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Thursday, 26 December 2024

CASE 803: GERMINOMA METASTASE, Dr PHAN THANH HẢI, Dr PHẠM HUỲNH BẢO TRÂN, Dr LÝ VĂN PHÁI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

A 42 year-old man with LLQ pain and  defecation troubles and some left neck lymph nodes for one week. He lost # 2kg. He denied to ask doctor his swollen right scrotum as ashamed of it.

Abdominal  and neck ultrasound detected some lymph nodes ( most big size # 51mm) into abdomen and retroperitoneum which were hypoechoic pattern maybe due to lymphoma infiltration.


Some 9-21 mm lymph nodes at left posterior triangular neck.



Lab data result has beta2 microglobulin elevated.


Histopathological biopsy result of the subclavian  node was lymphoma big cell. But histoimmunochemostaining was a germinoma metastase to lymph node.

Fuĺl body MSCT performed to evaluate the lymph nodes

But MSCT detected a # 46x58 mm right testicular tumor with metastase lymph nodes in the abdomen and retroperitoneum, at the groins and the subclavian region and left neck.





Scrotal ultrasound later confirmed a # 76x66x36 mm right testicular tumor and inguinal and pelvic lymph nodes metastase.


Surgery removed the right testicular tumor and 
planning of chemotherapy management. The patient remains well and ceases GI tract trouble.

Germinoma in elderly patient is rare entity and the ashamed feeling of his big scrotum was one dramatic cause for a difficult diagnosis.

Thursday, 19 December 2024

CASES 801-802: WARTHIN TUMOR, Dr PHAN THANH HẢI, Dr PHẠM THỊ CẨM VÂN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 Two cases of Warthin tumor were detected by ultrasound Medic and removed successfully.

CASE 1:

A 48 year-old man was diagnosed Warthin tumor of his left parotid which was #19×37 millimiter hypervascular hypoechoic pattern with some small cystic lesions inside. Microscopic result was a Warthin tumor and removed later.






CASE 2:

A 68 year-old with managed liver tumor was detected Warthin tumor in the left parotid in period check-up by ultrasound.





A  # 16x10x21 milimeter hypoechoic cystic mass inside the left parotid was vascularised in low flow.


Microscopic and macrospecimen results were  the Warthin tumor.

REFERENCE:



Wednesday, 11 December 2024

CASE 800: SMALL BREAST CANCER INCIDENTALLY DETECTION, Dr PHAN THANH HAI, Dr JASMINE THANH XUAN, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 A 66 year-old woman with a #10x7 millimeter spicular hypoechoic mass which invaded the skin above,  and a # 3.8 millimeter small node satellite, both of two lesions were nearby the nipple of the right breast. They were incidentally detected by ultrasound as small carcinoma, BI-RADS 4C. Strain elasticity was hard code. Axillary lymph nodes were inflamed nodes, LN-RADS 2.





Mammogram showed one right breast lesion beside the nipple, BI-RADS 4.



MRI confirmed the #11x9x10 millimeter tumor of the right breast, BI-RADS 5. Right axillary nodes still exist the hilus.




Results of core biopsy was an invasive breast carcinoma of no typical type, grade 2.


Histoimmunostaining result was an invasive carcinoma of the right breast.