CASE 905: LUMP of GOUT in HAND, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 An old man suffers from gout for a long time with his tophus [stone] lump on the right hand but now  that makes pain and he could not move the second finger. EULAR GOUT SCORE # 15 >8.0

X-ray and MRI show the erosions of the metacarpal and second phalanx bones close the tophus lump.

And a 33MHz ultrasound probe notes the tophus lump in hand in more details.

Joint deformity and limitation of motion in affected joint may occur if several attacks of gout occur each year. Uric acid deposits called tophi develop in cartilage tissue, tendons, and soft tissues. These tophi usually develop only after a patient has suffered from the disease for many years. Deposits also can occur in the kidneys, leading to chronic renal failure. 

https://medlineplus.gov/ency/imagepages/19833.htm

REFERENCES:

https://goutclassificationcalculator.auckland.ac.nz/

https://pmc.ncbi.nlm.nih.gov/articles/PMC11348250/n

https://radiopaedia.org/articles/gout

CASE 904: UTERINE SARCOMA, Dr PHAN THANH HAI, Dr NGUYEN THI TRINH, MRDIC MEDICAL CENTER, HCMC, VIETNAM

 A 57 year-old woman with bloting for 2 months and uterine fibroma which was known about 6 years. She got also hyperthyroidism but no clue of tuberculosis.

Ultrasound detected a #104x72mm uterine tumor, some #19×13 and 16x12mm necrotic inguinal lymph nodes and malignant ascites.

Lab data:

DISCUSSION:

Sarcoma of uterus always gets  big size rapidly, solitary,  its great dimension > 8 cm, cystic necrosis.

CASE 904: RECURRENCE of PHEOCHROMOCYTOMA, Dr PHAN THANH HẢI, Dr LÊ VĂN TÀI, MEDIC MEDICAL CENTER, HCMC, VIETNAMADRENAL TUMOR

 A 34 year-old arterial hypertension woman with HTA, tachycardia, fatigue, headache. She had undergone an endoscopic surgery 18 years prior for pheochromocytoma.

Ultrasound detected a # 25mm hypoechoic tumor nearby the IVC. Some surgical clips of prior surgery were seen close the tumor.

MRI confirmed a recurrence of pheochromocytoma.

She was removed the recurrent pheochromocytoma by via robot surgery.

CASE 903: COLON CANCER in Young Patient, Dr PHAN THANH HAI, Dr NGUYEN VAN HIEN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 36 year-old man with right flank pain for 2 months.

Ultrasound detected a right colon tumor which was suspected a GIST colon.

Colonoscopy and MSCT confirmed a transverse colon tumor.  MSCT noted the colon tumor invaded  mesentery and lymph nodes.

Lab date was not interesting.

Colonoscopy in the second time and biopsy result confirmed  a moderate differentiated adenocarcinoma of the transverse colon.

Endoscopic surgery removed the colon tumor.

Rejuvenation of the colon tumor may be in relation of the modern way of lifestyle.

CASE 902: INFANTILE THYROID CANCER: Dr PHAN THANH HAI, Dr NGUYEN XUAN HOANG, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 11 year-old boy, with a thyroid tumor for 2 years.

Ultrasound of thyroid detected a #19×17×21mm right lobe solid hypoechoic tumor # TI-RADS 5. Some metastase cervical hypervascular lymph nodes.

A year later the  PTC on the right lobe of thyroid was getting bigger.

Thyroidectomy and removing metastase lymph nodes group VI and radiation therapy were performed.

CASE 901: FISHBONE MIGRATING in SUBMANDIBULAR REGION, Dr PHAN THANH HAI, Dr LE VAN TAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 35 year-old man with his right swollen lower face for 3 weeks after perch fishbone choking. He was removed the fishbone but the pain relapsed after 2 weeks.

Ultrasound detected a # 11,3x3mm fishbone into the right submandibular gland.

MSCT confirmed the fishbone in the right upper submandibular region.

Surgery removed successfully the fishbone in the right submandibular gland.

Removing of fishbone by oneself may push it anywhere.

CASE 900: COEXISTING of GASTRIC GIST and LEIOMYOMA, Dr PHAN THANH HAI, Dr TRAN THI BAO CHAU, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 A 70 year-old woman with feeling of being gassy.

Ultrasound detected a # 45x21mm hypoechoic tumor of the gastric cardia.

MSCT and endoscopy confirmed the  45×21mm gastric tumor.

Gastroendoscopy noted a  cardia tumor pushed from outside. 

But endoscopic surgery detected another gastric GIST tumor of  the together the cardia tumor.

Results of the specimen with immunochemistry staining were a leiomyoma of the cardia coexisting of a GIST tumor of the gastric tuberosity.