Case 1

B.M, 44 yo, female, married, Filipino,

Roman Catholic, born on December 24, 1958 in
Romblon City, presently residing at Hagdan-
Hagdan, Romblon and was admitted for the 1
st

time at FMC on October 17, 2008.
Chief Complaint: Mass at the back

History of present Illness
Patient was born with a pigmented patch on
her back, 2x2 cm., brown in color, located at T4
level, non tender, soft upon palpation. There was
no other associated signs and symptoms noted.
28 years PTA, she noticed multiple cystic
masses on her face, body, and extremities with a
size ranging from 0.5cm x 0.5cm to 2cm x 2cm.
There was no other associated signs and symptoms
noted.


2 months PTA, she noticed that the mass
at the back became pruritic. She also noticed
that it was slowly growing. No other associated
signs and symptoms noted. No consultation was
done.
1 month PTA, the lesion grew bigger still
associated with slight tenderness. Due to
persistence of the above and condition, patient
sought consult, hence the admission
Past Medical History
Stab wound, umbilical area 2003
Family History
+ Heart disease (Mother)
- Lung, liver, kidney diseases
- HPN
- Malignancies
- DM
OB and Gyne History
Patient is a G2P2 (2002). She had her menarche at age 12,
moderate in flow, consuming 3-4 napkins/day. No associated
dysmenorrhea. Subsequent menses were regular at 28-30 days
interval.

Review of System
Constitutional: (-) fever, (-) weight loss, (-)anorexia
HEENT: (-) sore throat, (-) ear discharge, (-) blurring of vision
CNS: (-) headache, (-) dizziness, (-) LOC
CVS: (-) palpitation, (-)tachycardia, (-) orthopnea
Resp: (-) hemptysis, (-) colds, (-) cough
GIT: (-) vomiting, (-) abdominal pain, (-) diarrhea
GUT: dysuria, (-) hematuria, (-) oliguria
NMS: (-) arthralgia, (-)myalgia, (-)edema
Physical Exam
General Survey: Conscious, coherent,
ambulatory, febrile not in distress
VS: BP:120/80mmhg
CR: 84/min
RR: 20/min
T: 37.9 C
Wt: 60 kg
HEENT: Pink palpebral conjunctivae, white sclera, no
tonsillopharyngeal congestion, (-) NAD, cystic masses generally
distributed on the face

Neck: supple, (-) CLAD

C/L: symmetrical chest expansion, no retractions, no lagging, (+) 22cm
x 24cm mass over the thoracic area level T4, soft, warm by touch with
minimal erythema, clear breath sounds, no wheezes, no crackles

Heart: adynamic precordium, normal rate, regular rhythm, no murmur

Abdomen: flabby (+) 5cm linear scar umbilical area soft, non tender,
normoactive bowel

Extremities: full and equal pulse

Skin: (+) generalized multiple cystic masses ranging from 0.5 x 0.5cm to
3x3 on face, body and extremities.