I LEAVE IT AT THE FOOT OF MARY

WE THANK GOD THAT HE ANSWERED OUR PRAYER FOR DON TO BE SPARED OF RADIATION
BUT THERE IS NO CERTAINTY THAT THE TUMOR WILL NOT GROW AGAIN.IN FOUR MONTHS TIME DON WILL HAVE TO UNDER A CT SCAN ...AND EVERY 4 MONTHS THEREAFTER

DEAR ALL
HEREUNDER IS THE LONG AWAITED REPORT OF DR CHRISTOPHER CHEN OF CLEVELAND CLINIC
WESTON CITY. HE IS THE RADIATION ONCOLOGIST THAT DR SAVAGE ASKED TO SPEAK WITH US

HE REFERRED PAPA TO MR THYMOMA IN INDIANA..DR PATRICK LOEHRER.

WE HAVE AN APPOINTMENT ON APRIL 12 1 PM INDIANAPOLIS
THE APPOINTMENT AGENDA IS WITH REGARDS TO THE MARGIN BETWEEN THYMOMA STAGE 2 AND THYMOMA STAGE 3 AND NEED FOR RADIATION AND THE CONSIDERATION OF A CLINICAL TRIAL

AS OF TONIGHT PAPA IS THINKING TWICE ABOUT GOING TO INDIANA
ONE STEP AT A TIME

TESS A OF ALBANY HAS OFFERED TO MEET US IN CHICAGO AND LIEZEL THE DAUGHTER OF MANOY HAS OFFERED TO DRIVE US TO INDIANA FROM CHICAGO

CHRIS IS LOOKING INTO JOINING US FOR THE DOCTORS VISIT
WEST VIRGINIA IS NOT FAR FROM INDIANA

TIYEN SORRA HAS PROPOSED THAT WE CONSIDER A NEURO ONCOLOGIST INSTEAD OF GOING TO INDIANA WE SHOULD GO TO BALTIMORE .

WE ALSO HAVE AN ORDER FOR THE PULMO FUNCTION TEST BY THE NEURO DR MICHEL PULLEY
DON SAYS HE WILL DO THIS IN MANILA

WE WISH TO FLY BACK ON APRIL 9TH WHICH WILL BE ABOUT 6 WEEKS POST SURGERY
IF SO THEN WE WILL NOT GO TO INDIANA
IF WE GO TO INDIANA WE MAY HAVE TO DEPART ABOUT APRIL 16TH
NO FINAL DECISION YET

FOR TONIGHT ...I LEAVE IT AT THE FOOT OF MARY

CHEERS
MAMA /TITA MED/MED





Hi Mr. and Mrs. Villanueva,

I have reviewed the pathology report, which shows early stage II disease.

I therefore do not recommend radiation therapy.

Instead, I recommend CT scans of the neck/upper chest every 4 months.

You should follow-up with a neurologist as well and have him order these tests.

Best wishes!

Christopher Chen



"FINAL DIAGNOSIS
CLEVELAND CLINIC FLORIDA, WESTON, FL (S10-2320)
Thymus gland, excision
-Lymphocytic-rich thymoma (predominantly WHO type B1), focally
invasive (see comment)
COMMENT
The tumor is composed of multiple lobules of polygonal large
epithelial cells in a prominent background of lymphocytes. The
tumor focally extends into the pericapsular fibroadipose tissue
and is adherent to the visceral pleura of the lung tissue present
with the specimen. The peripheral margins are negative (less than
0.1cm) The pathologic stage is T2 (tumor invades pericapsular
connective tissue ) NX MX (stage ll). Immunohistochemical stains
for cytokeratins CAM 5.2 , AE1/AE3 and 5/6 were performed at the
Cleveland Clinic Ohio for the evaluation of this case. Dr. James
cook has also reviewed selected slides from this case and
concurs.
Electronically signed by A. Valeria Arrossi, MD