MKSAP: 38-year-old man with a mass in his right neck

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old man is evaluated for a mass in his right neck that he first noticed 2 weeks ago while shaving. The patient also reports experiencing a pressure sensation when swallowing solid foods for the past year and daily diarrhea for the past 2 months. His personal medical history is unremarkable. His younger brother has nephrolithiasis, and his father died of a hypertensive crisis and cardiac arrest at age 62 years while undergoing anesthesia induction to repair a hip fracture. On physical examination, vital signs are normal. A mass is palpated in the right lobe of the thyroid gland. No cervical lymphadenopathy is palpable. Results of laboratory studies show a serum calcium level of 10.6 mg/dL (2.7 mmol/L) and a thyroid-stimulating hormone level of 1.9 µU/mL (1.9 mU/L). A chest radiograph is normal. A thyroid ultrasound confirms a 1.4-cm mass in the right lobe of the thyroid gland. Which of the following is the most likely diagnosis? A: Benign familial hypocalciuric hypercalcemia B: Multiple endocrine neoplasia type 2 C: Parathyroid cancer D: Sarcoidosis Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Endocrinology Source Type: blogs