No

1. Oncosurgical Unit
Meeting
Minya university

2. Cases for discussion
By Res/ Muhammed Mukhtar

3. Case 1
Name ‫قفطان‬ ‫التواب‬ ‫عبد‬ ‫محمد‬
Age 50 yrs. old
Medical Hx. - ve
Surgical Hx. -ve
Presentation I.O
On
Examination
abdomen is distended, tenderness.

4. labs
HB 12
TLC 11.4
PLT 257
PC 95
INR 1.02
Ur 32
Cr 1.5
Na 137
K 4.6
Ca 1.1
)

5. CT Abdomen and pelvis:
Recto sigmoidal mass
Colonoscopy:
stricture at 15 cm from
anal verge and
colonoscopy can not
pass beyond , multiple
biopsies were taken
INVESTIGTIONS:

8. Radiology
Abdominal US:
-There is a well defined rounded hypo echoic focal lesion seen at the lt.
supra renal gland measuring 19 x 17 mm.
-no calcifications.
-Rt kidney angiomyolipoma at middle segment 16 x 14 mm.
- Enlarged fatty liver.

18. Case 2
Name ‫الدين‬ ‫محى‬ ‫منار‬
Age 20 yrs. old
virgin
Medical Hx. Negative
Surgical Hx. Negative
Presentation Recurrent attacks of Rt. Iliac Pain.
On
Examination
Not obstructed

19. labs
HB -
TLC -
PLT _
PC --
INR -
Ur -
Cr -
Na -
K -
Ca -
CEA _
CA 19-9 _

20. Operation:
cecal mass underwent
Rt. Hemicolectomy

23. MRI Pelvis
18/6/2022
 Circumferential abn. Soft tissue lesion.
 involving low rectal region (mainly on the Rt. Side),
 4 cm from anal verge.
 About 6.5 cm in length x 15 mm single wall thickness.
 Luminal narrowing
 Extended to meso-rectal fat planes.
 Intact levator ani
 Multiple enlarged loco-regional and pelvic LNs ( > 8mm),
Largest at lt. side 20x14 mm
 Involving internal sphincter, extending to inter-sphincter plane at
Rt. Side.
 T3c N2b stage III

28. Case 3
Name tdtn u’h
Age 45 yrs. old
Medical Hx. -ve
Surgical Hx. -ve
Presentation Rt breast mass
operation Rt. MRM

29. Labs:
ER +
PR +
Her 2 neu -ve
Ki67 80%
INR -
Ur -
Cr -
Na -
K -
Ca -

30. Chest X ray : free
Abdominal US: Free
Breast US:
Suspicious Rt breast mass with axillary Lns 2 x 1cm preserved hilum
MRI Breast:
Rt. Breast multicentric malignant neoplasm 2 x 2 cm
And 3 other lesions average size 10x8 mm
Intermediate Rt. Axillary LNS.
BIRADs VI
Tru cut Bx
IDC

32. Case 4
Name
Age 31 yrs. old
Medical Hx. Negative
Surgical Hx. !
Presentation Lt breast mass
On
Examination
.....

33. HB ..
TLC ..
PLT _
PC -
INR -
Ur ..
Cr ..
Na -
K -
alb ..
CEA ..
CA 19-9 ..
Labs:

34. Investigations:
MRI breast
Abdominal US
Chest X ray
Tru cut : IDC