The Worst End of Misinformation – A Case Report of Thyroid Cancer
Abstract:
Introduction: Clinical records provide an objective and comprehensive form of documentation of a patient's health history, aiming to support accurate, continuous care and communication between healthcare providers. Effective healthcare also relies on patients’ ability to understand and report their health status. Health literacy plays a crucial role. When limited, it can lead to delayed diagnoses, poor treatment adherence and misinformation.
Description: A 51−yo woman with a medical history of HT, depression, DM, osteoarthrosis, complains to the family doctor of fatigue and lively dreams. OSAS was initially suspected, prompting further investigation. Afterwards, she experienced dizziness and the feeling of “empty head”. A head-CT scan revealed small lytic lesions in the occipital bones suggestive of secondary bone metastases. Further diagnostic imaging, including thoracic-CT, identified an asymmetric thyroid gland with a hypodense nodule. The US revealed two nodules, characterized as TI-RADS 4 and 5. At this point, the patient remembered that 15 years ago had the indication to undergo FNA, due to a suspicious thyroid nodule; this was postponed because of her pregnancy status, and then it was never performed. Hurthle cell carcinoma was suspected.
Conclusion: This case highlights the complexity involved in healthcare, due to the fragmented medical records and poor inter-system communication. Furthermore, it also emphasizes the importance of promoting health literacy and capacitates patients to actively engage in their own care. The competences defining Family Medicine underscore its unique role in enhancing a longitudinal patient-physician relationship, as well as to advocate a quality healthcare that meets patient’s interests and needs.
