CASE 530: UMBILICOURACHAL SINUS ABSCESS, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

MAN 36YO, WITH HISTORY OF  SWOLLEN UMBILUS  AND DISCHARGE  AS A  PUS MASS FOR ONE MONTH.

ULTRASOUND SCANNING  SHOWS THE UMBILUS AREA  HAVING ONE MASS # 4 CM   INTRA ABDOMEN WALL AND AIR CONTENT ( US 1).

  

US 2 :CDI  SHOWS   TWINKLING  ARTIFACT  DOPPLER  CONNECTED TO URINARY BLADDER.

CT WITH CE : THIS MASS WITH ROUND BORDER  INTRA ABDOMEN WALL CONNECTED TO UMBILICUS (CT1, CT2  CROSSED-SECTION AND SAGITAL SECTION).

BLOOD TESTS = WBC RISES 12K,  CRP 12ng/mL,

RADIOLOGIST DIAGNOSTIC IS AN ABSCESS OF URACHAL SINUS.

OPERATION REMOVED THE ABSCESS.

CASE 529: CC HCC, Dr PHAN THANH HAI, Dr DUONG NGOC THANH, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

WOMAN 66 YO,   ULTRASOUND CHECK -UP DETECTED ONE MASS  5 CM AT R LIVER   HYPERECHOIC WELL- BORDERED  LOOKS LIKE  HEMANGIOMA (US 1, US 2, CENTRAL TUMOR NECROSIS).

BLOOD TESTS=  HBV AND HCV NON REACTIVE   WAKO TEST  STRONG POSITIVE.

MRI OF LIVER WITH GADOVIST , THIS TUMOR IS ENHANCED WITH GADO AND  STRUCTURE IS MORE FATTY TISSUE .  RADIOLOGIST REPORT IS AML LIVER ( MRI 1, MRI 2, MRI 3).

 CORE BIOPSY REPORT IS MORE FATTY TISSUE  WITH THE  SAME NUMBERS OF ABNORMAL CELL.

OPEN SURGERY RESECTION OF TUMOR  ( SEE MACRO  TUMOR WHICH IS  VERY DIFFERENT WITH LIVER TISSUE , WHITE  HARD   CENTRAL NECROSIS  WELL-BORDERD. MACRO 1, MACRO 2).

MICROSCOPIC REPORT IS  CLEAR CELL HCC   MORE 50%  CLEAR CELLS IN TUMOR.

CASE 528: LIVER TUMOR, Dr PHAN THANH HAI, Dr JASMINE THANH XUAN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

Woman 69 yo with history of mastectomy due to breast cancer for 18 years. Now for a screening  she chose full body CT.

CT reported a liver mass   at segment 5 ,  size# 6cm  (CT 1 and  CT 2).

Ultrasound reviewed:

 US 1: Liver  picture scan in April 2018  is  normal

US 2 :   A hypoechoic mass near the gall bladder.

US 3: Vascular supply for this mass is central tumor.

Blood tests= Wako test normal,  CA 15-3  normal .

MRI of liver with primovist  made  diagnostic  by radiologist is metastasis to liver ( MRI 1,  2,  3, 4).

Ultrasound guided  core biopsy  report = fibrosis

Summary of this case:
 A  mass in liver # 6 cm  suspected metastasis from breast cancer had been
 treated 18 years before and waiting for operation.
Operation of robotic laparoscopy removed big tumor and gall bladder.

Microscopic report is metastasis from suspected breast cancer.

MICROSCOPIC REPORT WITH IMMUNO-HISTOCHEMISTRY IS  METASTASIS MAY BE FROM BREAST CANCER  BEINGTREATED 18 YEARS AGO.

Reference   TNM  AND M DELAYED.

CASE 527: SPINE METASTASES, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

WOMAN 50 YO  3 YEARS AGO BEING TREATED  AT CANCER CENTER BY NPC  RADIOTHERPY AND RADICAL NECK DISSECTION. BUT NOW PAIN AT DORSAL  AREA.

ULTRASOUND OF PARAVERTEBRAL  AREA DETECTED  ONE MASS HYPOECHOIC AT THE LEFT LATERAL OF THE D10 SPINE.

 US 1, US 2  LONGITUDINAL SCAN,  US 3  CDI  NO MORE COLOR DOPPLER SIGNAL.

MRI  SPINE    DETECTED ABNORMAL D10  ( MRI1)   MRI 2  FOCUS  D10, MRI 3   CROSSED SECTION  D10,  MRI 4  TUMOR  T2   CALCIFICATION INTRATUMOR , MRI5  FRONTAL VIEW  NEAR  KIDNEY  UPPER POLE.

CORE BIOPSY  REPORT  IS  METASTASIS   BY  UNDIFFENTIATED CELL TUMOR .

CASE 526: BIG OVARIAN CYSTIC TUMOR, Dr PHAN THANH HAI, Dr TRAM THI TU HUONG, MEDIC MEDICAL CENTER, HCMC, VIETNAM

FEMALE PATIENT 17YO,   SINGLE,  IRREGULAR MENTRUAL CYCLE AND  ABDOMEN DISTENTION.

ULTRASOUND  DETECTED  BIG CYSTIC TUMOR FROM PELVIS TO EPIGATRIC AREA.

US 1 : LONGITUDINAL SCAN OF ABDOMEN AT MIDDLE LINE.

US 2 : AT PELVIS.

 US 3 : CROSSED-SECTION AT ILIAC ARTERY DIVISION.  

US 4 : SMALL UTERUS AND ASCITES AROUND.

MSCT  WITH CE.

CT1 : CROSSED-SECTION OF ABDOMEN AT KIDNEY LEVEL.

CT2 : CROSSED- SECTION OF TUMOR.

  

CT3 : FRONTAL VIEW  

BLOOD TEST : ROMA TEST NEGATIF  

SUMMARY =IT IS BIG OVARY CYSTIC TUMOR, SIZE 50CM,  MULTISEPTATION.  IOTA CLASSIFICATION B4.

OPERATION REMOVED RIGH BIG OVARY TUMOR CASE.

IOTA Classification

MICROSCOPIC RESULT IS MUCINOUS CYSTADENOMA BORDERLINE MALIGNANCY of OVARY.