CASE 811: ADOLESCENT PHYLLODES TUMOR (PT) and a REVIEW of P T in VMU, Dr PHAN THANH HẢI, Dr TRƯƠNG THỊ NGỌC TIẾN, Dr TRƯƠNG THỊ MỸ HOÀNG, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 14 year-old female adolescent with a right breast tumor rapid progressing bigger for 4 months.

Breast ultrasound assessment was classified BI-RADS 4. Mixed tumor with cystic and solid parts, hypervascular, micro calcified, irregular border, spiculated margin. Biopsy result was benign phyllodes tumor.

But the result of histoimmunologicostaining was a malignant phyllodes tumor.

Phyllodes tumor is rare in adolescent. Only 20 cases were published in litterature. 

Two cases in adolescent [one 15 yo, another 14 yo] were published on our VMU.

In women, there were 11 cases of phyllodes tumor published on our VMU. Phyllodes tumor (1-3% breast tumor) comes from the fibrous tissue, 27 % malignant, growing rapidly with large size [ > 20 cm]. 

PTB is a very rare breast tumor in women aged 35 to 55 years. Our patient is younger but the progress of the tumor is the same in the literature: "unilateral, nodular, painless mass which has a history of the mass but that grows rapidly in the short term".

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). American Cancer Society, July 2022.

REFERENCES:

1. REVIEW CASE 763 from Dr TRƯƠNG THỊ MỸ HOÀNG, MEDIC MEDICAL CENTER, HCMC.

2. CASE 292

3. REVIEW PT CASES 794-795 from Dr TRƯƠNG THỊ NGỌC TIẾN, MEDIC MEDICAL CENTER, HCMC.

4. CASE 654

5.

6. Phyllodes tumor: American Cancer Society.

CASE 810: ESOPHAGEAL DIVERTICULUM, Dr PHAN THANH HẢI, Dr TRẦN MỘC HIỆP, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 11 year-old  male child with the suspection of a 3rd branchial cleft cyst ?

Ultrasound detected an 12x18mm air -filled cystic lesion at the posterior face of the left lobe of thyroid. Water swallowing  made the aerial cyst moving and proved it belonging an esophageal diverticulum.

Later MSCT confirmed it an esophageal diverticulum. 

Reference

CASES 808-809: BLADDER TUMOR WITHOUT SYMPTOM, Dr PHAN THANH HẢI, Dr PHẠM THỊ THANH XUÂN, MEDIC MEDICAK CENTER, HCMC, VIETNAM

 Two cases with bladder tumor without symptom detected by chance by ultrasound.

CASE 1: 

A 51 year-old man with epigastric pain in general check-up.

Ultrasound detected a 5.4 mm small tumor nearby the neck of the bladder.

Urinary bladder endoscopy confirmed the bladder tumor. And the biopsy result was an urethelial carcinoma.

CASE 2: 

A 61 year-old man without sign of urinary tract troubles.

But ultrasound detected the 4.6x3.9mm bladder tumor.

Result of biopsy was urethelial carcinoma high malignancy.

Reference:

CASE 807: GB TUMOR, Dr PHAN THANH HẢI, Dr LÝ TRƯỜNG XUÂN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 32 year-old woman with epigastric painful cramping crisis for 4 months that was failed in gastritis management. Last night the cramping pain was getting worse and nauseous feeling which made her going to Medic Center.

Ultrasound detected  two echoic masses #35x17mm and 25x13 mm into her gallbladder and GB wall thickening #13 mm. There were some lymph nodes at the liver hilus and the pancreatic head.

MSCT confirmed the GB tumor and the gastric dilatation.

Surgery removed the GB tumor and the histopathological result of the specimen were a differentiazied adenocarcinoma of the gallbladder and lymph node inflammation.

CASE 806: RCC in Young Patient, Dr PHAN THANH HẢI, Dr NGUYỄN PHƯỚC TOÀN , MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 20 year-old man in general check-up without hematuria nor abnormal symptoms.

Ultrasound detected a #37 milimeter in diameter cystic mass at posterior face of the right kidney bulging the renal capsule. Lab data were in normal range.

MSCT confirmed the # 3X4 cm cystic tumor of the right kidney, BOSNIAK IV which bulged the renal capsule.

Endoscopic surgery removed the tumor with one half of the right kidney.

Result of the microscopic specimen was a clear cell RCC.

The patient still remains well in four years later follow- up.

CASE 805: BOWEL INTUSSUSCEPTION in Elderly Patient due to POLYP, Dr PHAN THANH HẢI, Dr TRẦN THÙY TRANG, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 63 year-old woman with some painful cramp crisis for one month but which was  increasing more and more in one week before going to Medic Center.

Her past history noted right colectomy as infarcted colitis, managed thyroid cancer and radical hysterectomy.

Ultrasound detected the  #64x35 milimeter mass of the bowel intussusception at RLQ with vasculature of the mass that synchronously existed the GB stones and the #27 mm right adrenal tumor.

MSCT confirmed the bowel intussusception, right adrenal tumor and GB stones.

Surgery removed the bowel part with the polyp inside.

Microscopic result of the polyp was a mixed hemangioma.

Intussusception in elderly patient is usually due to a tumor and in our case that was a single polyp originated a mixed hemagioma.

REFERENCE:

CASE 804: SYNCHRONOUS GASTRIC and COLON CANCER, Dr PHAN THANH HAI, Dr PHAM CHI TOAN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 50 year-old man with loss of weight, altered bowel habit, fatigue and abdominal pain.

Ultrasound detected gastric cancer and gastroendoscopy and MSCT confirmed later.

Gastric endoscopy and biopsy result.

MSCT

But there was a tumor of transverse colon which was proved by colonoscopy and histoanatopathological result.

Synchronous gastric and colon cancer is still rare, # 2.5% in male patient within 6 months.