Kalubalen Ciwon Ciwon Nono.

Game da haƙuri da yanayin

Wata mata ‘yar shekara 27 (sabuwar aure), tana da dunƙule mai tsayi a ƙirjinta na dama wanda aka tantance a wani wuri. Hoton duban dan tayi na nono ya nuna shi ya zama abin rufe fuska, raunin hypoechoic mai girman 32mmx23mm. A Fine Needle Aspiration Cytology (FNAC) ya nuna shi a matsayin Fibro Epithelial Lesion, mai yiwuwa ya zama Fibroadenoma. Mai haƙuri ya zaɓi magani mai ra'ayin mazan jiya tare da bibiya akai-akai.

Bayan watanni 3, an sami karuwa a girman kuma duban duban dan tayi ya nuna girman raunin ya zama 8mmx53mmx51mm, wani yanki mai ƙarfi kuma wani ɓangare na cystic, tare da motsin motsi da kuma kewaye da edema. Ra'ayin Masanin Radiyo shine cewa Fibroadenoma yanzu yana da lalatawar cystic da kumburi kewaye.

Halin Hali

A wannan lokacin, mai haƙuri ya gabatar da Dr. Uma Krishnaswamy, mai ba da shawara ga nono & Oncoplastic Surgeon a Asibitocin Apollo, Chennai. Jarabawar ta nuna taushin 10cmsx10cms, ƙwayar cystic a cikin nonon dama kusa da Ƙungiyar Nonuwa Areola, wanda ya tashi daga karfe 6 zuwa 9 na yamma tare da fashewar fata. Binciken asibiti yana ba da shawara sosai game da Giant Fibroadenoma tare da raguwa da bayan FNAC wanda ya haifar da hematoma mara warwarewa. Na biyu ganewar asali shi ne Phyllodes tumor nono, mai yiwuwa m.

Matsalolin jini na yau da kullun kafin a yi aiki sun nuna babu wani rashin daidaituwa na coagulation. An gudanar da gwajin sikanin duban dan tayi a matsayin wani bangare na hanyar gano cutar sau uku. Wannan ya bayyana wani 66mmx53mm, wani juzu'in da aka siffanta da kyau, wanda aka lullube shi, mai ƙarfi cum cystic mass tare da motsi na Brownian. Launi Doppler ya nuna ƙarancin kwararar jijiyoyin jini na ciki. Har ila yau, binciken Radiology ya kasance yana nuna rashin lafiyar Fibroadenoma tare da kewayen hematoma.

An biyo bayan wannan a cikin zama ɗaya tare da jagorar siginar ƙwayar ƙwayar ƙwayar ƙwayar cuta. 60ml na gaskiya, an shayar da sabon jini tare da cikawa nan da nan, yana hana Interventional Radiologist daga ci gaba zuwa biopsy saboda tsoron zubar jini. Wannan taron ya haifar da yiwuwar cewa yana da ciwon intracystic papillary tare da zubar da jini ko kuma ƙwayar Phyllodes.

Ana bin hanyar gano cutar, an gudanar da MR Mammogram. Wannan ya nuna wani rauni mai zurfi da hetero mai tsanani tare da yiwuwar necrotic da abun ciki na hemorrhagic. Babu ƙarin bayanan bincike da za a samu.

Yanayin Duniya

Gudanar da aikin tiyata na ƙwayar ƙwayar ƙwayar cuta ta Phyllodes na nono, ko mara kyau ko mara kyau, yana cike da ƙalubale. Cutar tana da tushe mai kyau, tare da abin da ke faruwa a ƙasa da 1% na duk ciwan nono. Akwai, duk da haka, manyan ƙalubale a cikin ganewar asali na farko da kuma bambance-bambance tsakanin Benign Phyllodes da Malignant Phyllodes, ko da yake ƙananan raunuka sun fi yawa. Wannan ƙalubale yana da alaƙa da dabarun tiyata da za a yi amfani da su don fitar da su tare da tazara mai ma'ana don hana sake dawowa, da kuma kiyaye kwalliyar nono. Wannan yana da mahimmanci musamman yayin da ciwace-ciwacen ƙwayoyin cuta na Phyllodes ke faruwa a cikin ƙaramin rukunin matasa (shekaru 25-30) a cikin al'ummomin Asiya tare da haɓakawa a cikin mata kuma da wuya a cikin maza masu Gynaecomastia.

Kwarewa a Asibitocin Apollo

Bayan tantancewar gabaɗaya da maganin sa barci, an ɗauke majiyyaci don yin tiyata tare da cikakken izini. Abubuwan da aka gano sun kasance na wani ɓangaren da aka rufe, ƙwayar necrotic tare da tsohon jini da gudan jini, tare da kitsen mai kumburi da kumburi. An yi fiɗa mai yawa na taro. Don cike gibin ƙara, an sake gina mammary flap na ciki. An sallami majinyacin bayan sa'o'i 24.

Jarrabawar ilimin tarihin tarihi ya nuna 9x6x4 cms m cum cystic mass tare da kayan friable ja mai duhu. Microscope ya nuna raunin neoplastic tare da filaye masu layi na epithelium da stroma cell spindle tare da tarwatsa mitosis da bayyanannun gefe. (Hoto na 3).

Gwajin histochemistry na rigakafi ya bayyana: Ki67 ƙimar 7 da p53 don zama mara kyau. Ma'anar don haka shine Phyllodes na matakin kan iyaka tare da ƙarancin yuwuwar cutarwa. A matsayin kwamitin Genomic don raunin Fibroepithelial a halin yanzu ba a samun kasuwanci a Indiya ba a bi shi ba.

Asibitocin Apollo - Rayukan Tafiya

Ƙungiyar Multidisciplinary a Asibitocin Apollo sun yanke shawarar ci gaba da aikin rediyo. Bayan kammala wannan, majiyyacin ya kasance ƙarƙashin kulawa ta kusa. gamsuwa da haƙuri ya kasance mai girma saboda babu sake dawowar ƙwayar ƙwayar ƙwayar cuta ta Phyllodes zuwa yau kuma sakamakon kwaskwarima ya kasance mai kyau.

Shaidar mara lafiya

Marasa lafiya ya gamsu da ayyuka da kulawa da ake bayarwa a Asibitocin Apollo.

[Taken id = "attachment_32227" tsara a layi = "alignnone" nisa = "700"] Hoto 1: Binciken Ultrasound na nono Dama[/taken magana]

[Taken id = "attachment_32228" tsara a layi = "alignnone" nisa = "700"] Hoto 2: MR Mammogram[/taken magana]

[Taken id = "attachment_32229" tsara a layi = "alignnone" nisa = "700"] Hoto na 3: Hoto na hoto yana nuna bututun da aka yi layi ɗaya
epithelium da kuma ƙara stromal cellularity da atypia
(x400 haɓakawa)[/taken magana]

[Taken id = "attachment_32226" tsara a layi = "alignnone" nisa = "700"] Hoto 4: Ki 67: 7[/taken magana]

adadi {
nisa: 100% !mahimmanci;
matattara-rubutu: tsakiya;
}