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Gastrointestinal bleeding due to hemobilia is a rare condition but can be very serious, even life-threatening. The main causes of biliary bleeding are invasive procedures in treatment, trauma, or malignant diseases. Chronic obstruction of the biliary tract can cause inflammation, erosion, and leakage of adjacent vascular structures and lead to pseudoaneurysm or hemorrhage, but this is very rare. In this article, we present a clinical case of upper gastrointestinal bleeding due to a pseudoaneurysm of the hepatic artery believed to have formed due to chronic cholangitis. An 81-year-old female patient with a medical history of chronic cholangitis was admitted to the hospital with recurrent inflammation accompanied by progressive upper gastrointestinal bleeding, potentially life-threatening. Ultrasound images and blood tests confirmed that the patient had anemia and cholangitis caused by stones. Gastrointestinal endoscopy showed bleeding suspected to be from the biliary tract. Hepatobiliary computed tomography confirmed that the common hepatic artery pseudoaneurysm located at the upper end of the common bile duct had active bleeding.

Biliary lithiasis is common in clinical practice. We present the case of a 53-year-old man referred to our hospital with a history of biliary lithiasis. Abdominal magnetic resonance imaging revealed gallbladder stones and common bile duct stones. To avoid surgery, we opted to apply percutaneous transhepatic techniques to clear gallbladder and bile duct stones. This study reports our experience using these techniques, including percutaneous transhepatic holmium laser lithotripsy for cholelithiasis combined with balloon dilation to remove common bile duct stones and avoid open surgery.

Abdominal effusion due to hepatic lymphorrhea post-hepatectomy is an extremely rare and complex complication in clinical practice. No standard treatment method has been established for this condition to date. We report a case of complicated intra-abdominal lymphatic leakage in a patient following hepatectomy to treat hepatocellular carcinoma. The patient underwent percutaneous embolization of the hilar hepatic lymphatic system, combined with intensive medical treatment. Percutaneous embolization represents a safe and effective method that should be considered as a first-line treatment for this complication.

A ruptured blister-like aneurysm of the internal carotid artery is a rare event with a high risk of recurrence and mortality. Selecting an appropriate treatment modality remains challenging due to a lack of consensus or specific recommendations in the literature. In this article, we present the case of a 68-year-old man who presented with ruptured blister-like aneurysms in the supraclinoid portion of the internal carotid artery. The patient was diagnosed and successfully managed using an endovascular coil embolization technique at our hospital. We aim to illustrate and share our experiences with this rare occurrence, which may assist in the treatment of similar cases in the future.

An encephalocele may be congenital or acquired and is characterized by the herniation of cranial contents through a skull bone defect. Most congenital encephaloceles occur in the occipital area, and temporal bone encephaloceles in children are rare. Congenital encephaloceles can be diagnosed either prenatally or after birth. We describe the case of a congenital temporal bone encephalocele in a 2-month-old boy that was diagnosed after birth. The patient presented with seizures and a bulging mass in the right neck that was detected by his mother during the second month after birth. The combined results from brain magnetic resonance imaging, computed tomography, and histological analysis confirmed the diagnosis of encephalocele. Although the surgical repair was offered, the family declined.

Mesenchymal hamartoma of the chest wall is a rare benign tumor that usually occurs in infants and children. The clinical presentations and imaging features are atypical and difficult to differentiate from malignant tumors. In this article, we present a case with a large mesenchymal hamartoma tumor of the chest wall. A large right-sided chest wall mass was discovered in a 6-month-old boy by his mother. Chest X-ray revealed a thoracic mass with well-defined margins on the right side that expanded into the right ribs. Chest computed tomography showed that the mass originated from the thoracic wall. The patient underwent complete removal of the mass, and histopathology results confirmed a mesenchymal hamartoma.

