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17024 Surgery

Kamli Rani, 75-years -old woman present with post myocardial infarction after 6 weeks mild CHF. There was past H/O neck surgery for parathyroid adenoma 5 years ago, ECG shows slow atrial fibrillation. Serum Ca2+ 13.0 mg/L and urinary Ca2+ is 300 mg/24 hr. On examination there is small mass in the Para tracheal position behind the right clavicle. Appropriate management at this time is:

ARepeat neck surgery
BTreatment with technetium-99
CObservation and repeat serum Ca2+ in two months
DUltrasound-guided alcohol injection of the mass
Surgery
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