Ms. Gavina Moscoso from Antique was a patient of mine for her papillary thyroid carcinoma. In March, 1984, the first time she consulted me at age 63, I did a total thyroidectomy, wedged resection of the esophagus, resection of the left recurrent laryngeal nerve with sternocleidomastoid myocutaneous flap. She had her first recurrence of her papillary thyroid carcinoma then. The initial operation was done in Antique in 1981 (3 years before I did my first operation on her). Because of an esophageal leak, I did a pectoralis myocutaneous flap on April 14, 1984 with subsequent resolution of the esophagocutaneous fistula.. In 1985, she had a neck node recurrence, which I excised. She had 3 neck node recurrences thereafter, in 1986, 1988, and in 1991 (she was 70 years old at this time). In all these recurrences, I just did excisions, rather than a neck dissection. The last time I saw her was in 1991. I did not see her thereafter until a relative of hers reported to me on May 5, 2004 that in 2003, Gavina died of “old age” in her sleep. Apparently, she did not die from a recurrence of her thyroid cancer. Attached is a picture given to me by the relative showing Ms. Moscoso celebrating her golden wedding anniversary in 1992.