Tuberculosis remains prevalent in developing countries. Central nervous system tuberculosis often occurs secondary to pulmonary tuberculosis, transmitted through the bloodstream, and has a high mortality rate. Meningitis is the most common presentation of central nervous system tuberculosis, followed by tuberculoma, tuberculous brain abscess, and miliary tuberculosis. In this report, we present a case of miliary tuberculosis in a 3 month-old boy. The patient had a fever and was breathless for 1 month. The patient appeared cyanotic, experienced a seizure, and became comatose. Chest computed tomography scan suggested a pulmonary miliary tuberculosis abscess in the right lung and mediastinal lymph node tuberculosis. Brain magnetic resonance imaging showed the lesions were homogeneously enhancing tiny 2-3 mm nodules characteristic of miliary TB. Polymerase chain reaction of the cerebrospinal fluid and sputum samples confirmed tuberculosis. The patient died 1 month after diagnosis.

Determining the cause of gastrointestinal bleeding is critical to determining appropriate treatment. Upper gastrointestinal bleeding from the pancreas, referred to hemosuccus pancreaticus, is a rare entity that can cause massive and life-threatening bleeding. Diagnosis remains challenging, and the mortality rate of hemosuccus pancreaticus remains high, ranging from 9.6%–90%. In this article, we present a case that was successfully diagnosed and treated at the Department of General Surgery, Hanoi Medical University Hospital, and a review of the available literature regarding this rare disease.

Ischiopagus conjoined twinning is a rare congenital defect. The surgical separation of conjoined twins is difficult because of the complex anatomy and physiology. Careful preoperative assessment, planning, and effective surgical teams are critically important for achieving a good outcome. We describe the successful separation of ischiopagus tetrapus conjoined twins as a representative case demonstrating the growth of pediatric surgery in southern Vietnam.

Mucoepidermoid carcinoma (MEC) is a common type of salivary gland malignancy; however, rarely, MEC can arise from the lung. This disease has a non-specific presentation and is often overlooked. Histologically, MEC can be classified into low-grade and high-grade forms. Surgical resection is the optimal treatment for low-grade tumors. In this article, we report a case of MEC in a 5-year-old girl who was initially misdiagnosed with pneumonia. The histological results revealed MEC. Thus, clinicians and radiologists should consider the possibility of this rare entity in patients who fail to respond to antibiotic treatments, even among the pediatric population.

Lymphoma with cardiac involvement is a high-risk lesion, especially in children. We report a rare clinical case of multifocal precursor B-cell lymphoblastic lymphoma in a child with cardiac involvement. A 4-year-old boy presented to the Vietnam National Children's Hospital with a vague headache, but magnetic resonance imaging of the head was normal. After 1 week, the patient showed symptoms of chest pain, fatigue, dyspnea, and abdominal pain. On transthoracic echocardiography and multislice computed tomography of the thorax, a mass was detected in the right atrial wall. Abdominal ultrasound showed a small bowel intussusception, multiple nodules in the intestinal wall, and mesenteric lymph nodes. Histopathology of the bowel confirmed the diagnosis of multifocal precursor B-cell lymphoblastic lymphoma. The patient responded to 3 cycles of chemotherapy for lymphoma. Therefore, combining multiple imaging methods allowed for early diagnosis and improved treatment.

Acute renal failure due to primary renal Burkitt lymphoma in children is extremely rare. We report a case with acute secondary renal failure in a 4-year-old boy who presented with abdominal pain, anorexia, and vomiting. Abdominal computed tomography scans showed bilateral nephromegaly with multiple hypoenhancing regions. Renal biopsy confirmed Burkitt lymphoma. There was no lymphadenopathy or evidence of other solid organ involvement. The patient was responsive to treatment using the EPOCH-R protocol (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab). Here, we describe the clinical and imaging features associated with this rare entity.

Choroid plexus papillomas (CPPs) are uncommon, benign intracranial tumors that can occur in both children and adults. In adults, CPPs are typically identified in the fourth ventricle, whereas in children, they most commonly occur in the lateral ventricle. CPPs that arise from the extraventricular system are extremely rare and difficult to diagnose. We report a case of extraventricular, atypical CPP located in the cervicothoracic spinal cord of a 2-year-old girl.

