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Monday, 15 July 2019

CASE 558: OVARIAN TUMOR but RISING CA 19-9, Dr PHAN THANH HAI, Dr LE DINH TIN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


WOMAN  39YO  SINGLE, WITH  PELVIS PAIN


ULTRASOUND  DETECTED  LEFT OVARY CYST  SIZE 4 CM, CLASSIFIED IOTA 3   SUSPECTED  ENDOMETRIOSIS OF LEFT OVARY.  

US 1=   CYST  MIXED   SOLID.
US2 = ELASTO  SUSPECTED  BENIGN CYST.



ROUTINE BLOOD TEST   HAD  CA19-9  VERY HIGH VALUE  MORE THAN 1000 UI, CA 125 = 32 UI.



MSCT OF ABDOMEN WITH CE 

CT1:  PELVIS   HAD CYST OF LEFT OVARY  LOOKED LIKE SIMPLE CYST. 
CT2 :IN UPPER ABDOMEN,  LIVER,  BILIARY SYSTEM AND PANCREAS ARE NORMAL.




LAPAROOPERATION   REPORTED  LEFT OVARY CHOCOLATE CYST  THAT SUSPECTED  ENDOMETRIOSIS.


MICROSCOPIC REPORT OF THIS CYST IS   ENDOMETRIOSIS CYST.


LAB TEST AGAIN AFTER 2 WEEKS  OF OPERATION  THE CA19-9 DROPPED DOWN TO 123 UI.

CONCLUSION :  ENDOMETRIOSIS CYST RISED VERY HIGH CA-19-9 VALUE  WHICH IS RARE CASE

UNKNOWN REASON. 

REFERENCE CASE .



Sunday, 7 July 2019

CASE 557: LEG TUMOR, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


Man 51 yo  detected  his right ankle  pain and swollen, difficult to walk  ( see photo). There is a   mass at achille tendon with small skin nodule ).






Ultrasound  scan of  this mass.
US 1=  this mass is solid, #5 cm  round bordered, displacing achille tendon)
US 2 = vascular supply from peripheric wall   
US 3 =  SMI can see  more vascular structure intra tumor   
US 4  = ultrasound detected big lymph node at right inguinal region





US 5  video : Doppler of vascular supply this lymph node suspected metastasis.





X-Rays  the right foot :  the bone is normal.

Biopsy of the lymph node  at right inguinal region is  metastasis from sarcoma.