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Sunday, 17 November 2019

CASE 573: BILIARY HAMARTOMA, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

WOMAN 51 YO FOR 5 YEARS CHOLECYSTECTOMY BY GALL BLADDER  STONE, NOW GETTING PAIN IN LIVER.

US SCANNING : GALL-BLADDER HAD BEEN REMOVED. CBD DILATED   OF 3CM IN DIAMETER   WITH DILATATION R/L BILIARY DUCTS IN LIVER  AND  THERE  ARE SOME  SMALL SPOTS LIKE CYST 0.5 CM.  CBD  IS  STENOSIS AT ODDI AREA  AND NO TUMOR OF PANCREAS.
US1   BW US   US2 CDI 



MRI OF LIVER   
MRI1  CROSSED SECTION OF LIVER   
MRI2   CBD DILATED WITH MANY SPOTS  LIKE CYST IN LIVER   THAT  ARE HAMARTOMA OF BILIARY CANALS.



ERCP  lCANNOT  ENTER THE CBD  (FOTO1, FOTO2)



OPERATION  REPORT   IS  CYST OF CBD AND STENOSIS  OF CBD AT ODDI SPHINTER.
 AND MANY SMALL NODULES AT SURFACE OF LIVER  BIOPSY (lFOTO CBD).


PROCEDURE  IS ROUX EN Y  FOR  ANASTOMOSIS OF CBD AND  DUODENUM.

CONCLUSION =IT IS  HAMARTOMA OF BILIARY SYSTEIM  WITH STONE STENOSIS OF CBD AND MANY SMALL LIKE -CYSTS OF BILIARY SYSTEM.

Wednesday, 6 November 2019

CASE 572: PROSTATE CANCER, Dr PHAN THANH HAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

Man 45 yo  with pain at sternum. SPECT bone scan detected multiple bone lesions ( spect photo).



Ultrasound at sternum detects osteolytic lesions. 


Blood test PSA rises 92 ng/mL

Transabdominal Ultrasound of prostate  US 1   section  prostate in small size 



US 2  sagittal view also prostate in small size without abnormal focal lesions 



US 3 elastoscan detected abnormal zone inside prostate  




US 4 sagittal elastography mapping one zone with kPa high,  #50kPa



Biopsy with TRUS elasto guide;   report is prostate cancer classified Gleason core 7



Summary=  US elastoscanning of prostate guide for biopsy is more accuracy than conventional TRUS guide alone.