Adrenocortical carcinoma (ACC) is a rare malignancy that arises from the adrenal cortex and can be classified as either non-functioning or functioning. A patient with non-functioning ACC may present no specific symptoms. Imaging analysis can provide some information to a clinician who suspects ACC, such as tumor size, density, washout, necrosis, hemorrhage, and calcification. Histopathology is used to confirm and determine the origin of the malignancy and can provide relevant prognostic information. Microscopic findings can be used to obtain information such as the Weiss score, resection surface features, Ki-67 proliferative index, and the degree of capsular and vascular invasion. Surgery can be curative for localized tumors, and adjuvant therapy using mitotane and cytotoxic chemotherapy is often employed for advanced-stage tumors. We describe a case report of a 32-year-old man with a non-functioning ACC that highlights the importance of radiological and pathological features in the diagnosis of ACC and their use as prognostic factors.

Lipomatous pseudohypertrophy of the pancreas is a rare disease with unknown etiology, and the pancreas parenchyma is replaced by pancreatic parenchyma by fat tissue. In this article, we aimed to report the case of a 26-year-old male patient admitted to hospital with loss of appetite for 6 months. Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) scans showed diffuse enlargement and fatty replacement over the whole pancreas, with scattered remnants of pancreatic parenchyma. Histologic results defined lipomatous pseudohypertrophy of the pancreas. To summarize, this case report is to put forward this extremely rare presentation and to sensitize clinicians that this entity can be a cause of exocrine pancreatic insufficiency, which requires patient follow-up for the appropriate treatment.

Primary hepatic neuroendocrine tumor (PHNET) is a rare type of neuroendocrine tumor (NET) that is also a primary hepatic tumor. Patients are present with almost no specific clinical symptoms and typically present with negative test results and atypical imaging characteristics; therefore, the differentiation of PHNET from other types of primary hepatic masses can be very difficult. In this article, we describe a case of PHNET that mimicked a liver helminth infection in a 57-year-old man. The diagnosis of PHNET in this patient was challenging, and the final diagnosis was based on imaging, histopathology features, and long-term follow-up.

Wilms’ tumor is the most common malignant kidney tumor found in children. The Horseshoe kidney is the most common renal fusion malformation. However, Wilms’ tumor is rarely identified in horseshoe kidney patients. Multimodal treatments in Wilms’ tumor can play important roles in increasing the survival rate. In this study, we report the case of a 6-year-old boy in whom a Wilms’ tumor was identified in a horseshoe kidney. The tumor was successfully treated with preoperative chemotherapy, followed by surgical resection.

Malignant tumors that originate from the mesenchymal tissue of the mammary gland, known as breast sarcomas, are very rare and can be divided into 2 types: primary and secondary (therapy-related development). Breast sarcomas are aggressive tumors associated with a poor prognosis. Treatment options include the coordination of surgery, chemotherapy, and radiotherapy. We present a case of a 51-year-old female who presented to the hospital after noticing a palpable mass in the left breast and bloody nipple discharge. These symptoms lasted for more than 4 months. Postoperative histopathology revealed an undifferentiated pleomorphic breast sarcoma. After 8 months of treatment, the patient experienced metastasis to the brain and lungs.

Transurethral resection of bladder tumor (TURBT) is one possible treatment approach for bladder tumors. Bladder wall perforation is one potential complication of TURBT. Signs of perforation include abdominal distension, the inability to distend the bladder, and the low retrieval of irrigation fluids. Peritonitis may occur if a perforation diagnosis is delayed. Early detection and diagnosis are crucial for the prevention of severe complications, such as peritonitis and sepsis. Here, we describe a case of a 69-year-old male with a bladder rupture secondary to TURBT.

Pleuropulmonary blastoma is a rare, aggressive, malignant tumor of the lungs or pleura that primarily affects children. Pleuropulmonary blastoma is classified into 3 types based on morphology, including cystic (type I), mixed (type II), or solid (type III). These morphological types correlate with prognosis. In this article, we present a case of type III pleuropulmonary blastoma in a 2-year-old girl. The patient was treated with tumoral resection and chemotherapy; however, she experienced local recurrence and spinal metastasis after 5 months of treatment.

