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Wednesday 25 September 2019

CASE 566: PERIVASCULAR TUMOR, Dr PHAN THANH HAI, Dr HO CHI TRUNG, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


WOMAN 36YO  DETECTED  ONE MASS AT THE LEFT THIGH,  PAINFUL  PALPATION.

ULTRASOUND OF  THIS MASS.

US1:  THE PERIVASCULAR TUMOR  OF LEFT FEMORAL ARTERY  HAD HYPOECHOIC PATTERN ,  SIZE 4 CM  AND THE FEMORAL ARTERY IS STILL IN THIS MASS.
US2 : THE LEFT FEMORAL VEIN  DILATED  BUT  FEMORAL ARTERY IS NOT STENOSIS
US3 : COMPRESSION OVER THIS TUMOR  THE FEMORAL VEIN IS COMPRESSIBLE  
US 4:  CROSSED SECTION THIS MASS  THE ARTERY LUMEN STILL HAD NORMAL FLOW.  
SONOLOGIST SUSPECTED  THAT TUMOR OF PERIVASCULAR FEMORAL ARTERY.




MRI  OF THIS MASS  SHOWED  THIS TUMOR FROM THE WALL OF ARTERY  ( MRI1) 
MRI2  VEIN DILATATION.



CT ANGIO: NORMAL  FLOW OF LEFT FEMORAL ARTERY.


Operation  removes the tumor covered around  left  femoral artery.




MICROSCOPIC REPORT OF THIS TUMOR IS  LEIOMYOMA  OF VASCULAR WALL  ( ANGIOLEIOMYOMA).


REFERENCE CASE  


For 9 months post op: only removing tumor, now pain and touchable  beneath scar, the perivascular tumor is in recurrence.





Sunday 15 September 2019

CASE 565: SUPRARENAL AORTIC ANEURYSM, Dr PHAN THANH HAI, Dr LE TU PHUC, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


Man 72 yo with pain at RUAQ.


CHEST X-RAYS AND  SPINE  X-RAYS CANNOT DETECTED  ABNORMAL.

US SCANNING OF EPIGASTRIC AREA  DETECTED ONE MASS NEAR AORTA IN RETROPERITONEUM  # 4 CM   WITH DOPPLER  FLOW IN THIS MASS
US 1: PW DOPPLER SHOWS ARTERY FLOW PATTERN
US 2: THIS FLOW IS CONNECTED TO AORTA.






MSCT CE AORTA   
CT1 = CROSSED SECTION AND FRONTAL VIEW  THIS  MASS IS ANEURYSM WITH  BLOOD CLOT INSIDE  
CT2 = 3D VIEW  THIS SITUATION IS  CLOSE  BY SMA AND RENAL ARTERY 



EMERGENCY ADMITTED TO HOSPITAL FOR  TREATMENT PLANNING.
Operation for devascularization  SMA and renal artery  (DSA 1)AND  PUT STENT IN AORTIC ANEURYSM (DSA 2).


AFTER OPERATION  IN ICU  ULTRASOUND POCKET AT BEDSITE WITH BUTTERFLY IQ  MAKES SURE AORTIC FLOW.




Thursday 5 September 2019

CASE 564: VAGINAL CUP, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

Woman 35 yo  goes to general ultrasound check up .
Ultrasound scans at pelvis detected  uterus  had IUD T shape.
 U S 1  cervix deformation looks like tumor on longitudinal scan with   some echogenic things around the vagina.

U S 2  longitudinal scan  cervix  and vagina


U S 3:  crossed section scan  cannot see well  cervix by echogeneicity prothesis


 U S 4: scan at uterus  detected T shape IUD.



MSCT scan  detected a vaginal cup covered over cervix.




Conclusion:  we should know  some abnormal pictures due to vaginal cup.