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+A 75 yo M w/ metastatic papillary thyroid cancer s/p XRT 19 sessions who presented with 2 days of worsening dysphagia for solids, poor oral intake, weight loss 20 pounds over last several weeks and some lethargy.
+Papillary thyroid cancer dx w/ right neck mass
+--s/p neck mass resection; unable to perform thyroidectomy
+--high bleed risk, proximity to trachea and recurrent laryngeal nerve and large tumor size
+--s/p XRT to neck 
+--s/p RAI ablation
+--Metastatic to lymph nodes and adrenal glands
+* s/p hernia repair
+* s/p tonsillectomy
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