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CASE 361: TUMOR of MUSCLE RECTUS ABDOMINIS, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

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Woman 33yo, 4 months after cesarian operation  detected a  mass near umbilicus on right side, fixed  palpation, 
Ultrasound.scanning of   this mass revealed  intra abdominal wall mass, from lower part of  rectus abdominis muscle. ( US 1, US 2.  US 3 ( linear probe), video) . Video clip  shows this tumor  from anterior abdominal wall ).




On MRI, this tumor is solid, size of 12 cm, structure looked like  uterine  myoma.
( MRI1, MRI2, MRI3).





Discussion:

At first,  diagnosis from one  OBGY  doctor is endometriosis  post c-section. But  another  sonologist  from  Obgy hospital is pediculate fibroma of uterus. One  radiologist  looking  MRI  says tumor of rectus abdominis muscle  same as  fibromuscular mass.
Operation for remove this tumor; operator reported  this tumor was well bordered,  hard,
and developered from  rectus muscle, not  from the middle line if c-section.
Macro.view of  section surface look like  fibroma.



Discussion 2: In past history she had been first c-section for first delivery 3 years ago. During second pregnancy, this patient known having fibroma of uterus from doctor ObGyn. It is mistaken prenatal diagnosis. Her past history is very important issue for diagnosing today.

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