Dr.

Philip Wright
Surgical Registrar
Brisbane General Hospital
765 Brunswick St. Valley
4444
QLD

06 October 2019

Dear Dr. Wright,

Re: Ms. Sandra Marcus, DOB: 15/01/1983

I am writing to refer Ms. Marcus, a 36-year-old librarian, who presented with signs and symptoms of
multi-nodular goiter. Your valuable assessment would be highly appreciated.

Ms. Marcus is a single woman with one child aged 7 years. She has been suffering from asthma for
which she uses a Ventolin inhaler. She has no known allergies.

On 05/07/19, Ms. Marcus presented a 2-month history of olive-sized swelling in her neck. On
examination, a 2x2 cm anterior neck swelling, non-tender along with moveable of deglutition was
observed.

Two weeks later, Ms. Marcus’s ultrasound revealed multiple nodules with calcification on both lobes of
her thyroid although her other blood tests were normal. Therefore, she was advised to do surgery to
rule out the malignancy and wanted one week to consider it.

On today’s visit, Ms. Marcus’s neck swelling was reported to increase in size along with a 1-week history
of hoarseness voice. On examination, enlarged lymph nodes on her right side, and firm with limited
mobility were noted. In the meantime, she accepted surgical intervention and examination of possible
malignancy.

In view of the above, I would be grateful if you could manage Ms. Marcus’s condition. Please contact me
if you have any further queries.

Yours sincerely,

Dr. Kay