CASE 761: GASTRIC SLIDING HERNIA, Dr PHAN THANH HẢI, Dr VÕ NGUYỄN THÀNH NHÂN, MEDIC MEDICAL CENTER, Dr NGUYỄN PHÚ HỮU ( BINH DÂN HOSPITAL), Dr NINH NGUYEN (USA), HCMC, VIETNAM.

 

A 71 year-old woman with cardiovascular disorders: extrasystolic, ischemic heart, aortic valve regurgitation.

Lab data: Troponin T elevated.

MSCT for 30% coronary  branches obstruction but incidentally detected gastric sliding hernia through esophageal split of the diaphragm.

Chest X-ray and barium esophage: diaphragmatic hernia.

Endoscopy confirmed  diaphragmatic sliding hernia of the stomach.

Normal Respiratory function.

Operation for gastric hernia was done and the woman remains well. 

Barium esophageal films confirmed the gastric  sliding hernia being solved post-op.

Coronary symptoms may mimick gastric signs especially in women, and in this case, coronary MSCT could also detect a gastric sliding hernia beside  the 30% stenosis of branches of coronary arteries.

CASE 759-760: GI GIST, Dr PHAN THANH HẢI, Dr TRẦN THANH NGA, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

Case 1: Jejunum GIST in a 69 year-old woman.

Case 2: Stomach GIST in a 83 year-old woman.

References:

CASE 758: PULMONARY LEIOMYOMA, Dr PHAN THANH HẢI, Dr TRẦN THỊ BÍCH THÙY, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 

A 58 year-old woman with a #53x35 mm mass at the base of the right lung was detected incidentally by ultrasound in annual check-up. The mass rubbed out the liver mirror artifact, and was proved a lung tumor in differentization from a consolidation lesion.

MSCT confirmed the right lung tumor.

Operation removed the right lung tumor.

Histopathological result was a pulmonary leiomyoma.

CASE 757: ILEOCECAL TUBERCULOSIS, Dr PHAN THANH HẢI, Dr LÊ ĐÌNH TÍN, Dr LÊ VĂN TÀI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

A 48 year-old man with RLQ pain for 3 years.

Ultrasound detected terminal ileum wall # 9 mm thickening and nephrocalcinosis due to gout.

Colonoscopy detected a diverticule of the cecum.

But MSCT represented an ileum tumor with left kidney stone.

Operation removed the terminal ileum and the right colon.

But the result  of histopathology was an ileocecal tuberculosis.

In reviewing of his past history, the patient may suffer from lung tuberculosis.

CASE 756: PHYLLODES TUMOR, Dr PHAN THANH HẢI, Dr DƯƠNG NGỌC THÀNH, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

A 51 year-old woman with a huge # 12 cm breast tumor BI-RAD 4B,  and fibroadenoma on two sides  were confirmed on breast ultrasound and mammography.

Results of 2 times of biopsy were fibroadenoma, benign tumor.

A lumpectomy performed and result was  phyllodes tumor.

Phyllodes tumors (or phylloides tumors) are rare breast tumors that start in the connective (stromal) tissue of the breast, not the ducts or glands (which is where most breast cancers start). Most phyllodes tumors are benign and only a small number are malignant (cancer).Jun 15, 2022

Phyllodes Tumors of the Breast - American Cancer Society

American Cancer Society

https://www.cancer.org › cancer › types › breast-cancer

CASE 755: PARATHYROID TUMOR, Dr PHAN THANH HẢI, Dr LÝ VĂN PHÁl, Dr HỒ KHÁNH ĐỨC, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 A woman in her 58 s with osteoarthritis pain for years but failed in management. Blood calcium raising ( 3.14mmol/l), elevated PTH, and critical osteoporosis.

Ultrasound detected a # 34x11 mm hypoechoic mass at posterior face of left lobe of thyroid maybe a parathyroid tumor. 

And many stones in both two kidneys.

MSCT confirmed the left parathyroid tumor.

Operation performed to remove the parathyroid tumor.

Histopathological result was a parathyroid tumor with intact capsule.

PTH came back of 15.89 pg/mL after removing the parathyroid tumor.

CASE 754: OVARIAN CANCER, Dr PHAN THANH HẢI, Dr TRẦN MỘC HIỆP, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 66 year-old woman with loss of weight and constipation for months.

Ultrasound detected a # 86x106 mm right pelvic cystic tumor which was in front of the sacrum-coccyx and elevated the rectum from behind. It may a GIST but could not ruled out of an ovarian tumor.

Both two kidneys were in hydronephrosis without stone, may due to be pressed in pelvic region.

Lab data were not interested.

MSCT represented an 9x10 cm ovarian tumor and vegetations in the pelvis which caused the hydronephrosis .

Surgery removed the ovarian tumor FIGO IIB, uterus, anexals, rectum and sigmoid colon, epiploon, and an arteficial anus was made.

Histopathologic result was Retroperitoneal malignant tumor [high grade adenocarcinoma], primary peritoneal cancer.

Remaining well post-op, the patient was going through a chemotherapy planning.