our tumor board presentation

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presented at surgery tumor board trivandrum medical collage

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By: iruu (11 month(s) ago)

a.a i am dr. irum , can u plz send me ur presentation.

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Tumor boardS4 unit : 

Tumor boardS4 unit Dr Abdul Basith P.T

Geetha : 

Geetha 36 yrs Female DOA :8/02/09 c/o abdominal distention Urinary retention o/e abdomen distended and tense Investigations wnl USS abdomen: lymphatic cyst

Past history : 

Past history 27 yrs Female DOA:08/07/ 2000 LSCS on 14th may 2000 C/o abdominal pain afterwards post C.S USS showed Right ovarian cyst

Explorative laparotomy in SATH on 3/07/2000 : 

Explorative laparotomy in SATH on 3/07/2000 Retroperitoneal multi loculated cystic mass With IVC stretched over it Extending from lower pole of left kidney up to the pelvis Due to unforeseen circumstances (?power failure) cyst dissection was abandoned Marsupilisation of the contents and cyst wall sent for biopsy

USS on 10/07/2000 : 

USS on 10/07/2000 Multi loculated cystic mass 150*65*45mm With thin septations in rt lumbar and iliac regions with close proximity to IVC and iliac vessels

Cyst wall biopsy : 

Cyst wall biopsy Cystic lymphangioma Bx no 9995

Cyst fluid analysis : 

Cyst fluid analysis Lymphocytes only Cyst fluid urea :32 mg% Cyst fluid creatinine : 0.6%

Follow up : 

Follow up Re admitted on 04/06/01 c/o abdominal pain Investigations : wnl CT scan: retro peritoneal lymphangioma extending from under surface of liver to superior aspect of urinary bladder Compressing the IVC Lateral displacement of rt ureter

Explorative laparotomy on 10/7/01 : 

Explorative laparotomy on 10/7/01 Malrotation of cyst seen Retro peritoneal Partial dissection of cyst done and loculi were opened up Small cysts were scattered trough out anterior and posterior surface of uterus and omentum partial dissection of cyst done Loculi were opened up

Slide 10: 

After doing an appendicectomy too wound Closed after putting a Drain

USG 28/3/02 : 

USG 28/3/02 Multi loculated cyst in right lumbar region

Follow up 2/10/02 : 

Follow up 2/10/02 c/o pain abdomen o/e incisional hernia + Managed with analgesics and anti spasmodics

Re admitted on 19/6/06 : 

Re admitted on 19/6/06 c/o abdominal pain Abdominal swelling Investigations wnl USG abdomen :retroperitoneal lymphangioma

Incisional hernia repair on 21/06/06 : 

Incisional hernia repair on 21/06/06 Paramedian incision Defect 12*3cm Multiple lymph cysts over peritoneum was unattended to as the disease was extensive Incisional hernia repaired using a prolene mesh

Re admitted on 15/11/08 : 

Re admitted on 15/11/08 c/o abdominal pain Massive abdominal distension Loss of appetite Cystic mobile swelling in right iliac fosse Lower border palpable mild ascitis Investigations wnl CA-125: 177 mg/dl CEA :1 mg/dl

CT abdomen 28/10/08 : 

CT abdomen 28/10/08 Complete cystic appearance of enlarged peritoneal cavity Left sided displacement of uterine axis Ipsilateral adnexal prominence Consider left adnexal uterine primary neoplastic pathology with pseudomyxoma peritonii spread

Explorative laparotomy with debulking of cyst 25/11/08 : 

Explorative laparotomy with debulking of cyst 25/11/08 Large multi loculated lymphatic cyst with adhesions Extending from sub hepatic space to pelvis Contained hemorrhagic and clear fluid Cyst aspirated and decompressed Cyst wall excised (anterior) Abdomen closed

CT abdomen 16/02/09 : 

CT abdomen 16/02/09 Suggestive of residual and recurrent lesions Lung :posterior mediastinum shows lymphatic cyst with no enhancement Cystic lung changes in bibasilar segments Vertebral body lytic lesions in L2,3,4

contd : 

contd Spleen cysts in upper part Due to extensive involvement of retro peritoneum lung spleen and bones a generalized condition like lymphangiomatosis has to be considered