Ultrasound revealed a right kidney tumor 37x40 mm, at the middle of anterior face, solid, hyperechoic pattern without rim sign that not ruling out a RCC, and a 13 mm small cyst of right lobe of the liver.
Lab data normal.
MSCT represented a 17x20mm right renal tumor maybe a RCC.
Robot surgery removed successfully a right kidney tumor. Histopathological result was a renal clear cell carcinoma of kidney.
A 31 year-old woman with loose stool for 2 months and epigastric pain that was in gastritis treatment but not the loose stool not resolving. She lose her weight of one kilogram and cramping feeling in her right flank.
Ultrasound detected right colon wall thickening maybe due to tumor.
Cancer of colon seems to be more early in appearance in the young patients. And in late stage [liver metastase] liked the young woman in this case.
A 45 year-old man with epigastric pain for 2 months but failed in gastritis management in a hospital and getting worse his status.
At Medic Center, ultrasonography revealed the transverse colon wall thickening =12-17 mm associated with malignancy, which was linked to a neighboring abscess measuring 59x21 mm that was sealed off. A fistula between the cancer and the abscess was seen on ultrasound.
Lab data: WBC=20,51x10^9/L, CEA: 5.47ng/mL
MSCT confirmed the abscess at posterior of the transverse colon due to perforated transverse colon cancer.
Open surgery removed the # 5x5 cm transverse colon cancer which perforated at posterior face and an arteficial anus was done. But 3 days later, this artificial anus was necrotizing then the proctotoreusis was done secondly.
The histopathological result was a high differentiazed carcinoma invasive of colon.
The patient remained well after the 2 complex operations.
A 58 year-old infected HBV man with RLQ pain for 5 days.
Ultrasound detected edema of the last part of jejunum maybe due to inflamation. It existed edema of pelvic peritoneum beside the appendix.
MSCT represented an inflamed appendix and foreign body as fish bone # 30mm which perforated the appendiceal wall.
Endoscopic surgery confirmed a fish bone and removed the inflamed appendix.
Result of histopathological specimen was an acute necrotized appendicitis.
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.
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:
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.
CASE 745:
A male child 11 year-old presented a calcified node in left lobe of thyroid by ultrasound.
A girl 14 year-old with a left thyroid tumor and cervical lymph nodes.
Microscopic result was papilary thyroid carcinoma, group VI Bethesda classification.
