Case 2: Man 47 year-old with right pyriformis sinus tumor and right submandibular nodes in mass metastasis.
Case 3 :Man 67 year-old with left pyriformis sinus tumor and left cervical lymph nodes metastasis.
Abdominal ultrasound revealed a #5.1x3.7 cm hepatic abscess in the right hepatic lobe, a small hemangioma, a sludge in gallbladder and a right renal cyst.
Lab data noted WBC : 13.3 H and a positive sero Fasciola sp Elisa.
MSCT confirmed an abscess of the liver maybe due to parasite.
An amount of chocolate fluid was drained out and antibiotics were managed.
A 28 year-old girl with a doubtful mass at her left face which only appears in prone position for 20 years. That mass is yet diagnosed from many clinics since 8 years old.
Fig 1: Swollen left cheek and unclear the left nasolabial groove were in bending and sitting position.
Face ultrasound detected nothing in supine position. But in bending down her head the left nasolabial groove disappears. Then the left cheek was swollen and ultrasound revealed a #35x15mm echoic cystic lesion into the left masseter space.
MSCT non CA confirmed the cystic lymphangioma in the left masseter space in two positions : supine (upper line) and prone (lower line)
The girl was pleased with the explanations but she denies any procedure of FNAC or puncture for sclerotherapy that may causing any scar of her face.
The cystic lymphangioma in the masseter space is a rare entity. The story which we learned about of the case is paid attention at something doubtful of the patient’ complaint and trying to find it out. In that case it only was the appropriate position to detect a ghost mass on the left cheek of the nice girl.
REFERENCES:
1. 2020 Hong Kong Journal of Paediatrics. Vol 13. No. 4, 2008 - Imaging Features of Common Non-nodal Neck Masses in Children.
2. PMC- J Oral BiRes. 2018 Sep-Dec; 8(3): 200–202.
published online 2017 Jun 13.
doi: 10.1016/j.jobcr.2017.06.001.PMCID: PMC6107903 PMID: 30191108 - Lymphatic malformation of the masseter.
3. Radiology Key Fastest Radiology Insight Engine 2.3 Hemangiomas and Vascular Malformation.
Malformation
A 49 year-old man with a big painless mass at the lower part of his neck on the right side. The mass gots bigger rapidly causing cough in hard squizzing.
CT Scan noted a #8.5x2.9cm right lymph node necrosis or metastase. The lungs were intact.
But MRI suspected a big lymph node abscess.
Ultrasound detected a # 3x8cm big mass which had a cystic pattern between the neck vessels and adhered the vagal nerve of the right neck ; maybe a giant cystic degeneration schwannoma of the right vagal nerve sheath.
Surgery removed the right mass of the neck; the result post-op was a cellular schwannoma of the nerve sheath of the right vagal nerve.
A 10 year-old boy with sweating and severe headache episodes since September 2024; his HTA 160/100 mmHg in theses episodes.
Also, in June 2024, his mother was diagnosed pheochromocytoma at MEDIC CENTER and remains well post-op.
Ultrasound noted both adrenal glands normal.
But lab data showed 10 times increased both catecholamines in blood : 2414.3 H and urine: 736.5H.
⁷MSCT detected two ectopic pheochromocytoma on the left side: one adhered the adrenal gland and other was between the IVC and the aorta.
A medical management plan was applied carefully before the surgery for removing the two pheochromocytoma.
The catecholamines come back post-op but the lucky boy and his mother has stiĺl been in following up for many years.
APPENDIX 1:
APPENDIX 2
Ultrasound detected a # 25x12mm tubal structure at the RLQ with peritoneal fatty edema at the end of appendix in suspecting an acute appendicitis.
MSCT confirmed an inflamed appendix with fecolith inside.
Endoscopic surgery was done for removing the inflamed appendix in 24 hours from the onset.
