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Saturday, 25 February 2017

CASE 419: PELVIC TUMOR, Dr JASMINE THANH XUÂN, Dr VÕ NGUYỄN THÀNH NHÂN, Dr LÂM CẨM TÚ, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

      36yo female patient, 13 days delayed period, was diagnosed left side ectopic pregnancy. HCG=2786mUI/mL. Patient were re-examination at Medic.
      Embryonic sac inside uterus d# 8mm, 2 normal ovaries and rules out EP.
      During Transvaginal Ultrasound exam, incidental mass was detected, sized # 35 x 40mm, rich echo. It located beside left ovary, hypervascular supplied was identical which reassemble a kidney. On abdominal view, 2 kidneys and other organs were normal. During consultation, 9/11 doctors thought a third pelvic kidney which is rare but possible.
      After reconsultation, patient wants abortion so we move on to CT exam. In arterial phase, the mass enhanced and shows connection with sigmoid colon and in late phase, rules out pelvic kidney diagnosis. CT Virtual Colonography was performed, air was pumped to inflate colon for better view. On 3D image, the mass reveals as polyp within sigmoid lumen.

      Next, the patient underwent endoscopic colon: demonstrated a bledding, 25cm away from anus, very mobile polyp with long stalk. Sample biopsy confirmed normal tubular polyp.

A studied case was represented around 11 doctors via email which was diagnosed exactly by MSCT and confirmed by colonoscopy.



























 Bài học 3: email hội chẩn.










1 comment :

VIETNAMESE MEDIC ULTRASOUND DIAGNOSIS said...

Theo nhu chi mo ta, pelvic mass la dang dac (solid mass) nay nam ben trai, co ve nhu tach roi khoi buong trung trai va tu cung, nen minh co the co cac ly giai ve dinh danh pelvic mass nhu sau:

1. It nghi den ovarian mass (vi 2 buong trung deu quan sat ro) va hydrosalpinx (vi day la solid mass),

2. Co the la pedunculated subserosal fibroids khong chi?

3. Co the la cac non-gynecological mass nhu u tu duong nieu (it nghi vi cac u nay nam retroperitoneal area), u tu duong tieu hoa (co xac suat cao hon, minh can lam them tumor markers hoac sieu am lai, hoac MRI sau khi co benh nhan nay giai quyet xong cai thai). Tô Mai Xuân Hồng,MD PhD.