TY - JOUR T1 - IMage of the month—quiz case AU - Lieberman SM, Vouyiouklis M, Elangovan S, Morris LT Y1 - 2011/07/01 N1 - 10.1001/archsurg.2011.158-a JO - Archives of Surgery SP - 879 EP - 880 VL - 146 IS - 7 N2 - A 41-year-old man presented with a 1-year history of a slowly expanding right neck mass (Figure 1). During the past few months, he had also developed diffuse bone pain and had recently begun to use a cane to walk. The patient's medical history was significant for end-stage renal disease as a sequela of Wegener granulomatosis; he had been receiving hemodialysis for more than 10 years. Five years ago, the patient underwent neck surgery, although he was unable to provide specific details. Physical examination revealed a transverse Kocher incision and a 2-cm round, mobile mass in the right neck at level III. Laboratory testing revealed hypercalcemia (total calcium level, 11.7 mg/dL; reference range, 8.0-10.4; to convert to millimoles per liter, multiply by 0.025) and elevated parathyroid hormone level (>2500 pg/mL; reference range, 12-65 pg/mL). SN - 0004-0010 M3 - doi: 10.1001/archsurg.2011.158-a UR - http://dx.doi.org/10.1001/archsurg.2011.158-a ER -