Case library

A 54-year-old postmenopausal woman finds a firm, painless lump in the upper outer quadrant of the right breast. It is 2 cm, hard, irregular and tethered to skin. There is one mobile axillary node.

Four hours after a total thyroidectomy for multinodular goitre, a 61-year-old woman becomes agitated with noisy breathing. The wound is tense and swollen and her oxygen saturation is falling.