CASE 830: PANCREATIC CANCER and a REVIEW of the PERITONEAL CARCINOMATOSIS, Dr PHAN THANH HẢI, Dr TRẦN NGÂN CHÂU, MEDIC MEDICAL CENTER, HCMC, VIETNAM

A 58 year-old man with epigastric pain and flatulence for one month.

Ultrasound detected a # 21x27mm hypoechoic tumor of the pancreatic body and peritoneal carcinomatosis [PC]: large amount of malignant ascites, metastatic lymph nodes and peritoneal cake.

Lab data showed raised CA 19-9 : 807 U/mL and CA 125: 95.7U/mL

MSCT confirmed the peritoneal carcinomatosis.

Surgery was done for the peritoneal node biopsy. The result was an adenocarcinoma grade 2 metastasis with the pancreatic origin.

Surgical report noted many  # 10mm nodes seeding on the peritoneum that made retractile the  epiploon and the mesentery. There was a #80 mm hard mass seemed to be the primary tumor at the mesenteric root of the transverse colon.

DISCUSSION :

Ultrasound detects easily the PC but difficultely finds out the origin of the PC.

There were 3 published cases of extraovarian primary PC,

2 published cases of malignant mesothelioma,

1 published case of mucinous carcinoma (unknown the origin),

In total, 5 cases of not having the origin, 1 case of unknown the origin. (PLS view cases 128, 164, 298, 332, 448).

CASE 829: ACCESSORY TARSAL NAVICULAR BONE, Dr PHAN THANH HẢI, Dr MÃ NGUYỄN MINH TÙNG, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

A 48 year-old man with his swollen right ankle pain for one month. His past history denies any clue of trauma or arthritis.

 Vascular ultrasound of the right ankle detected normal result  but it existed only an amount of collected fluid around his right ankle.

Lab data and tarsal X-ray were normal.

But MSCT and MRI detected an accessory tarsal navicular bone.

REFERENCE:

https://www.foothealthfacts.org/conditions/accessory-navicular-syndrome-(1)

CASE 828: COLONOURINARY BLADDER FISTULA due to DIVERTICULITIS , Dr PHAN THANH HẢI, Dr NGUYỄN KIM HIẾU, MEDIC MEDICAL CENTER, HCMC, VIETNAM

A 51 year-old man with dysuria with bloody urine for 2 weeeks.

Ultrasound detected thickening wall of sigmoid colon which adhered the urinary bladder. And there was a fistula between with air into the urinary bladder.

MSCT  and cystoscopy confirmed a colonourinary fistula.

Result of specimen post-op of the endoscopic surgery was a perforated diverticulitis which made a fistula into the  urinary bladder wall.

CASE 826-827: PARATHYROID TUMOR, Dr PHAN THANH HẢI, Dr LÝ VĂN PHÁI, BS HỒ KHÁNH ĐỨC, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Two cases of parathyroid tumor detected by ultrasound. The parathyroid tumor were solid, hypoechoic pattern while in normal case of  parathyroid gland may seen with hyperechoic pattern. Sometime it is mimiking as a thyroid nodule.

PTH and  blood calcium were decreased their values when the parathyroid were removed.

 

Case 1

Case 2

CASE 825: SEMINAL VESICLE TUMOR, Dr PHAN THANH HAI, Dr NGUTYEN MINH THIEN, MEDIC MEDICAL CENTER. HCMC VIETNAM

A 44 year-old HBV-infected man with dysuria for months but no fever.

TRUS detected a mass # 34x37mm beside the right seminal vesicle.

But 2-time-biopsy results were not related to a retroperitoneal cancer.

 The mass was getting bigger so a pelvic 

 surgery was done to remove the mass.

 

The final result post-op was an retroperitoneal epithelial cyst. 

 

CASE 824: THYMUS CARCINOMA, Dr PHAN THANH HẢI, Dr HUYNH ĐứC TH ỤC ĐOAN, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 A 57 year-old man with thoracic wall pain for 6 months  that failed in analgesic management. No dign of myasthenia .

MSCT detected  destruction of the sternum and an anterior mediastinum tumor maybe thymic cancer.

Core biopsy with guided ultrasound results were poor differentiated thymus carcinoma.

Histoimmunochemistry staining confirmed a thymic squamous cell carcinoma.

CASE 823: PERFORATED STOMACH due to FISHBONE, Dr PHAN THANH HẢI , Dr VÕ THỊ THANH THẢO, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 61 year-old man with epigastric pain last month.

Ultrasound detected accidentally a # 26 mm fishbone which perforated his stomach. On transverse section the fishbone looked like a gastric ulcer. Lab data were in normal values.

MSCT confirmed a fishbone perforating the stomach with the free end into the abdominal cavity.

Endoscopic surgery removed the fishbone from the pyloric wall of the stomach to the peritoneum.