CASE 755: PARATHYROID TUMOR, Dr PHAN THANH HẢI, Dr LÝ VĂN PHÁl, Dr HỒ KHÁNH ĐỨC, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 A woman in her 58 s with osteoarthritis pain for years but failed in management. Blood calcium raising ( 3.14mmol/l), elevated PTH, and critical osteoporosis.

Ultrasound detected a # 34x11 mm hypoechoic mass at posterior face of left lobe of thyroid maybe a parathyroid tumor. 

And many stones in both two kidneys.

MSCT confirmed the left parathyroid tumor.

Operation performed to remove the parathyroid tumor.

Histopathological result was a parathyroid tumor with intact capsule.

PTH came back of 15.89 pg/mL after removing the parathyroid tumor.

CASE 754: OVARIAN CANCER, Dr PHAN THANH HẢI, Dr TRẦN MỘC HIỆP, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 66 year-old woman with loss of weight and constipation for months.

Ultrasound detected a # 86x106 mm right pelvic cystic tumor which was in front of the sacrum-coccyx and elevated the rectum from behind. It may a GIST but could not ruled out of an ovarian tumor.

Both two kidneys were in hydronephrosis without stone, may due to be pressed in pelvic region.

Lab data were not interested.

MSCT represented an 9x10 cm ovarian tumor and vegetations in the pelvis which caused the hydronephrosis .

Surgery removed the ovarian tumor FIGO IIB, uterus, anexals, rectum and sigmoid colon, epiploon, and an arteficial anus was made.

Histopathologic result was Retroperitoneal malignant tumor [high grade adenocarcinoma], primary peritoneal cancer.

Remaining well post-op, the patient was going through a chemotherapy planning.

CASE 753: INCIDENTAL RCC, Dr PHAN THANH HẢI, Dr NGUYỄN THỊ THẢO HIỀN, Dr PHẠM LÊ DIỄM CHI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

A 51 year-old man without any symptom in an annual check-up.

Ultrasound revealed a right kidney tumor 37x40 mm, at the middle of anterior face, solid, hyperechoic pattern without rim sign that not ruling out a RCC, and a 13 mm small cyst of right lobe of the liver.

Lab data normal.

MSCT represented a 17x20mm right renal tumor maybe a RCC.

Robot surgery removed successfully a right kidney tumor. Histopathological result was a renal clear cell carcinoma of kidney.

CASE 752: COLON CANCER in Young Woman, Dr PHAN THANH HẢI, Dr TRƯƠNG CÔNG THÀNH, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 A 31 year-old woman with loose stool for 2 months and epigastric pain that was in gastritis treatment  but not the loose stool not resolving. She lose her weight of one kilogram and cramping feeling in her right flank.

Ultrasound detected right colon wall thickening maybe due to tumor.

Colonoscopy showed the right colon tumor with ulcer and vegetations.

MSCT confirmed the right colon tumor and liver metastase in the right lobe.

Lab data showed occult blood in stool [FOBT] and stool calprotectin positive.

Result of histopathological specimen was well differentiazed carcinoma of colon.

Cancer of colon seems to be more early in appearance in the young patients. And in late stage [liver metastase] liked the young woman in this case.

CASE 751: PERFORATED COLON CANCER, Dr PHAN THANH HẢI, Dr NGUYỄN VĂN HIỀN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 A 45 year-old man with epigastric pain  for 2 months but failed in gastritis management in a hospital and getting worse his status.

At Medic Center, ultrasonography revealed the transverse colon wall thickening =12-17 mm associated with malignancy,  which was linked to a neighboring abscess measuring 59x21 mm that was sealed off. A fistula between the cancer and the abscess was seen on ultrasound.

Lab data: WBC=20,51x10^9/L, CEA: 5.47ng/mL

MSCT confirmed the abscess at posterior of the transverse colon due to perforated transverse colon cancer.

Open surgery removed the # 5x5 cm transverse colon cancer which perforated at posterior face and an arteficial anus was done. But 3 days later, this artificial anus was necrotizing then the proctotoreusis was done secondly. 

The histopathological result was a high differentiazed carcinoma invasive of colon. 

The patient remained well after the 2 complex operations.

CASE 750: PERFORATED APPENDICITIS due to FISH BONE, Dr PHAN THANH HẢI, Dr BÙI HỒNG LĨNH, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

A 58 year-old infected HBV man with RLQ pain for 5 days.

Ultrasound detected edema of the last part of jejunum maybe due to inflamation. It existed edema of pelvic peritoneum beside the appendix. 

MSCT  represented an inflamed appendix and foreign body  as fish bone # 30mm which perforated the appendiceal wall.

Endoscopic surgery confirmed a fish bone and removed the inflamed appendix.

Result of histopathological specimen was an acute necrotized appendicitis.

CASES 748-749: GASTRIC WALL ABSCESS, Dr PHAN THANH HẢI,Dr PHAN THANH VIỆT BÌNH, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 

2 cases of gastric wall abscesses were incidentally detected  with epigastric pain for one month and were failed in the urban medical management.

Case 748:

A 32 year-old man with epigastric pain for one month. 3 years before he went through a gastritis.

Ultrasound detected thickening of antrum wall with fluid collection inside may having foreign body and fatty liver.

Endoscopy represented a gastric wall abscess. 

MSCT confirmed a gastric wall thickening without foreign body and ruling out a gastric tumor.

By antibiotics  treatment the gastric abscess disappeared after one month.

Case 749:

A 22 year- old girl with epigastric pain for a half of month. 

Ultrasound detected gastric wall thickening maybe gastric polyp.

Endoscopy described a gastric wall abscess.

Biopsy results was gastric hyperplasia.

MSCT detected no gastric tumor, but gastric wall abscess was noted.

She took a medical management and remained well after one month.

Gastric wall abscess is a rare entity  and endoscopy may help detecting it.

Infected Streptococcus is the main source of infection (75%). And Staphylococcus, E.coli Hemophilus influenza, Pseudomonas. Candida [rare].

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