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Wednesday 18 April 2018

CASE 488: CT SCANNING INCIDENTAL DIAGNOSIS of RECTUM CANCER, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM


Woman 79 yo  being treated  right kidney stone.  3 years ago, with  ultrasound of abdomen in  black and white images   detected a stone with size 1 cm (US 1, US 2   longitudinal scan and crossed  section of right kidney).


On color Doppler  it exists an AVM  with calcification ( US 3, US 4).



MSCT with CE of abdomen  for   sure  AVM  of right kidney (CT 1,CT 2, CT 3, CT 4, CT 5) , radiologist reported at  CT 3 image  one mass  at  pelvis  like  sigmoid colon  tumor.






Coloendoscopy  confirmed that  rectum tumor  # 16 cm, high from anus.



Biopsy on the way (endoscopic image)
MRI  preop  takes staging of rectum cancer T4 N1 Mx.




Conclusion: Abdomen CT for  diagnosing AVM of right kidney detected incidentally a rectum cancer on AVM and stone kidney patient.

Operation  for  resection of rectum tumor and reanastomosis by stappler (MACRO ).



MACROSCOPIC  REPORT  IS  ADENOCARCINOMA  OF RECTUM.





SUMMARY  = CTA  IS THE BEST DIAGNOSING MODALITY for RENAL AVM  at THE SAME TIME  OF INCIDENTAL DIAGNOSING FOR RECTUM CANCER  WHICH WAS MISTAKED BY ULTRASOUND.

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