SUMMARY Placenta acrreta spectrum is a condition in which the placenta partially or completely invades and cannot be separated from the uterus muscle. Placenta previa is a condition in which the placenta partially or completely covers the cervix. Both phenomena increase the risk of postpartum haemorrhage, hemostasis disorders, and threaten the life of the mother and the fetus. Combine of the two phenomena increase blood loss in cesarean delivery as well as postpartum period, and is a great challenge required multidisciplinary for successful management. Prophylactic endovascular intervention is a minimally invasive treatment method, which plays an important role in prevent haemorrhage in the management of placenta accreta spectrum. This report describes a case of placenta percreta combine with placenta previa, which received prophylactic endovascular intervention using balloon occlusion of internal illiacs and uterine arteries embolization and underwent a cesarean delivery at 36 weeks. The patient had a successful delivery and preserved the uterus after surgery. Key word : Placenta acrreta spectrum, prophylatic balloon occlusion, uterine artery embolization

SUMMARY Sarcoma is a general term for a type of cancer found in the connective tissue cells (the cells of the mesenchyme). There are many types of sarcoma because connective tissue cells are present everywhere in the body (bone, cartilage, blood vessels ...) but this type of cancer is divided into 2 main groups, bone sarcoma, and soft tissue sarcoma. Rhabdomyosarcoma (RMS) belongs to the group of soft tissue sarcoma of skeletal muscle, is a common malignancy, and is one of the leading causes of cancer death in children. Alveolar rhabdomyosarcoma (ARMS) is a subtype of RMS that is extremely rare in adults. We present a pediatric case of ARMS, primary in the butt area with pulmonary metastases, confirmed by histopathology and immunohistochemistry. Reported data and literature review will help physicians have a better diagnostic approach when encountering similar cases. Keyword: Rhabdomyosarcoma; alveolar rhabdomyosarcoma, soft tissue tumor lung metastasis.

SUMMARY Nontraumatic chylothorax (NTC) is the presence of chylous fluid in the pleural cavity. Unlike traumatic chylothorax, diagnosis and interventional treatment has very high rate of success while nontraumatic chylothorax has many difficulties in both diagnosis and treatment. The most important in management of NTC is depicting the lesion of lymphatic vessel which is varying from patient to patient. The current understanding of the anatomy of the chylous circulation allows for successful diagnosis and treatment in some patients, but the incidence is still limited. This article reviews the causes of chylothorax and approaches to diagnosis and treatment of patient with NTC. Keywords: chylothorax, thoracic duct embolization *

SUMMARY Background: Mechanical thrombectomy is considered the firstline treatment method for acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Two current main techniques include stent retriever and direct aspiration. Recently, endovascular treatment for AIS has reached a great progression, in which the Solumbra technique, a combination of stent retriever and direct aspiration techniques, has been introduced to achieve high rate of recanalization, to minimize the occurrence of distal embolization and to improve clinical outcomes. We reported initial experience utilizing Solumbra technique at Cho Ray Hospital. Materials and Methods: Case series report of patients with acute ischemic stroke treated by Solumbra technique at Choray Hospital, from 01/2019 to 01/2021. Clinical, angiographic and outcome features were collected and evaluated. Results: There were 23 cases treated by Solumbra technique: the mean age was 72 years old, mean NIHSS at admission was 19, good recanalization rate of TICI 2b-3 was achieved in 18/23 (78.3%), functional independence outcomes (90-day mRS 0-2) was 10/23 (43.5%) patients. The embolization to new territories (ENT) was 2/23 (8.7%), the rate of symptomatic intracranial hemorrhage (sICH) was 4/23 (17.4%) and mortality rate was 3/23 (13%) patients during follow-up. The average time from arterial puncture to recanalization was 37.3 minutes. Conclusion: Mechanical thrombectomy using Solumbra technique appeared to be a fast, safe and effective method with high recanalization rate and good clinical outcomes. Solumbra would be a promising technique to reduce thrombus fragmentation and distal embolization. Key words: Acute ischemic stroke, large vessel occlusion, endovascular treatment, Solumbra technique.

