CASE 559: WARTHIN TUMOR, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

MAN 62 YO WITH HISTORY OF 2 YEARS AGO  SLOW GROWTH AT RIGHT PAROTID GLAND  NO PAIN NO DISTURBE  OF MASTICATION. 

ULTRASOUND  REPORT

US 1: ONE MASS AT SUPERFICAL LOBE OF RIGHT PAROTID GLAND # 3 CM HYPOECHOIC.

US 2 :  DILATATION OF SALIVARY DUCT.

US 3 : SMI  SHOWS MORE VASCULAR MICROSTRUCTURE NO LYMPH NODE AROUND.

US 4 : ELASTOSCAN THIS TUMOR IS SOFT PATTERN.

MS CT with CE = THIS TUMOR IS ENHANCED VERY HIGH, WELL LIMITED  BORDER, CT 1 CT2 CT3 .

OPERATION for PAROTIDECTOMY.  SEE MACRO  TUMOR IS NECROTIC CENTRAL

MICROSCOPIC REPORT IS WARTHIN TUMOR.

FOTO OF  PATHOLOGIST ALDRED SCOTT WARTHIN

REFERENCE CASE.

CASE 558: OVARIAN TUMOR but RISING CA 19-9, Dr PHAN THANH HAI, Dr LE DINH TIN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

WOMAN  39YO  SINGLE, WITH  PELVIS PAIN

ULTRASOUND  DETECTED  LEFT OVARY CYST  SIZE 4 CM, CLASSIFIED IOTA 3   SUSPECTED  ENDOMETRIOSIS OF LEFT OVARY.  

US 1=   CYST  MIXED   SOLID.

US2 = ELASTO  SUSPECTED  BENIGN CYST.

ROUTINE BLOOD TEST   HAD  CA19-9  VERY HIGH VALUE  MORE THAN 1000 UI, CA 125 = 32 UI.

MSCT OF ABDOMEN WITH CE 

CT1:  PELVIS   HAD CYST OF LEFT OVARY  LOOKED LIKE SIMPLE CYST. 

CT2 :IN UPPER ABDOMEN,  LIVER,  BILIARY SYSTEM AND PANCREAS ARE NORMAL.

LAPAROOPERATION   REPORTED  LEFT OVARY CHOCOLATE CYST  THAT SUSPECTED  ENDOMETRIOSIS.

MICROSCOPIC REPORT OF THIS CYST IS   ENDOMETRIOSIS CYST.

LAB TEST AGAIN AFTER 2 WEEKS  OF OPERATION  THE CA19-9 DROPPED DOWN TO 123 UI.

CONCLUSION :  ENDOMETRIOSIS CYST RISED VERY HIGH CA-19-9 VALUE  WHICH IS RARE CASE

UNKNOWN REASON. 

REFERENCE CASE .

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CASE 557: LEG TUMOR, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

Man 51 yo  detected  his right ankle  pain and swollen, difficult to walk  ( see photo). There is a   mass at achille tendon with small skin nodule ).

Ultrasound  scan of  this mass.

US 1=  this mass is solid, #5 cm  round bordered, displacing achille tendon)

US 2 = vascular supply from peripheric wall   

US 3 =  SMI can see  more vascular structure intra tumor   

US 4  = ultrasound detected big lymph node at right inguinal region

US 5  video : Doppler of vascular supply this lymph node suspected metastasis.

X-Rays  the right foot :  the bone is normal.

Biopsy of the lymph node  at right inguinal region is  metastasis from sarcoma.