CASE 780: UROEPITHELIAL PAPILLOMA and IBS, Dr PHAN THANH HẢI, Dr PHẠM THỊ THANH XUÂN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 69 year-old man with IBS syndrome and dysuria. But he concerned more his colon for 3 months which went through a polypectomy in the past. And the dysuria maybe due to an enlarged prostate of the elderly as in his thought.

Ultrasound revealed a papilloma in the full of urine of the bladder which was not rule out a malignant tumor. And it existed nothing about enlarged prostate also the colon tumor.

Bladder endoscopy was done and confirmed a bladder tumor with its stalk at the bladder neck.

A cauterised endoscopy was performed to remove the 2x3 cm bladder tumor.

Histoanapathological result was an uroepithelial papilloma.

CASE 779: VIRTUAL COLONOSCOPY for SIGMOID COLON CANCER, Dr PHAN THANH HẢI, Dr LÂM CẨM TÚ, Dr VÕ NGUYỄN THÀNH NHÂN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 66 year-old man post cerebral ischemic disorder with constipation for 2 months. Sometimes he notes a bloody stool. His doctor would like a diagnosis for his client before the day of  September 2nd, so sending him to Medic Center on August 31. Because all of the hospitals will be in the day off from September 1 to 3 to celebrate the day of the National Independence of Vietnam.

Abdominal ultrasound detected nothing but a virtual CT colonoscopy revealed rapidly a sigmoid colon tumor and some colonic polyps.

Later a conventional colonoscopy was performed and biopsy of a # 2cm tumor of sigmoid colon which is far from the anus about 20 cm, and some polyps.

The  imaging diagnostic results last in some hours in one day of the August 31, for a sigmoid colon tumor. And waiting for the histoanapathologic result will be reply on the September 5.

The result is moderately diferentiazed adenocarcinoma of colon.

REFERENCE:

Computed tomographic (CT) colonography, also called CTC, virtual colonoscopy (VC) or CT pneumocolon, is a powerful minimally invasive technique for colorectal cancer screening [from Radiopaedia.org].

CASE 778: GASTRIC YOLK SAC TUMOR, Dr PHAN THANH HẢI, Dr LÊ THANH LIÊM, Dr VÕ NGUYỄN THÀNH NHÂN, MEDIC MEDICAL CENTER, HCMC, VIETNAM

A 84 year-old myocardial ischemia man with stenting cononary artery in annual check-up.

Since September 2023, AFP value was 6,015 ng/mL, and April 2024, ultrasound and MSCT detected an exophytic cardia gastric wall tumor # 69x90x30mm and metastatic lymph nodes.

But gastric endoscopy was negative. 

While AFP value elevated highly  3,667 ng/mL ultrasound and MSCT detected no liver tumor.

Later in May 2024, the cardia gastric wal tumor # 82x83mm, and lymph nodes were getting bigger on ultrasound and MSCT . 

A higher AFP value =5,685 ng/mL noted again. And at that time, it appeared some liver nodules in the right and left lobe =73-61-46-20-14mm on ultrasound. The echogenic structure of these nodules were complex, one hyperechoic, another mixed echoic that might come from the gastric tumor instead a multiple HCC.

No surgery was performed for the elderly patient and he died some days in this week.

But in the literature there were only 6 cases of the gastric tumor with high value of AFP . These cases belong to the primary gastric yolk sac tumor with immunohistochemistry stain results.

The primary gastric yolk sac tumor with high value of AFP is still a very rare malignant entity.

REFEẺENCE:

PRIMARY GASTRIC YOLK SAC TUMOR

CASE 777: BREAST LYMPHOMA, Dr PHAN THANH HẢI, Dr VÕ THỊ LOAN, MEDIC MEDICAL CENTER, VIETNAM

 A 33 year-old woman in annual check-up.

Breast Ultrasound, AVBS detected 2 phyllodes tumors, mixed echogenic, hypervascular without axilarry node.

An Automated Volume Breast Sonography [AVBS] video clip:

Mammography revealed 2 blurred masses # 5 cm, BI-RADS 4.

Breast MSCT confirmed right breast mass 7x5 cm and left one 4x3 cm.

2 breasts were getting bigger and painful in 3 weeks later and the breasts becoming more reddish skin appearance.

Core biopsy and histoimmunostaining result was Lymphoma B high malignancy.

REFERENCE:

VMU CASE 391

CASE 776: RUPTURED LEFT LIVER ABSCESS, Dr PHAN THANH HAI, Dr LE VAN TAI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

A 52 year-old man with LUQ pain for 4 days in body bending walking. History noted he got liver abscess in one year before which was successfully in medical management.

Ultrasound detected a left liver abscess with fluid collection close by the inferior border of the left lobe of liver.

Chest Xray film was normal and the heart was nothing abnormal detected.

MSCT confirmed a 104× 56 mm left liver abscess in rupture with abdominal fluid collection close by the left lobe, the stomach and the spleen.

The left liver abscess was drained out  4 hours

 later by via endoscopic surgery.

CASE 775: ECTOPIC TESTICULAR SEMINOMA, Dr PHAN THANH HAI, Dr TRAN THI BAO CHAU, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 52 year-old monk with LUQ pain for days.

Ultrasound revealed 2 left kidney stones # 6 mm. And a RLQ mass#40x37 maybe GIST beside the cecum. His scrotum were empty both 2 sides.

MSCT detected right testicle at RLQ and left one inside the left inguinal canal. And a left renal stone.

Surgery removed the right testicular tumor and reconstructed the left inguinal canal in bringing back the left undescended testicle to the left scrotum.

Result of histoanapathogy of the right testicular tumor was seminoma.

So the monk got a testicular tumor that maybe due to be misplaced into the abdominal cavity; and an undescended testicle in the left inguinal canal which is called a cryptochism.