This case involves a middle-aged male patient in Idaho who had a previous medical history significant for diabetes and hepatitis c, who had been under the care of an Advanced Registered Nurse Practitioner. He was taking multiple medications to treat his condition, including Onglyza. At one point, the patient developed a worsening persistent cough, with swelling of his lower face and neck as well as upper shoulder and neck pain. The nurse practitioner treated him with hydrocodone for pain, as well as repeated course trials of different antibiotics. After several months of no improvement, the patient was referred to another clinic. At the new clinic, the patient was seen by a physician assistant who managed and followed his care for diabetes and hepatitis. Years passed by with the patient still complaining of throat pain and enlargement; however, no further studies nor investigations for the neck swelling were carried out. Eventually, another provider at the clinic noticed the swelling in the patient’s neck and promptly referred him to a surgeon. Further workup revealed the patient suffered from Stage IV thyroid cancer, requiring a complete thyroidectomy.
