CASE 692: Five Year HCC post-op, Dr PHAN THANH HẢI, Dr DƯƠNG NGỌC THÀNH, MEDIC MEDICAL CENTER, HCMC , VIETNAM.

 A 71 year-old female patient with her history of a liver tumor which was quite difficult diagnosed 5 years before.

She had been go through ultrasound, MSCT  and liver biopsy 2 times in 2 other hospitals, but the results were benign hepatic tumor and no clue of infected HCV and HBV.

In Medic Center, ultrasound noted a 50 milimeter right liver hemangioma and MRI  with gado was an AML but not ruling out HCC.

But HCC risk tests with WAKO test were positive and positive antiHBe in that time.

After 2 months of the five year before to examine the liver tumor, the HCC  diagnosis was made and the tumor was removed surgically when the patient aged 66.

Histopathological report was a poor differentiazed carcinoma of liver with fatty degeneration  and hepatic chronic inflammation.

And 5 years went by the female patient remains well. The right lobe of liver exists a fibrosis scar.

The prognosis of HCC patient will be well if an effective management performs successfully in time for the female patient [Acceptable 5-year survival].

CASE 691: LEFT ADRENAL TUMOR, Dr PHAN THANH HẢI, Dr VÕ THỊ PHƯƠNG TRINH, MEDIC MEDICAL CENTER, HCMC, VIETNAM

A 48 year-old female patient without arterial hypertension signs is incidentally detected a tumor of adrenal gland #20×22 mm by ultrasound.

MSCT confirmes  a 16x22 mm left adrenal benign tumor  which HU before CE is 69 and HU post CE =26. CE discharge is over 50% that may proove the benignity of the tumor.

4 months after the left adrenal tumor is removed by endoscopic surgery.

Result of pathology is a benign adrenal tumor with thin fibrous capsule.

CASE 690: APPENDICULAR ABSCESS, Dr PHAN THANH HAI, Dr NGUYEN NGOC XUÂN GIANG, MEDIC MEDICAL CENTER - BINH AN HOSPITAL KIÊN GIANG, VIETNAM

A 56 year-old female patient with umbilical pain for one week, comes to Binh an hospital after 4 days in constipation.

Ultrasound detects an abscess in RLQ but could not rule out a PID. Although sonologist notes an appendicular abscess but could not reveal the inflammed appendix into the pelvic abscess.

MSCT confirms a 60x80 mm  right pelvic abscess contrast captured and edema of the wall of terminal jejunum. The report is pelvic abscess maybe an appendicular abscess.

Endoscopic surgery drained the pelvic abscess and the patient remains well.

CASE 689: RECTUM WALL GIST, Dr PHAN THANH HẢI, Dr LÊ TUẤN KHUÊ, MEDIC MEDICAL CENTER, HCMC, VIETNAM

A 56 year-old female patient with 6 month constipation and bleeding from her anus  for 2 weeks.

Rectal endoscopic result is a hemorrhagic rectal tumor which is far from anal orifice 20 millimeters.

MRI confirms a 53x41 mm tumor of the rectal canal.

A transperineal biopsy with ultrasound-based guiding is done for a 42x48x44mm vascularised solid mixed tumor.

Result of histoimmunology is a GIST tumor of  rectum wall.

The female patient is planned for a surgery and chemotherapy.