MORNING REPORT

Hannan Khairu Anami

Diana Lestari
Sabwan Yulio

Patient H, male, 63 years old, came to AA

General Hospital (inpatient at Cenderawasih

1)
Chief complain : pain at mass below under the

right ear since 3 weeks ago

Recent Illness History

Since 3 weeks the patient felt pain and
growing at below the right ear. The pain
spread to the head, continuously, pain when
touched. The mass was as big at half baseball,
there is a surgical scar over the mass,
remove blood and pus. Patient previously
operated in the private hospital.

3 months ago, the mass was only as big as

marble, no pain, dense, immobile, had the same
as skin color, clear border, slippery surface, and
has no discharge. The mass became bigger day
by day, can not be moved and started to be
pain. Patients no change in hearing, not hard to
open mouth, and also no pain swallowing
Patients were examined at private hospitals and
recommended surgery.

Past Illness History

No history of previous tumor

Family History
No family who have tumors

Physical Examinations
General Status
General condition
: looked moderate illness
Consciousness : Composmentis
Vital signs :
BP
: 140/80 mmHg
HR : 82 x/minute, regular
RR : 24 x/minute
Temp
: 36.5 C

Head and neck : Locally status

Thorax : Normally
Abdomen : Normally
Ekstremity : Normally

Regio Bucal dextra:

Inspection : a mass below right ear, as big as half
baseball, red, tense, scar stitches have pus. ear lobe
looks slightly raised
Palpation : a mass was 3,5 x 4 x 1 cm, solid, not
immobile, warm, pain, not clear border, slippery surface.
No lymph node enlargement

Planing examination:

Blood examination
Biopsi

Hb
: 12.9 mg/dl
Ht
: 40.1 %
WBC : 11000 mg/dl
Platelet : 337.000 mg.dl

Working diagnose

parotis tumor suspect malignant stadium III

and infection
Therapy:

parotidectomy
antibiotic

THANK YOU