RESUMO
A 57-year-old male patient was admitted for evaluation of an enlarged neck lymph node. Previously, the patient had undergone three operations for recurrent medullary thyroid cancer. In preoperative neck ultrasonography, several nodules were identified in right level 3, level 5 and central neck area, which were suspicious for recurrence of thyroid cancer. Selective neck dissection for nodules was performed. Pathologic reports for nodules in right level 3 area were consistent with traumatic neuroma.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Excisão de Linfonodo , Linfonodos , Esvaziamento Cervical , Pescoço , Neuroma , Recidiva , Glândula Tireoide , Neoplasias da Glândula Tireoide , UltrassonografiaRESUMO
The extravasation of chyle into the peritoneal space usually does not accompany an abrupt onset of abdominal pain with symptoms and signs of peritonitis. The rarity of this condition fails to reach preoperative diagnosis prior to laparotomy. Here, we introduce a case of chylous ascites that presented with acute abdominal pain mimicking peritonitis caused by ovarian torsion in a 41-yr-old female patient with advanced gastric carcinoma. An emergency exploratory laparotomy was performed but revealed no evidence of ovarian torsion. Only chylous ascites was discovered in the operative field. She underwent a complete abdominal hysterectomy and salphingo-oophorectomy. Only saline irrigation and suction-up were performed for the chylous ascites. The postoperative course was uneventful. Her bowel movement was restored within 1 week. She was allowed only a fat-free diet, and no evidence of re-occurrence of ascites was noted on clinical observation. She now remains under consideration for additional chemotherapy.