IgG4-related sclerosing cholangitis (IgG4-SC) is a relatively newly identified disease that is frequently associated with autoimmune pancreatitis. The differential diagnosis between cholangiocarcinoma, primary sclerosing cholangitis, and IgG4-SC can be challenging due to significant overlap among the clinical and imaging characteristics. We report the case of a 71-year-old woman who was diagnosed with IgG4-related disease based on increased serum IgG4 levels, imaging, and clinical presentation, which showed systemic involvement, including sclerosing cholangitis and kidneys. The patient presented with chronic jaundice. Magnetic resonance imaging revealed bile duct strictures and the dilatation of upstream bile ducts, smooth wall thickening with uniform enhancement in the delayed phase, and no vascular infiltration. Multiple low-density, wedge-shaped areas were identified in both kidneys, which were hypointense on T2-weighted images and hyperintense on diffusion-weighted images. The serum IgG4 levels of this patient were elevated to nearly 10-fold the normal upper limit. A diagnosis of IgG4-SC associated with IgG4-related kidney was made. Based on this case, pre-surgery IgG4 serum treatment in patients with non-malignant bile duct stenosis was recommended to exclude IgG4-SC.

Pericallosal artery aneurysm (PAA) is a relatively uncommon type of intracranial aneurysm that tends to rupture more frequently and cause higher mortality rates than other types of cerebral aneurysms. Surgery to address PAA is difficult due to its deep-seated location, the size of the aneurysmal sac, and the limited surgical field. In recent years, with the development of percutaneous interventions, endovascular treatment has become the preferred, minimally invasive intervention method for the treatment of pericallosal aneurysms. In this article, we present a case of PAA that was successfully treated with flow diversion therapy in a 51-year-old male.

Spontaneous cerebrospinal fluid (CSF) rhinorrhea is rare and may develop secondary to inner ear malformation. A possible diagnosis of CSF leak should be considered in any pediatric patient who presents with hearing impairment, rhinorrhea, or otorrhea. Temporal bone computed tomography should be performed in children with hearing impairments. We describe a case of congenital inner ear anomaly in a 12-month-old girl who presented with intermittent rhinorrhea after birth and detected hearing problems when she was 6 months. After diagnosis, the CSF leak was surgically repaired without complications.

Hepatic mesenchymal hamartoma is an uncommon tumor composed of myxoid mesenchymal tissue with fluid accumulation. Here, we report a case of hepatic mesenchymal hamartoma in a 3-year-old patient who was referred to the hospital with abdominal pain and a slight fever. An abdominal ultrasound suggested a liver abscess; however, computed tomography revealed a mass with both cystic and solid components. Liver biopsy confirmed hepatic mesenchymal hamartoma, and this patient underwent the complete removal of this tumor.

Lymphoma is one of the most common cancers of the orbital and lacrimal glands, after squamous cell carcinoma and melanoma. Based on cell origin, most lymphoma cases are classified as non–Hodgkin lymphoma. Orbital lymphoma can be either primary or secondary. The clinical manifestations of lymphoma are diverse, with the most common symptoms being bilateral or unilateral proptosis, limited eye motility, swelling, pain, changes in visual acuity, and diplopia. In this article, we describe the case of a 6-year-old male who presented with bilateral rapid orbital swelling for 10 days. This patient underwent surgical biopsy, and the final diagnosis was bilateral orbital secondary non–Hodgkin lymphoma.

Although mycotic (infected) aneurysms are uncommon, they can affect any artery. The most frequently involved vessel is the aorta as well as femoral and cerebral arteries. A vascular-colonic fistula from infected aneurysms is even rarer, which remains a challenge for diagnosis and treatment. In this case report, we aimed to illustrate an 89-year-old man presenting initially with an aneurysm of the right common iliac artery. Forty days later, this lesion was infected and produced fresh blood in the rectum and sigmoid colon observed by colonoscopy. The final diagnosis of this case was a right common iliac artery aneurysm-colonic fistula due to infection. The patient was successfully diagnosed and treated with surgery at our hospital.

Inflammatory myofibroblastic tumor (IMT) is an uncommon neoplasm that rarely arises in the genitourinary system. IMTs in the vulva in infants are extremely rare in the literature. The tumor consists of myofibroblastic spindle cells accompanied by inflammatory cell infiltration. In this article, we aimed to describe the case of IMT in the vulva. A newborn girl presented with a mass in the vulva detected in the prenatal period. The patient was treated with surgery and chemotherapy. Follow-up 8 months after surgery showed no signs of recurrence. In conclusion, IMT has a variable clinical presentation, surgery is the optimal approach, but in cases without complete resection, chemotherapy is essential.

