BROOKHAVEN NATIONAL LABORATORY | Name U HOSPITAL of the MEDICAL RESEARCH CENTER NO. NIT NO 8-18-89 R UPTON, NEW YORK DISCHARGE SUMMARY = PAVILION 1 OPD -2range of normal. Pollowing TSH administration (10 units daily for 3 days) the thyroid uptake of 131 Tt had showed a good increase. However the serum thyroxin level did not show any increase over the pre TSH atimulation level. X-ray of the chest showed extrinsic presaure on the trachea, probably from Do Not Wate In Binding Margin thyroid enlargement. The basal metabolic rate was -8. laboratory findings were essentially negative. The remainder of the HOSPITAL COURSE: His hospital course was uneventful, FINAL DIAGNOSIS : Adenomatous goiter. The following thyroid experts were consulted: Dr. J.E. Rall and Dr. J. Rbbins of NIH, and Dr. B. Colcock of Lahey Clinic, Boston. The consensus was that surgical removal of diseased thyroid tissue was indicated. The patient was transferred to the New England Baptist Hospital in Boston on August 18, 1968 and under general anesthesia the thyroid gland was explored on August 20th. The gland was found to be grossly multinodular with many cystic areas and a subtotal thyroidectomy was performed. Microscopic examination by Dr. W.A. Meissner of the New England Deaconess Hospital resulted in a diagnosis of “adenomatous goiter". Recovery from surgery was uneventful and the patient was transferred back to this hospital on August 25th. The surgical wound healed nicely and the patient was placed on L-Thyroxin (Synthroid, 0.3 mg. daily). He was discharged from the hospital on August 30, 1968 to travel back to his home in the Marshall Isiands. DISCHARGE MEDICATION: To continue thyroid medication for life, The patient was given ample hormone supply to last him for approximately a month. A note was sent to the Marshallese practitioner who will be in charge of the patient stressing the importance of continued thyroid medication, Met @ Cao Robert A. Conard, M.D. RAC :mam Dict: 9-13-68 Typed: 9-16-68 BNL 720A - 70 -