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Saturday, 9 May 2015

CASE 310: CAMEL HUMP'S SIGN of THE NECK, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

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case-310-camel-humps-sign-dr-phan-thanh-hai


Woman 31 yo,   4 months ago detected  left postero-lateral of the neck swelling, no painful  (see foto).


XRays of the neck:  normal cervical spine bone (xray1, xray 2).


Ultrasound  of this mass  revealed  intra trapezius muscle,  echo  very poor, hypovascular,   crossing  middle line of the neck ( us 1, us 2).




MRI of  the neck  with gado, found out this mass  intra trapezius muscle  well- bordered and  enhanced with gado, and central necrosis.






Core biopsy was done. Wait for histoimmunostaining report.

Biopsy  tumor  report  is  rhabdomyosarcoma.




1 comment :

HaiPhuong, MD said...

Approaching an intramuscular mass, the bigger question at stake is whether malignant or benign.
The mass is irregular in shape and likely homogenously hypoechoic . Myxoma and NerveSheathTumor are ruled out since they are usually well-defined and fusiform.
As its aggressive overgrowth, desmoid most fits the scenario. (eventhough it is rare) It typically absent/minimal vascularity whereas malignancy
(sarcoma, metastasis) tends to highly vascular.
However, any >5cm non-fatty soft tissue tumor should be considered sarcoma unless proven otherwise by biopsy. (ExpertDDX, 2010).
Conclusion: Sarcoma
Dxx: Desmoid tumor