CASE 255: PERI-BREAST TUMOR, Dr PHAN THANH HẢI-Dr JASMINE THANH XUÂN, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Woman 34yo, in palpation detected herself at RUEQ one mass suspected breast tumor.

Mammography confirmed one mass   with  macrocalcification.. at 1h  site of right  breast with dense tissue (see 2 mammo pictures).

Ultrasound  scanning  at  right  breast  detected  one  hypoechoic ellypsoid mass with size of  3cmx2cm  in major pectoralis muscle, Upon CDI  scan  this mass was  hypovascular, and elastoscan  was  hard tissue, no  axillary  lymph node ( see  ultrasound scan B mode, CDI, elasto).

What is your suggestion of diagnosis ?.

MRI of mammary glands  were  done, this  mass  was  retromammary,  inside  major pectoralis muscle  on right site. The  signal  suggestion was hemangioma (see 2 MRI pictures).

FNAC report was compatible with retromammary hemangioma.

  

Operation removed completly this mass; microscopic report  was  cavernous hemangioma.

 

REF case   pdf.

 

CASE 254: CASTLEMAN DISEASE in COLONIC MESENTERY, Dr JASMINE THANH XUÂN, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

A 22 yo female patient with a  mass of right abdomen which was detected by ultrasound check-up and thought to be a mesenteric tumor or a lymph node in mesentery. It was well-bordered and vascular structure without any symptom.

MSCT confirmed the 14x17mm mesenteric tumor in right abdomen with CE enhancement.

Open surgery removed the mass from posterior space of right colonic mesentery.

Microscopic result is a Castleman disease in mesentery,  which is an uncommon lymphoproliferative disorder that may be localized to a single lymph node (unicentric) or occur systemically (multicentric).

It was a  second case at Medic Center.
The first case of Castleman disease  was posted in 2010.
CASTLEMAN DISEASE in RETROPERITONEAL SPACE at MEDIC CENTER

CASE 253: GOSSYPIBOMA (TEXTILOMA) POST CAESAREAN SECTION for a YEAR, Pham Hong Dong,M.D; Nguyen Duc Duy Linh,M.D; Phu Van Tuot,M.D; Nguyen Ngoc Xuan Giang,M.D., MEDIC Binh An Kien Giang Hospital

A 26 year-old female patient who had complained mild pain at her pubic region  presented lower abdominal pain a month prior. She  overwent a caesarean section a year ago for delivery her child.

Ultrasound findings:A cystic mass (about 83x46 mm) containing distinct internal hyperechoic wavy, striped structures.    

           

CT Scan abdomen: A mass of 11 x 9 cm with thicken enhancing walls was seen in pelvis.

But diagnosis of gossypiboma was made and at laparotomy: a surgical sponge (18x22 cm) with adjacent inflammatory tissue and pus were removed successfully.

          

DISCUSSION:

A diagnosis of gossipiboma pre-op seems to be very difficult that always need skill and experience. Because of  imaging findings of gossypiboma are nonspecific and complexe so the right diagnosis in pre-op is still acchived about 1/3 of cases in literature.

But whenever an unknown mass into abdomen with exist surgical scare that should dissolve it may be a gossypiboma or not.