Introduction: Autoimmune encephalitis refers to a group of diseases characterized by the presence of antibodies that directly attack receptors on the neuron surface and are associated with cognitive and behavioral disorders. Alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor autoimmune encephalitis is very rare and has been reported in only a few individual cases, with little clinical experience. Case report: We describe the clinical manifestation and disease course of the first diagnosed case of anti-AMPA receptor encephalitis at the Neurology Department of Children’s Hospital 2 in November 2020. A previously healthy 10-year-old presented with symptoms over 2 periods. During each period, the patient presented with multiple focal seizures, a cognitive-behavioral disorder, and amnesia. The brain magnetic resonance imaging (MRI) results were persistently normal. Electroencephalography (EEG) recorded many focal spikes and spike waves. Antibodies against N-methyl D-aspartate (NMDA) were not detected. Antibodies against AMPA receptors were detected in the serum and cerebrospinal fluid using an indirect fluorescent antibody test. This patient was treated with immunotherapy, including methylprednisolone and intravenous immunoglobulin (IVIG), and antiepileptic drugs, such as oxcarbazepine, topiramate, and levetiracetam. The seizures were controlled, but the cognitive-behavioral disorder was only partially resolved. Conclusion: This case report contributes to the clinical understanding of anti-AMPA receptor encephalitis disease manifestation, the response to the immunotherapy, and relapse.

Urinoma is an uncommon and severe complication that commonly results from ureteral stone formation, causing urinary tract obstruction, urinary tract trauma, or a pelvis mass. Ureter perforation due to malignancy, leading to subcapsular urinoma, is rare. In this article, we aimed to describe a case of secondary subcapsular urinoma in an adult male. The patient was diagnosed with ureter perforation secondary to the invasion of embryonal carcinoma lymph node metastasis.

Abstract Congenital bronchobiliary fistula (CBBF) is a very rare malformation associated with clinical symptoms of dyspnoea, vomiting, cyanosis, persistent pneumonia, and poor response to antibiotics. Typical imaging techniques used to diagnose this malformation include bronchography, computed tomography (CT), cholangiography, hepatobiliary nuclear imaging, and magnetic resonance imaging (MRI). We diagnosed a case of CBBF that was initially diagnosed as non‐resolving pneumonia. CT and fistulography were used to obtain the correct diagnosis. The fistula was confirmed by fistulography under the guidance of bronchoscopy. Surgical excision of the fistulous tract was performed, with complete recovery. The aim of this report was to emphasize the epidemiology and clinical features of CBBF patients.

Inflammatory pseudotumor (IPT) of the kidney is a rare benign disorder with unknown etiology. In IPT patients, some nonspecific symptoms might present, such as fever, hematuria, and back pain. As it can appear on computed tomography and magnetic resonance imaging as a hypovascular mass with surrounding fat stranding, IPT can be misdiagnosed as a primary tumor. Since the clinical symptoms, radiographic features, and preoperative findings can be inconsistent, it is imperative to confirm IPT based on histopathological assessment. In the present study, we describe a case of renal IPT in a 13-year-old girl. The patient was treated with nephrectomy of the right kidney since the preoperative diagnosis was renal carcinoma. Pathological examination revealed an IPT. This article emphasizes the importance of preoperative definitive diagnosis in avoiding unnecessary nephrectomy.

Undifferentiated embryonal sarcoma of the liver (UESL) is a rare, malignant, mesenchymal tumor that is commonly observed in children. The symptoms and imaging characteristics of UESL are not specific and can be mimicked by other tumors or liver abscesses. The tumor often appears as a large, heterogeneous, echoic solid mass with small cystic areas, presenting a cyst-like appearance on computed tomography (CT) and magnetic resonance imaging (MRI). The histopathological manifestations of UESL consist of stellate-shaped and spindle cells scattered on a myxoid background, with high mitotic counts. Cells with multiple or bizarre nuclei can also be observed. Here, we illustrate a 9-year-old male diagnosed with UESL by describing the imaging and histopathological characteristics that resulted in the diagnosis.

