroidal thymus.

Part 2: Parathyroid, right excision (8.3 grams)
     A. Normocellular parathyroid
     B. Thymus with no significant Abnormalities.



Right subtotal thyroidectomy DRMC

Oct 21, 2008 - 1 comments
Tags:

right subtotal thyroidectomy

,

surgery



Surgeon: Gregory J. Roscoe MD
PREOP DIAGNOSIS: Right thyroid mass approximately 1.8 cm. skinny needle biopsy benign.
POSTOP DIAGNOSIS: Same, with an area less that 5 mm, could be papillary carcinoma variant.
OPERATION/PRODECURE: Right subtotal thyroidectomy with recurrent nerve dissection and Stryker drain place and secured. Frozen section.

TECHNIQUE: The patient was brought to the operating room and identified. Under endotracheal anesthesia the patient was adequately anesthetized. On evaluation of the neck, the patient did have fullness to the right lobe of the thyroid. The patient was prepped and draped in the usual sterile manner. A curvilinear incision was then made and taken down through the skin and subcutaneous tissues. Strap muscles were divided in the midline. Overall, dissection was then carried into the right lobe of the thyroid. The patient had a lrge mass as noted, approximately 2 cm within the lobe of the thyroid, and a small additional lobe perithyroid; apparently a benign looking parathyroid adenoma. The right lobe was dissected in the usual fashion dissecting in the midline as well as sacrificing the superior, middle and inferior lobe vasculature as well as identifying the recurrent nerve and following it to insertion in the lateral aspect of the larynx. The left lobe, overall, felt extremely soft and regular even though scanning revealed some nodularity. At that poin the lobe was submitted. A small parathyroid was reimplated on the right side. At that point the frozen section revealed a benigh adenoma within the thyroid. However, the adjacent piece appeared to be, at this point, difficult to call but a variant of papillary carcinoma. Further studies are pending. A small bit of Arista was placed as well as a Stryker darin was placed and secured with 2-0 silk. Closure was accomplised with mattress stitches of 3-0 chromic as well as skin staples. A pressure dressing was placed as well as foam tape used.

labs ERMC

Oct 13, 2008 - 0 comments
Tags:

calcium

,

T7

,

labs

,

malabsorption



Calcium 10.0
FT1 (T7) 2.8