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Thursday, 26 September 2013

CASE 210: LEFT ABDOMINAL MASS, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM


Man  53 yo acute pain  onset at left lower abdomen, no fever, pain  progressing and  cannot  lay down in decubitus position.
Ultrasound  abdomen first  showed  that  fluid collection around  liver and pelvis with one mass size of 3cm-4cm   at the painful area  (left lower abdomen)  like pseudokidney sign.





MSCT  without CE of abdomen detected  one mass with  intraluminal air and its wall was thickened more than 1cm which suggested inflammation like enteronecrosis.



This patient promptly was sent to BINH DAN HOSPITAL.and  abdomen x-ray for  check up  was done [see  photo].


Blood tests=   WBC rising 17K with  88% neutrophil.

Emergency operation as  diagnosis about peritonitis.due to perforation.
This mass is of  small intestine.which was looked like tumor or inflamation.

.
Wait  for  microscopy report.
Microscopy reports that a cancer But we have to wait for immunohistostainning to make sure that a malignant GIST or Carcinoid.

REFERENCE

Sunday, 15 September 2013

CASE 209: A LUNG MASS, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Man 59yo in check-up lung x-ray detected a mass at left lung, asymptomatic, no history tuberculosis, non smocking patient.





Ultrasound of the lung showed that was a cystic avascular with well bordered mass, size of 4 cm.





MSCT CE said that cystic mass bilobar looked like a bronchogenic cyst.



Operation via endoscopic thoracotomy, and punction of this mass leaking out the milky fluid. Resection this tumor with macrospecimen picture.
Wait for pathology report, but the surgery report said it looked like a caseum cyst of tuberculosis.

REFERENCE:

Monday, 9 September 2013

CASE 208: RETROPERITONEAL EXTRAUTERINE PREGNANCY, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

WOMAN  26yo UNDERWENT in vitro fertilization–embryo transfer (IVF–ET) WAS WAITING FOR THE RESULT.

BETA HCG  WAS RISING UP FROM 9K  TO 17K  BUT ULTRASOUND  CANNOT FIND OUT THE   INTRAUTERINE NIDATION.

AT THE RIGHT  OVARY SITE,  ULTRASOUND DETECTED ONE  MASS OF 2 cm WITHOUT BLOOD SUPPLY WHICH WAS  BIG AND  CYSTIC HEMORRHAGIC, NEAR RIGHT ILIAC VEIN.
.




FIRST LAPAROSCOPY DETECTED NOTHING.
ONE WEEK LATER   MRI WAS PERFORMED ALSO DETECTED  THIS MASS WHICH WAS  GROWING IN RETROPERITONEAL SPACE, NEAR  RIGHT ILIAC VEIN. Beta HCG AT THAT TIME WAS  UP TO  39K.


OPEN  SURGERY  REMOVED THIS  MASS, SUSPECTED EXTRAUTERINE PREGNANCY 
WAIT  FOR   PATHOLOGY REPORT  AND  FOLLOW UP THIS CASE  AS  EXTRAUTERINE PREGNANCY IN RETROPERITONEUM.