Horseshoe lung is a rare, congenital, pulmonary anomaly in which the caudal and basal segments of the left and right lungs are joined together. Most cases of horseshoe lung are associated with scimitar syndrome. Horseshoe lung can be diagnosed using pulmonary angiography, showing that the isthmus of the pulmonary parenchyma crosses the midline into the contralateral side. The isthmus parenchyma is typically supplied by the hypoplastic pulmonary artery. Clinical symptoms, therapeutic methods, and prognosis depend on the incidence of pulmonary hypertension, heart failure, recurrent pneumonia, and other combinations of congenital malformations. In this article, we describe two cases of horseshoe lung associated with scimitar syndrome and pulmonary malformation.

Primary laryngotracheobronchial amyloidosis is a rare pulmonary disease that can cause endobronchial stenosis. This disease has never previously been reported in Vietnam. We aimed to report a laryngotracheobronchial amyloidosis case in a 43-year-old female, which may be the first reported case in Vietnam. The patient had a 4-year history of progressive hoarseness, dyspnea, and hemoptysis. Multiple bronchial biopsies combined with detailed clinical information suggested an amyloidosis disease. Red congo staining was positive in bronchial samples, and a further workup found positive red congo staining in subcutaneous fatty tissue biopsy samples. Tracheostomy was performed due to severe dyspnea related to laryngeal stenosis. A multidisciplinary consultation was held, and chemotherapy with melphalan and dexamethasone were prescribed due to the systemic effects of the disease. After 2 cycles of chemotherapy, the patient showed improvement in dyspnea and cough. Due to the inexperience of both the clinicians and pathologists, this case was diagnosed quite late. In the future, if this diagnosis is considered in the differential diagnosis, an earlier diagnosis and better treatment outcome can be reached.

A respiratory fungal infection is a severe clinical problem caused by endemic or opportunistic fungi. Although pulmonary fungal infections may be associated with no symptoms, the patient may also present with cough, fever, chest pain, and hemoptysis. Trichophyton spp., a dermatophyte fungus, is a dermatologic pathogen and can cause a deep, sometimes fatal infection. Here, we report the first case of a deep Trichophyton spp. Infection in Vietnam and possibly the first case of Trichophyton spp. pneumonia in the literature, which responded completely to medical therapy. This article highlights the epidemiology of fungal lung infections and describes the clinical approach for when to suspect and how to diagnose this disease.

Pulmonary mucoepidermoid carcinoma (PMEC) is an extremely rare tumor of the respiratory system. The clinical presentation of PMEC is variable and nonspecific, including cough, hemoptysis, and wheezing, and may mimic other symptoms of pneumonia or asthma. Here, we present a case of PMEC in a 12-year-old male who was diagnosed with and treated for asthma for 2 years. The patient presented with symptoms of respiratory failure that did not respond to steroids or bronchodilator medications. Chest computed tomography (CT) scans revealed an endotracheal tumor. The patient underwent complete tumor resection, with no signs of recurrence 6 months after treatment.

Thyroid-stimulating hormone- (TSH-) secreting pituitary adenoma (TSH-oma) is a rare cause of secondary hyperthyroidism and can be misdiagnosed as primary hyperthyroidism. We report a case of a 15-year-old male patient who was one of two monozygotic twins and exhibited hyperthyroidism syndrome. The laboratory results showed secondary hyperthyroidism, with increased levels of free T3 (FT3) and free T4 (FT4) and no TSH inhibition. Magnetic resonance imaging (MRI) and histopathological examination of the pituitary gland confirmed pituitary microadenoma. The patient was treated with methimazole, propranolol, and somatostatin analogs to restore euthyroidism before undergoing an endoscopic transsphenoidal resection of the pituitary tumor. After surgery, the hyperthyroidism symptoms improved, thyroid hormones normalized, and MRI of the pituitary gland showed the complete removal of the tumor with no recurrence after 2 years of follow-up.

Primary pulmonary artery sarcoma is a rare tumor that mimics pulmonary embolism. Patients may present with cough, dyspnea, chest pain, and weight loss. The diagnosis is challenging. Herein, we report a case of 29-year-old female patient who had presented with dyspnea, fatigue for 2 weeks. Computed tomography pulmonary angiography scan suggests pulmonary embolism. We decided to perform surgical embolectomy. The histopathological results, however demonstrated primary pulmonary artery intimal sarcoma. The patient died 1-month post-surgery because of respiratory and circulatory failure.