SUMMARY Most thyroid nodules are benign and do not require treatment, but large (≥3 cm) benign thyroid nodules usually cause clinical symptoms or cosmetic concerns and therefore require treatment. Traditionally the treatment for benign thyroid nodules consists of surgery and levothyroxine medication, however, both have many drawbacks. Minimally invasive surgical alternatives are becoming more attractive for the treatment of thyroid nodules. Beside Radiofrequency ablation (RFA), Microwave ablation (MWA) is a method of thermal ablation to induce thyroid tissue necrosis and has been applied to various benign and malignant tumors with good results. Objectives: We determine the safety and efficacy of the Microwave Ablation procedure to treat large benign thyroid nodules. Materials and Methods: We report a series of 40 large benign thyroid nodules patients who underwent Microwave Ablation for treatment at Thoracic Surgery Department Cho Ray hospital from Apr-2018 to Sep-2019. Results: There were 31 females and 9 males, with a median age of 46 years. The medians with the largest diameter and volume of the nodules were 40 mm and 22 ml. Four (10%) minor complications were observed. The mean volume reduction ratio (VRR) was 75.1, 85.2, and 96.4% after 3, 6, and 12 months. The mean symptom and cosmetic scores dropped from 8.0 and 2.8 (before treatment) to 2.8 and 1.3 (at 12 months), respectively. Thirteen nodules (31%) require two MWA sessions. Conclusions: MWA is safe, effective, and can be a good option to treat large benign thyroid nodules. More studies with large datasets and long follow-ups are needed to improve its safety and efficacy. Keywords: Large benign thyroid nodules; Microwave ablation (MWA); Volume reduction ratio; Symptom score; Cosmetic score.

Summary Objective: We aimed to evaluate the effectiveness early outcomes of PAE in treating BPH patients with acute urinary retention (AUR). Method and results: in this prospective study approved by the institutional review board, a signed informed consent was obtained. There were fourteen patients with AUR due to BPH from 07/2017 to 07/2018. The patients were successful removal of the bladder catheter after 1216 days. Post-intervention 3 months, average evaluation of IPSS, Qol, PSA (ng/ml) and PV (cm3 ) decreased 63,2%; 73,19%; 79,98; 29,97% (ultrasound) 31,75 (MRI); Qmax 11,46 (ml/s), PVR 55,58 (ml). Conclusion: PAE in patients with AUR due to BPH is safe and effective. Key word: bening prostatic hyperplasia (BPH), Prostatic Artery Embolization (PAE), Acute Urinary Retention (AUR).

SUMMARY Objectives : Study on 18FDG-PET/CT imaging characteristics of lesions in non-small cell lung cancer before treatment and the role of 18FDG-PET/CT in the staging of patients with non-small cell lung cancer. Methods: Retrospective study, descriptive analysis on 43 non-small cell lung cancer patients who were newly detected taken 18FDG-PET/CT at Military Hospital 103 from February 2017 to February 2022, including 32 patients who were indicated for surgery after 18FDG-PET/CT scan without any specific treatment. Results: The average size of lung tumor was 40.98±21.53mm, there was a correlation between SUVmax index and primary tumor size. The SUVmax value increased with stage T. The mean SUVmax value of the lymph node group >10mm was 10.59±6.12 higher than that of the node group <10mm was 5.56±2.47. After PET/CT scan, the N0 stage accounted for 32.6%, the N1 stage accounted for 23.3%, the N2 stage accounted for 23.3%, and the N3 stage accounted for 20.9%. The mean SUVmax value of the tumor in the M1 group of patients was 15.96±4.29, which was higher than that of the M0 group of patients was 14.57±8.26.18FDG-PET/ CT detected 100% of primary tumor lesions in the lung, 18FDG-PET/CT accurately diagnosed stage T at 71.88%, higher than CT with 68.75%, accurately diagnosed stage T at 68.75%. N segment at 81,25%, higher than CT with 75%. Sensitivity, specificity, positive predictive value, negative predictive value of 18FDG-PET/CT in the diagnosis of stage N are: 100%; 68,42%; 68,42% and 100%. Keywords: Non-small cell lung cancer, 18FDG-PET/CT, SUVmax.

SUMMARY Objective: Evaluation of the transforaminal epidural steroid injection for the treatment of lumbar disc herniation under computed tomography-guided Subject and method : 80 patients with lumbar disc herniation were diagnosed at 108 Central Military Hospital from June 2020 to June 2021. Longitudinal follow-up and prospective study Results : Location of transforaminal L3-L4 35%, L4-L5 58 %, L5S1 7%. VAS score before intervention, 1 day, 14 days, 1 month and 3 months after intervention were 6,48 ± 1,46; 3,21 ± 1,53; 2,74 ± 1,37; 2,55 ± 1,44; 2,75 ± 1,39 and ODI score before intervention, 1 day, 14 days, 1 month and 3 months after intervention were 59,26 ± 12,18; 35,68 ± 7,97; 33,63 ± 6,14; 30,18 ± 6,01; 28,15 ± 6,46. Statistically signficant difference Conclusion: Transforaminal epidural injection is an effective method of pain management and functional improvement for patients with lumbar disc herniation Keywords: Lumbar disc herniation, epidural injection, transforaminal