CASE 486: POLAND’S SYNDROME, Dr PHAN THANH HẢI, Dr TRẦM THỊ TÚ HƯƠNG, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Woman  42 yo with  right breast hard mass,clinical examination of asymetric thorax (photo).

Ultrasound of right breast detected one 5 cm mass, multilobular, hypoechoic  with blood supply arround this tumor ( US 1, US 2 ),  US 3  detected axillary lymph node, US 4  in comparison of right to left chest wall  shows absence of right major and minor pectoralis muscles.

Chest X-Ray : clear right lung in comparison to left  lung due to  right chest wall muscle defect.

Mammography  diagnosis is  breast tumor with  Bi-Rads 4  T2N1Mx.

MRI   made diagnosis of  right breast tumor  with   pectoralis muscle defect of chest wall: it  is Poland’s syndrome.

FNAC of  this tumor  with cytological report of  adenocarcinoma of breast tumor.

Reference  : Case report   Poland ' s Syndrome complicated with breast cancer.

CASE 485: CONGENITAL RENAL LYMPHANGIOMATOSIS, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Female patient 15 yo with  pain at lumbar region.

Ultrasound and CT detected  perirenalcystic  collection, kidney deplacement no stone no hydronephrosis. CT  urology with CE: no leaking of contrast to fluid,  but urologist suspected  urinoma  ( CT 1, CT 2,  crossed section , CT3  frontal section, CT 4  2 kidneys  deplacement, CT 5 urinary system).

Puncture of this fluid  analysis is not urine,  like  lymphatic fluid.

Operation at right kidney  with argon laser for ablation of right renal capsule, and the left kidney was removed perirenal capsule.

Ultrasound of 2 kidneys shows  normal structure with vascular supply  (US 1, US 2, US 3, US 4  ascites).

And  MRI   after 3 months of  operation=The right kid has  many perirenal cysts,    and  left  kid  has fluid  collection arround without hydronephrosis ( MRI 1, MRI 2)​​.

Conclusion:   this case  is a congenital renal lymphangiomatosis case.

REFERENCE:

CASE 484: SPLEEN TUMOR, Dr PHAN THANH HẢI, Dr NGUYỄN PHÚ HỮU, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

Man 59yo with history of  trauma  at the right lung 10 years ago; today  getting pain at right costal area. Chest X-rays detected an old fracture of one rib with changing  costo-diaphragmatic sinus (chest film).

Ultrasound of abdomen detected a liver hemangioma and a big tumor of spleen ( US 1:  liver with hemangioma),  US 2:   round tumor in the pleen, size 9.26cm. US 3:   vascular supply of this tumor.

MRI  with gado  = MRI 1: liver tumor  as a hemangioma and  spleen tumor; MRI 2, MRI 3.  

Blood tests and cancer markers are negative.

Operation  removed the big spleen;   see  macro  looks like hemangioma.

MICROSCOPIC REPORT IS  CAVERNEOUS HEMANGIOMA.

REFERENCE:

CASE 483: UTERINE GIANT MYOMA, Dr PHAN THANH HẢI, Dr DƯƠNG NGỌC THÀNH, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

Woman 47yo  still has mense with the big growth of abdomen (photo).

US scanning  detected  a solid tumor cover over abdominal cavity ( US 1, US 2  US 3  longitudinal scanning over aorta),  US 4 : elastoscanning of tumor structure is hard and  inhomogeneous.

CT scan with CE of this mass is enhanced CE slowly: CT1, CT 2  sagittal view of  the tumor and uterus, CT 3: tumor near right kidney.

MRI  with gado= MRI 1:  crossed section, necrotic cystic formation of tumor structure. MRI 2 : longitudinal scan, MRI 3:  frontal view.

Preoperative diagnosis is big uterine myoma.

Macroscopic  photo of this tumor.

Hysterectomy was done.
Microscopic report is  leiomyoma.

REFERENCE= case pdf.