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This page provides a translation of the results of several surveys carried out in the RCRC n.a. N.N. Blokhin. Medical examination data: February 4, 2011. Infantile infection: chickenpox in 2006 Vaccination: poliomyelitis in 2004 Family’s oncology history: uncle-cousin and aunt-cousin on mother’s side had malignant disease. Allergic anamnesis: not diagnosed Medical history: In January 2011 left superior lymph-node hyperplasia and cheek edema was diagnosed. Visited a community-based doctor who assigned an antibacterial therapy – no response detected. Additionally applied to a hospital where the referral to Tyumen oncological hospital was given. In February 2011 the biopsy of soft tissues of mandibular angle was performed. Histology: undifferentiated carcinoma, cancer, malignant thymoma, teratoblastoma. Due to the pain in lower limb, head ache and back pain the МRТ was performed. The image of neck’s soft tissues shows temporal fossa with multiple bone metastases to lungs, lymph nodes – neuroblastoma and carcinoma. Objective opinion: patient is in a bad condition; complains of bone pain, back pain; poor appetite, during 2 weeks lost 4-5 kg of weight, total weakness. Skin and pharynx are clean. Fauces is not hyperemic (not red). Heart action is within normal range. The breathing is weak. No rale defined. Abdomen is not swollen. No increase in the liver mass defined. The formation of non-distinct shape and size (3x2 cm) is felt on the left side of inguinal area. The stool and urine parameters are within the normal range. St-localis: The solid formation of non-distinct shape on the neck and cheek is clearly seen during the throat examination. Conclusion: the tumor of the neck soft tissues is on the right side with metastases in bone? lungs? lymph nodes? Recommended: 2. X-ray computer tomography of lungs + computer tomography and angiography of the brain, nasal pharynx + paranasal sinus. 3. Revision of x-ray image + MRT disk. 4. Bone biopsy. 5. Skeleton radioisotopic detection. 6. Soft tissue radioisotopic detection. 7. Magnetic-resonance tomography. 8. Revision of biopsy material. Based on patient condition the ultrasonic examination is required urgently! February 15, 2011. The condition of the girl is very bad, she is poorly walking. The paracentesis of formation and bone biopsy is done using nitrogen oxide! After consultation with the diagnostician, E.V. Zakharova, urgently perform x-ray computer tomography of the lungs! X-ray Section. Dasha Lukyanenko February 14, 2011 Examination type: ultrasonic examination. During ultrasonic examination of the right cheek soft tissues, right upper mid of neck and right submandibular area the massive formation of irregular shape with undular contours was identified (formation size is 8.0x4.1x5.4 cm). Formation structure is moderately heterogeneous, solid. The Doppler sonography showed that the formation is moderately vascularized; vessels are mostly with arterial blood circulation. Tumor goes under the base of the skull. The lymph nodes have small calcareous changes. Liver, spleen, kidneys and pancreas are not modified. In the retroperitoneal of inferior vena cava area and in the peritoneum of the jejunum the small non-modified lymph nodes are defined. Free fluid in the abdomen and in the small pelvis is not diagnosed. On the left of hypogastrium the formation of 2.1x1.6 cm of the heterogeneous Hyperechoic structure is defined, adjacent to abdominal wall of splanchnic cavity (metastasis?). Conclusion: ultrasonic examination detected the features of parameninx tumor on the left, and metastasis in the abdomen (??). MRT study description is required. Radiodiagnosis Section. Computer tomography and magnetic resonance tomography. Study report. Dasha Lukyanenko Examination type: Chest x-ray tomography At the x-ray tomography the multiple local and focal pseudinoma of lung tissue in the both lungs with the size of 0.5 to 2.0cm are found, as well as subpleural induration of lung tissue. Intrathoracic lymph nodes with the size of 0.6 cm and bronchopulmonary lymph nodes with the size of 3.0 cm on the right side are detected. On the left side of the front-upper mediastinum the massive formation with the size of 3.2x2.4x2.0cm is diagnosed. The pesthole of destruction is defined in the body of sternum, right side of the front part of III rib, lower part of thoracic vertebrae. Conclusion: x-ray tomography image shows multiple pestholes in the lungs, intrathoracic lymph nodes, pleural nodules, mediastinum which are most likely to be secondary nature (metastases).
Radiodiagnosis Section. Computer tomography and magnetic resonance tomography. Examination record. Dasha Lukyanenko Examination type: MRT of entire body. The torous, massive formation with the size of 7.5x5.7x5.9cm is identified in the submandibular area on the right which developed to the intratemporal fossa and penetrated to the middle cranial fossa (intracranial growth). The formation destroys lateral and lower wall of the right eye-pit, penetrates the eye-pit, genyantrum and sphenoid sinus. The signal from the right part of the spheroid bone body is modified. The right mastoid bone is filled with substance (inflammation? tumor infiltration)? The formation also displaces the right wall of the fauces. The size of the intracranial tumor is 2.0х1.0х1.5cm. Multiple damage of the lung tissue by round, different-sized formations are identified, the formation in pleura is also determined. The massive formation with the size of 3.0x2.7cm is diagnosed in the right lung aperture (lymph node? epineurial metastasis)? Increased lymph nodes mostly on the right are identified in the root of the. Two massive formations with the size of 1.3x0.7 and 2.0x1.7cm are identified in the left iliac area. Multiple skeleton bones affection in the thighs and sural bones are identified, as well as the hyper-intensively changed MR signal from pelvic bones, vertebra T2-R3, sternum and ribs. Conclusion: MRT image shows massive formation of the parameninx localisation on the right, metastasis – affection of lungs, pleura (?), peritoneum (?), bones and bone marrow.
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