Hematology - Oncology
Sample Name: Parathyroid Adenoma Excision
Description: Excision of right superior parathyroid adenoma, seen on sestamibi parathyroid scan and an ultrasound.
(Medical Transcription Sample Report)
PREOPERATIVE DIAGNOSIS: Right superior parathyroid adenoma.
POSTOPERATIVE DIAGNOSIS: Right superior parathyroid adenoma.
PROCEDURE: Excision of right superior parathyroid adenoma.
ANESTHESIA: Local with 1% Xylocaine and anesthesia standby with sedation.
CLINICAL HISTORY: This 80-year-old woman has had some mild dementia. She was begun on Aricept but could not tolerate that because of strange thoughts and hallucinations. She was found to be hypercalcemic. Intact PTH was mildly elevated. A sestamibi parathyroid scan and an ultrasound showed evidence of a right superior parathyroid adenoma.
Prior to the procedure, a peripheral blood sample had been obtained and placed in a purple top tube labeled "pre-excision." It was our intention to monitor intraoperative intact parathyroid hormone 10 minutes after removal of this parathyroid adenoma. However, we could not obtain 3 cc of blood from either the left foot or the left arm after multiple attempts, and therefore, we decided that the chance of cure of hyperparathyroidism by removal of this parathyroid adenoma was high enough and the improvement in that chance of cure marginal enough that we would terminate the procedure without monitoring PTH. The neck was irrigated with saline and hemostasis found to be satisfactory. The sternohyoid muscles were reapproximated with interrupted 4-0 Vicryl. The platysma was closed with interrupted 4-0 Vicryl, and the skin was closed with subcuticular 5-0 Monocryl and Dermabond. The patient was awakened and taken to the recovery area in satisfactory condition having tolerated the procedure well.
Keywords: hematology - oncology, parathyroid adenoma, superior parathyroid adenoma, excision, sestamibi parathyroid scan, sestamibi parathyroid, parathyroid scan, sternohyoid muscles, superior parathyroid, parathyroid, sestamibi, platysma, adenoma, ultrasound, sternohyoid, thyroid, muscles,