Surgery Blog for Surgeons

Metastasis dependancy on the primary tumor?

Recently I had an interesting case with a weird behavior of a suspected metastasis after resection of the primary tumor.

A 43 years old gentleman came in July 2008 to the Medical Service with nausea, vomiting and abdominal pain. The workup showed a tumor in the 3rd portion of the duodenum as well as a big mass in the right liver lobe, so the IM guys asked us to take a look. They performed two attempts to biopsy the masses which showed no tumor. This was the reason for the decision to resect the tumor.

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Breast implants in elderly women from Egypt

A recent case in my ER offered a very interesting finding. A 1930 born woman from Egypt got a CXR. Among the common findings in the CXR of an elderly woman, a couple of breast implants could be seen. The colleague who had the case did not come to the idea of performing breast exam on the woman. All of us were somehow surprised seeing the implants. I first saw the date she was born and noticed that I never saw breast implants in a woman of this age. But the real surprise was that the patient is of Egyptian origin who never lived outside Egypt, being only a visitor in Germany.

Who could imagine that behind the traditional Muslim dress of a 77yo woman with a headscarf, a couple of 2 big breast implants could be find? Wilhelm Conrad Röntgen made it possible. :)

Take a look at the pictures:

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