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Thursday 18 July 2024

CASE 773: PCC MIMICKING RENAL CYSTIC TUMOR, Dr PHAN THANH HAI, Dr NGUYEN MINH THIEN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 61 year-old diabetic man in  annual check-up with a #15-17mm left renal cyst known by non CE MSCT for years.

MSCT of full body detected a #21x16mm left adenal tumor, a thyroid cyst and renal cysts and a #17mm renal  tumor  which moderatly captured CE cannot ruled out a RCC.


He has got a thyroid tumor#19mm and a colon polyp.



Coronary arteries were slightly stenosis.

Lab data were not interested except an endocrinal adrenal tumor.



Endoscopic surgery removed the left papillary cell carcinoma PCC and a 

hafl of kidney 


with the left adrenal tumor.







Histopathological results were left PCC and left endocrine 0cortical adrenal tumor.









Thursday 11 July 2024

CASE 772: THYROID CANCER METASTATIC to ESOPHAGUS ?, Dr PHAN THANH HẢI, Dr NGUYỄN TUẤN CƯỜNG, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A  47 year-old diabetic man, hoarsening, with thyroid tumor on the left lobe.

Ultrasound represented a # 49x34 mm solid mass, blurred contour, strong posterior shadowing, close to cervical esophagus with thickening wall.


He had got the lefl vocal paralysis.


MSCT and endoscopy detected  an esophageal tumor at 1/3 middle part, invading the left lobe of thyroid.



Histopathogical results were an esophageal cancer, poor differentiazed squamous cell carcinoma.



Patient died some weeks later in chemotherapy management.

 


Wednesday 12 June 2024

CASE 771: BOWEL G.I.S.T, Dr PHAN THANH HẢI, Dr LÊ THỐNG NHẤT, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 

A 38 year-old woman with a # 47x58 mm GIST of her small bowel at LUQ, and later MSCT confirmed it.





The author would like to describe the sonographic appearances of a bowel GIST: echo mixed, with hypoechoic or cystic areas in case of large tumor. The adhered GIST from one side developes out of the lumen, exophytic, while the other side is intact. Endoscopic ultrasound could represent the layers of the wall of the tumor and help to guide the tumor biopsy.


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Merriam- Webster

exo​phyt​ic tending to grow outward beyond the surface epithelium from which it originatesused of tumors compare endophytic.tending to grow outward beyond the surface epithelium from which it originates.





CASE 770: INSULINOMA (PNET, PANCREATIC NEUROENDOCRINE TUMOR), Dr PHAN THANH HẢI, Dr TRẦN THỊ TRÚC PHƯƠNG , MEDIC MEDICAL CENTER, HCMC, VIETNAM.


A 66 year-old diabetic man with hypoglicemic crisis after meal 3-4 hours, Whipple's triad positive.

Lab data: FPG low, C-peptid (fasting) elevated




Ultrasound detected a  # 20#6.5mm mass at the pancreatic tail and some hepatic cyts.


.


Cystic lesion of the pancreas tail # 2.6x2.2 mm with Doppler sign.





MSCT confirmed a 32x20mm PNET at the tail of pancreas: tissue density, highly captured contrast media.



Histoimmunopathologic stainning was a pancreatic neuroendocrine tumor [insulinoma].


References:










CASE 769: APPENDICULAR MUCOCELE, Dr PHAN THANH HẢI , Dr VÕ THỊ THANH THẢO, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 62 year-old woman in check-up with her past history of surgery for an intracrania hemorrhagia and ovarian cyst.

Abdominal ultrasound detected a RLQ cystic mass #47×27mm beside the right colon which filled off debris that maybe a mucocele or a  pseudomyxoma peritonei.



Lab data were normal.

MSCT confirmed an # 42x22 mm appendiceal mucocele.



Surgery removed  a cystic mass at the end of the appendix.



Histopathological result was mucocele low grade.


Reference:



Saturday 8 June 2024

CASES 767, 768: PARATHYROID TUMOR, Dr PHAN THANH HAI, Dr LY VAN PHAI, Dr VO THI THANH THAO, Dr HO KHANH ĐUC, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 Two cases of pararthyroid tumor were spontanously detected by ultrasound with renal stones, bone mineral density [BMD] measurement for osteoporosis  and the neck tumor.

Case 767: A 58 year-old woman with renal stones on abdominal ultrasound who went through neck ultrasound, BMD measurement and parathyroid hormone (PTH) lab data.




Her PTH was coming back post-op.



Case 768: Female patient 57 year-old with neck tumor.





References:






Thursday 6 June 2024

CASE 766: RENAL CLEAR CELL CARCINOMA, Dr PHAN THANH HẢI, Dr PHẠM THẾ ANH, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 60 year-old woman with a cystic renal tumor on the left side which was detected by ultrasound.


MSCT confirmed the left renal tumor at the lower pole of the left kidney.



An ultrasound-guided renal biopsy was conducted at Medic Center.





Result of  renal biopsy was a renal clear cell carcinoma. And a surgery for the left renal tumor was done one week later the diagnostic was made.



The risk of seeding of tumor cell  in renal biopsy is very rare before removing the renal tumor by surgery.