In from 6a-3p: only a 9 hour shift, how lucky am I?!? We had resected a few lipomas from the armpit and underarm of an unfortunate young man, and then we did a thyroidectomy with central neck dissection. First thyroid case I've seen, it was cool. It's so strange to see someone's neck cut open! There are so many things to see in the neck, so many important vessels, nerves, organs, muscles, blood vessels are there (Carotid Artery, Jugular Vein, Vagus Nerve & its branches like the recurrent laryngeal nerve, the esophagus, the trachea, lots of muscles like the sternocleidomastoid, the STRAP muscles that help us swallow, etc.). The patient had Medullary Carcinoma of the Thyroid and also many wart-like/leprosy like growths called Neurofibromas all over the skin. So we suspected that the patient may have a MEN syndrome (Multiple Endocrine Neoplasias Syndrome), so we checked for a pheochromocytoma...which was found to be negative. We expected the patient to be in the MEN2b category...There are 3 classes of MEN: MEN1 (Pituitary Cancer, Pancreatic Endocrine Tumors, Parathyroid Cancer); MEN2a (Parathyroid Hyperplasia, Pheochromocytoma, Medullary Thyroid Carcinoma), and MEN2b (Medullary Thyroid Carcinoma, Pheochromocytoma, Neurofibromatosis). The incidence of MEN2b is 1 in 40,000, so it would have been somewhat rare to have had a patient with this particular syndrome. It was an interesting case none-the-less!
I'm in tomorrow morning for rounds and then I have the rest of the weekend off (THANK GOD!!!!). I need a break from it for a few days!!!!
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