Indexing Title: JMDEGUZMAN’s Medical Anecdotal Report [04-3]

MAR Title: Patient with Anterior Neck Mass

Date of Medical Observation: May  22, 2004

Narration:

            Carlos (not his real name), a 46 year-old male consulted at the OPD two weeks ago complaining of slowly growing anterior neck mass for four years. He was previously seen at other institution wherein thyroid function test was done showing normal results. A thyroid scan was also requested. He was then advised thyroidectomy pending cardiopulmonary and endocrine clearance.

On physical examination, cardiac rate was 80 per minute, an 8cm well-defined solid mass, soft in consistency, non-tender, does not move with deglutition noted on left anterolateral neck area.

My primary diagnosis was Anterior Neck Mass, Left probably Lipoma. I referred the patient to our service consultant and approved the plan for excision.

He was then operated with informed consent one week ago without undergoing cardiopulmonary and endocrine clearance. The operation went fine and true enough we removed an 8cm well-delineated yellowish fatty like tissue, subplatysmal on location at the anterolateral neck area.

Our final diagnosis was, Lipoma, Anterolateral Neck Area, Left (99% certainty.
 

Insights (Discovery, Stimulus, Reinforcements)

A thorough and good physical examination is the most basic and most valuable tool that we as doctors must possess. Processing the evidences gathered is another thing. We are fortunate that at OMMC, Department of Surgery we are taught how by the introduction of the Patient Management Process.

We have brought patient satisfaction for not doing unnecessary laboratories, ancillary procedures, and routine pre-operative clearances saving time and money.