CASES 748-749: GASTRIC WALL ABSCESS, Dr PHAN THANH HẢI,Dr PHAN THANH VIỆT BÌNH, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 

2 cases of gastric wall abscesses were incidentally detected  with epigastric pain for one month and were failed in the urban medical management.

Case 748:

A 32 year-old man with epigastric pain for one month. 3 years before he went through a gastritis.

Ultrasound detected thickening of antrum wall with fluid collection inside may having foreign body and fatty liver.

Endoscopy represented a gastric wall abscess. 

MSCT confirmed a gastric wall thickening without foreign body and ruling out a gastric tumor.

By antibiotics  treatment the gastric abscess disappeared after one month.

Case 749:

A 22 year- old girl with epigastric pain for a half of month. 

Ultrasound detected gastric wall thickening maybe gastric polyp.

Endoscopy described a gastric wall abscess.

Biopsy results was gastric hyperplasia.

MSCT detected no gastric tumor, but gastric wall abscess was noted.

She took a medical management and remained well after one month.

Gastric wall abscess is a rare entity  and endoscopy may help detecting it.

Infected Streptococcus is the main source of infection (75%). And Staphylococcus, E.coli Hemophilus influenza, Pseudomonas. Candida [rare].

REFERENCES:

CASE 747: HCC and infected HBV, Dr PHAN THANH HẢI, Dr PHẠM CÔNG CHÁNH, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

A woman 51 year-old infected HBV for one year only using herself functional foods.

Ultrasound revealed a # 18 mm hypoechoic mass in right lobe of liver and splenomegaly and cirrhosis.

Lab data noted platelets # 50,000, liver enzymes raised and AFP negative, but HCC risk WAKO test elevated: PIVKA II (DCP): 84.2 mAU/mL

Liver MRI with Primovist confirmed a right hepatic node that maybe was  a nodular regenerative hyperplasia (NRH, FNH) or small HCC.

Liver tumor was removed by RFA after liver biopsy and DCP downed to 72mAU/mL.

CASES 745-746: PTC in CHILDREN, Dr PHAN THANH HẢI. Dr NGUYỄN TUẤN CƯỜNG, MEDIC MEDICAL CENTER, HCMC, VIETNAM

CASE 745: 

A male child 11 year-old presented  a calcified node in left lobe of thyroid by  ultrasound.

Microscopic specimen was papilary thyroid carcinoma, group V Bethesda classification. 

 CASE 746:

A girl 14 year-old with a left thyroid tumor and cervical lymph nodes.

Microscopic result was papilary thyroid carcinoma,  group VI Bethesda classification. 

CASE 744: MUCINOUS BREAST CARCINOMA, Dr PHAN THANH HẢI, Dr PHAN THỊ CẨM VÂN. MEDIC MEDICAL CENTER, HCMC, VIETNAM.

A young woman 28 year-old with a left breast lump.

Mammography noted a left breast mass at 7 0' clock on a breast type D. BI-RADS 4.

Ultrasound detected a #20×14 mm left breast speculated tumor, far from nipple 3 cm. BI-RADS 4a.

Mammothermography

MRI confirmed a 23×20 mm left breast tumor captured strongly CE. BI-RADS 5. Axillary nodes inflammatory form.

Biopsy results was mucinous breast carcinoma invasive.

Microscopic specimen post-op was mucinous breast carcinoma invasive.

Young woman with a rare breast tumor.

REFERENCE:

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StatPearls [Internet].

 

Mucinous Breast

Faten Limaiem; Faran Ahmad.

Author Information and Affiliations

Last Update: February 12, 2023.

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Continuing Education Activity

Mucinous carcinoma of the breast is a relatively rare subtype of breast cancer accounting for about 2% of all breast carcinomas. According to the latest WHO classification of tumors of the breast, mucinous carcinoma is classified as a special type of breast cancer. This activity describes the pathophysiology, etiology, and presentation of mucinous breast cancer and highlights the role of the interprofessional team in its management.

Objectives:

• Outline the pathophysiology of mucinous breast cancer.
• Describe the evaluation of a patient with mucinous breast cancer.
• Summarize the treatment options for mucinous breast cancer.
• Review the importance of improving care coordination among interprofessional team members to improve outcomes for patients affected by mucinous breast cancer. 

CASES 742-743: 2 CASES of BREAST TUMOR with NEGATIVE MAMMOGRAPHY, Dr PHAN THANH HẢI, Dr HỒ CHÍ TRUNG, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

2 CASES of BREAST TUMOR with UNCLEAR MAMMOGRAPHY

Case 742:

A woman 64 year-old in check-up.

Mammography findings noted breast in B group, nearly a doubtful breast mass on right side.

Ultrasound revealed a small # 7 mm spidicular mass in right breast. Elastography was a hard tumor. BI-RADS 5. Axillary nodes were metastases 

Core biopsy and chemoimmunologic staining resulted a small invasive carcinoma of the breast. A mastectomy was done and microscopic result was  carcinoma.

Case 743:

 

A woman 34 year-old with right lung cancer, positive EGFR and right pleural effusion has bee managed for 4 months. She herself found her right breast harder.

On mammography her right breast belonged type D (dense) which could not detect the tumor.

But ultrasound detected easily a big 37×19 mm tumor in BI-RADS 5 with cervical metastasized nodes.

The poor young woman with 2 kinds of cancer at the same time. 

Core biopsy resulted invasive breast carcinoma metastasized cervical nodes. And rib bones

and left pelvic bone on scintigraphy.

CASE 741: HEMORRHAGIC MESENTERIC HEMANGIOMA, Dr PHAN THANH HẢI, Dr NGUYỄN NGHIỆP VĂN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

A woman 49 year-old  with a critical left flank pain for 1 day which was progressed continously. It made the woman in rigidity of her body to against her abdominal pain and to defecate many times.

Ultrasound detected a #58 mm well-limited mass containing sludgy fluid full-filled at left side of abdomen nearby her left kidney, and abdominal wall. And a renal cystic  and a kidney stone also existed.

MSCT confirmed a # 50x60 mm mesenteric cystic tumor as it was non captured CE,  HU 51.0 maybe a mesenteric cyst including hemangioma that adhered to left colon, left kidney  and abdominal wall.

Endoscopic surgery revealed the mass adhered the mesentery and the left colon, and the abdominal wall, then an open surgery was done.  

Microscopic result was a hemorrhagic hemangioma of the mesentery. 

Hemangioma in hemorrhagia of the mesentery is a rare entity. The scenario is too complex for exactly diagnosing pre-op.

CASE 740: DIFFUSE SCLEROSING VARIANT of PTC, Dr PHAN THANH HẢI, Dr NGUYỄN KIM HIẾU, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

  

A woman 42 year-old with swollen neck on right side and hoarseness.

Neck ultrasound detected a hypoechoic thyroid, hypovascularized and diffuse microcalcification. It exists lymph nodes both 2 sides of her neck.

FNAC result was  a papilary thyroid carcinoma [PTC] with lymph nodes metastases, Bethesda classification group VI.

A thyroid total  and metastasized lymph nodes removed  and radiotherapy was done later.

Reference: