Displaying publications 1 - 20 of 214 in total

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  1. Metastasis to the sinonasal tract from sigmoid colon adenocarcinoma
    bin Sabir Husin Athar PP, bte Ahmad Norhan N, bin Saim L, bin Md Rose I, bte Ramli R
    Ann Acad Med Singap, 2008 Sep;37(9):788-3.
    PMID: 18989497
    INTRODUCTION: Metastatic adenocarcinoma from the gastrointestinal tract to the sinonasal tract is rare. The histological morphology of this lesion is indistinguishable from the colonic variant of primary sinus adenocarcinoma or intestinal-type adenocarcinoma (ITAC).

    CLINICAL PICTURE: This is a report of a case of metastatic adenocarcinoma of colorectal origin to the paranasal sinuses in a 52-year-old female who was previously treated for adenocarcinoma of the sigmoid colon. A histologic study of the surgical specimen from the sinonasal cavity demonstrated a tumour identical to the patient's prior primary tumour of the colon. The sinonasal neoplastic tissue showed marked positivity for carcinoembryonic antigen and expressed cytokeratin 20, which differentiates metastatic colonic adenocarcinoma from ITAC.

    TREATMENT/OUTCOME: The patient received palliative radiation but died 3 months after the diagnosis.

    CONCLUSION: Distinguishing metastatic adenocarcinoma from gastrointestinal tract from ITAC can be difficult. In view of the resemblance, immunohistochemical staining can help in differentiating them. It is important to recognise these as metastatic lesions as the treatment is mainly palliative.

    Matched MeSH terms: Fatal Outcome
  2. Spermatic cord metastasis from a medulloblastoma
    Thambi dorai CR, Azmi A, Rahman AJ, Subathra S, Hayati AR, Zulfiqar A
    Pediatr Surg Int, 2001 Nov;17(8):654-6.
    PMID: 11727063
    A 4-year-old boy presented with metastases in the spermatic cord and ribs 2 years after treatment for a primary medulloblastoma (MB). The testis was free of tumor. A MB presenting with a metastasis to the spermatic cord has not been reported to date. The role of a ventriculo-peritoneal shunt in promoting such spread should be considered in planning management.
    Matched MeSH terms: Fatal Outcome
  3. Fulltext Primary extraskeletal Ewing's sarcoma/primitive neuroectodermal tumour of breast
    Ikhwan SM, Kenneth VK, Seoparjoo A, Zin AA
    BMJ Case Rep, 2013 Jun 21;2013.
    PMID: 23813511 DOI: 10.1136/bcr-2013-009584
    Primary primitive neuroectodermal tumour (PNET) and extraskeletal Ewing's sarcoma belongs to the Ewing's family of tumours. Primary tumours arising from breast are very rare. There are only a few case reports published on primary extraskeletal Ewing's sarcoma and PNET arising from breast. We present an extremely rare case of an inoperable primary Ewing's sarcoma arising from left breast with contralateral breast, lymphatic and lung metastasis.
    Matched MeSH terms: Fatal Outcome
  4. Clinical manifestations in trisomy 9
    Kannan TP, Hemlatha S, Ankathil R, Zilfalil BA
    Indian J Pediatr, 2009 Jul;76(7):745-6.
    PMID: 19475342 DOI: 10.1007/s12098-009-0158-2
    Complete trisomy 9 is a lethal diagnosis and most fetuses diagnosed thus die prenatally or during the early postnatal period and majority of such cases have been known to end in spontaneous abortion in the first trimester itself. One such rare survival of fetus ending in normal delivery and surviving until 20 days is reported here detailing the clinical manifestations of the child during the period of survival. The salient clinical features observed were small face, wide fontanel, prominent occiput, micrognathia, low set ears, upslanting palpebral fissures, high arched palate, short sternum, overlapping fingers, limited hip abduction, rocker bottom feet, heart murmurs and also webbed neck, characteristic of this trisomy 9 syndrome.
    Matched MeSH terms: Fatal Outcome
  5. Fulltext Large adrenocortical carcinoma extending into the inferior vena cava and right atrium
    Hisham AN, Sarojah A, Zanariah H
    Asian J Surg, 2003 Jan;26(1):40-2.
    PMID: 12527494
    A case of large adrenocortical carcinoma extending into the inferior vena cava and right atrium is reported. Computed tomography showed a large mass displacing the left kidney inferiorly with an intravascular tumour thrombus extending into the inferior vena cava and right atrium. Radical surgery under hypothermia and cardiopulmonary bypass was performed and the tumour mass, together with the tumour thrombus, was successfully removed. The presence of intravascular tumour extension alone should not be a contraindication to radical surgical therapy, as it is the best hope for prolonged survival.
    Matched MeSH terms: Fatal Outcome
  6. Fulltext Two variants of uterine leiomyoma in Malaysia's last Sumatran rhinoceros (Dicerorhinus sumatrensis)
    Salleh A, Zainuddin ZZ, Mohamed Tarmizi MR, Yap KC, Zamri-Saad M
    Vet Q, 2020 Dec;40(1):250-257.
    PMID: 33045934 DOI: 10.1080/01652176.2020.1836431
    Following its capture in March 2014, an adult female Sumatran rhinoceros frequently showed profuse vaginal bleeding. An ultrasonography suggested the presence of multiple reproductive lesions, including two uterine masses which were suspected to be leiomyomas. Soon after, an open pyometra was confirmed. Later in November 2019, the patient died and necropsy confirmed the presence of two uterine masses; one was located at the cervico-uterine junction and another in the uterine body, with pyometra, and cystic endometrial hyerplasia. Based on histological, special stains, and immunohistochemical examination, it was shown that one of the masses was composed of large, ovoid and polyhedral neoplastic mesenchymal cells with eosinophilic cytoplasm and a few binucleated cells surrounded by collagen fibres. It was tested positive for SMA and vimentin, while negative for desmin, cytokeratin AE1/AE3, EMA, CD34, and S100. The other mass was composed of mesenchymal cells undergoing myxoid degeneration as evidenced by the presence of glycosaminoglycan-rich matrix. It was tested positive for SMA, vimentin, partially positive for desmin, and negative for the other markers. With the aid of human medical nomenclature, these masses were diagnosed as epithelioid leiomyoma and myxoid leiomyoma, respectively. This report provides a clinical presentation, and histologic descriptions of the two variants of leiomyomas that have not been reported in veterinary medicine.
    Matched MeSH terms: Fatal Outcome
  7. Fulltext Fatal mediastinal biopsy: How interventional radiology saves the day
    Yaacob Y, Muda S, Zakaria R
    Ann Thorac Med, 2012 Apr;7(2):107-9.
    PMID: 22558017 DOI: 10.4103/1817-1737.94534
    This was a case of a 35-year-old man with mediastinal mass requiring computed tomography (CT)-guided biopsy for tissue diagnosis. A posterior approach with an 18-gauge biopsy needle was used to obtain tissue sample. Post biopsy, patient condition deteriorated and multiphase CT study detected active bleeding in arterial phase at the biopsy site with massive hemothorax. Subsequent angiography showed arterial bleeder arising from the apical branch of the right pulmonary artery. Selective endovascular embolization with NBCA (n-Butyl cyanoacrylate) was successful. Patient survived the complication. The case highlighted a rare complication in a common radiology procedure and the value of the interventional radiology unit in avoiding a fatal outcome.
    Matched MeSH terms: Fatal Outcome
  8. Fulltext Idiopathic pulmonary haemosiderosis occurring in a Malaysian patient
    Hanip MR, Isa MR, Zainudin BM
    Singapore Med J, 1994 Oct;35(5):535-7.
    PMID: 7701382
    A young East Malaysian lady presented with haemoptysis in 1989. Since then she had recurrent episodes of dyspnoea and two occasions of respiratory failure requiring assisted ventilation. An open lung biopsy showed intra-alveolar haemorrhage with diffuse interstitial fibrosis consistent with idiopathic pulmonary haemosiderosis after excluding secondary causes of pulmonary haemorrhage. She failed to respond to corticosteroid and continued to depend on oxygen until she succumbed to the illness 2 years after the presentation.
    Matched MeSH terms: Fatal Outcome
  9. Fulltext Resection and reconstruction of retroperitoneal sarcoma of spinal roots
    Imran Y, Zulmi W, Faisham WI, Zainal M
    Med J Malaysia, 2004 Dec;59 Suppl F:75-7.
    PMID: 15941171
    Matched MeSH terms: Fatal Outcome
  10. Fulltext Survival predictors in paraquat intoxification and role of immunosuppression
    Koh KH, Tan CH, Hii LW, Lee J, Ngu LL, Chai AJ, et al.
    Toxicol Rep, 2014;1:490-495.
    PMID: 28962262 DOI: 10.1016/j.toxrep.2014.06.010
    Paraquat poisoning resulted in multiorgan failure and is associated with high mortality. We audited 83 historical cases of paraquat poisoning in past 2 years treated with conventional decontamination and supportive treatment, followed by enrolling 85 patients over a 2 year period into additional immunosuppression with intravenous (i.v.) methylprednisolone and i.v. cyclophosphamide. Our results showed that age, poor renal function and leucocytosis are the main predictors of fatal outcome. Immunosuppression regime rendered higher survival (6 out of 17 patients (35.3%)) versus historical control (1 out of 18 patients (5.6%)) (p = 0.041) in the cohort with admission eGFR < 50 ml/min/1.73 m(2) and WBC count > 11,000/μL. In contrast, there was no difference in survival with immunosuppression regime (38 out of 64 patients (59.4%)) compared to historical control (30 out of 52 patients (57.7%)) (p = 0.885) in those with eGFR > 50 ml/min/1.73 m(2) or WBC < 11,000/μL at presentation. Multivariable logistic regression showed survival probability = exp(logit)/(1 + exp(logit)), in which logit = 13.962 - (0.233 × ln(age (year))) - (1.344 × ln(creatinine (μmol/L))) - (1.602 × ln(rise in creatinine (μmol/day))) - (0.614 × ln(WBC (,000/μL))) + (2.021 × immunosuppression) and immunosuppression = 1 if given and 0 if not. Immunosuppression therapy yielded odds ratio of 0.132 (95% confidential interval: 0.029-0.603, p = 0.009). In conclusion, immunosuppression therapy with intravenous methylprednisolone and cyclophosphamide may counteract immune mediated inflammation after paraquat poisoning and improve survival of patients with admission eGFR < 50 ml/min/1.73 m(2) and WBC count > 11,000/μL.
    Matched MeSH terms: Fatal Outcome
  11. Disseminated Penicillium marneffei infection: a report of five cases in Singapore
    Kurup A, Leo YS, Tan AL, Wong SY
    Ann Acad Med Singap, 1999 Jul;28(4):605-9.
    PMID: 10561784
    Penicillium marneffei has emerged as an important opportunistic pathogen in HIV-infected patients in Southeast Asia. We report the first 5 cases of P. marneffei diagnosed in Singapore. All the patients were HIV-infected and were either Thai nationals or had frequently travelled to Thailand. Fever, weight loss, anaemia and papular skin lesions were common clinical manifestations in our patients, all of whom had the organism isolated from blood. Skin biopsy specimens showed histological evidence of P. marneffei in 2 patients. In 1 patient each, the organism grew in cultures of specimens from bone marrow and respiratory secretions. Amphotericin B therapy followed by itraconazole were used in 3 of our 5 patients and was associated with good clinical response and outcome.
    Matched MeSH terms: Fatal Outcome
  12. Adult-onset nasopharyngeal diphtheria: an uncommon but rapidly progressive and potentially fatal infection
    Ding CH, Wahab AA, Marina Z, Leong CL, Umur N, Wong PF
    Trop Biomed, 2021 Jun 01;38(2):119-121.
    PMID: 34172699 DOI: 10.47665/tb.38.2.045
    Nasopharyngeal diphtheria is an acute infectious upper respiratory tract disease caused by toxigenic strains of Corynebacterium diphtheriae. We report a case of a young adult who presented to us with a short history of fever, sore throat, hoarseness of voice and neck swelling. He claimed to have received all his childhood vaccinations and had no known medical illnesses. During laryngoscopy, a white slough (or membrane) was seen at the base of his tongue. The epiglottis was also bulky and the arytenoids were swollen bilaterally. The membrane was sent to the microbiology laboratory for culture. A diagnosis of nasopharyngeal diphtheria was made clinically and the patient was treated with an antitoxin together with erythromycin, while awaiting the culture result. Nevertheless, the patient's condition deteriorated swiftly and although the laboratory eventually confirmed an infection by toxin-producing C. diphtheriae, the patient had already succumbed to the infection.
    Matched MeSH terms: Fatal Outcome
  13. Adrenal cytomegaly associated with diaphragmatic hernia: report of a case
    Ong BB, Wong KT
    Malays J Pathol, 1996 Dec;18(2):121-3.
    PMID: 10879233
    A rare case of a 22-week-old foetus with unilateral adrenal cytomegaly and left diaphragmatic hernia is reported. Typical cytomegalic cells were found focally in the left adrenal but the right adrenal was normal. There was no stigmata of the Beckwith-Wiedermann syndrome. The association of adrenal cytomegaly with various congenital malformations, the significance and possible pathogenesis of this condition is discussed.
    Matched MeSH terms: Fatal Outcome
  14. Sudden death during jungle trekking: a case of heat stroke
    Nadesan K, Chan SP, Wong CM
    Malays J Pathol, 1998 Jun;20(1):49-54.
    PMID: 10879265
    Heat stroke, which is also known as "sun stroke," is a medical emergency, and fatalities can occur unless it is diagnosed early and treated efficiently. Heat stroke may manifest quite suddenly, giving little time to differentiate it from extreme physical exhaustion in collapsed subjects. It is also known to lead to serious disseminated intravascular coagulation. Sudden death in a young female is presented who collapsed after trekking in a hilly, jungle area in Malaysia on a warm, humid day. She had joined a weight reduction programme a few weeks earlier. She was found collapsed and in a semiconscious state in the jungle by her groupmates and was taken to hospital. On admission she was unconscious, hyperpyrexic, with rapid, thready pulse and a low blood pressure. Biochemical studies revealed metabolic acidosis, elevated liver and cardiac enzymes and impairment of renal function. Her coagulation profile was found to be impaired and she started bleeding through the mouth and nostrils. She also developed watery diarrhoea and initially a septicaemic condition, including acute enteritis was suspected. Despite active treatment, her condition deteriorated and she died eight hours after admission. Autopsy confirmed a generalised bleeding tendency, with pulmonary, oesophageal and gastrointestinal mucosal haemorrhages. Flame-shaped subendocardial shock haemorrhages were seen in the interventricular septum on the left side of the heart. The findings support a diagnosis of heat stroke. Various aspects related to heat stroke, the autopsy diagnosis and its prevention are discussed.
    Matched MeSH terms: Fatal Outcome
  15. Fulltext Double Philadelphia chromosome-positive B acute lymphoblastic leukaemia in an elderly patient
    Tang YL, Raja Sabudin RZ, Leong CF, Ko CC, Chia WK, Salwati S, et al.
    Malays J Pathol, 2015 Dec;37(3):275-9.
    PMID: 26712675 MyJurnal
    A rare case of double Philadelphia chromosome-positive B Acute lymphoblastic Leukaemia (B-ALL) is reported here. A 60-year-old lady presented with one month history of fever, submandibular lymphadenopathy, loss of appetite and weight loss. Physical examination revealed multiple palpable cervical lymph nodes. Blood film showed leucocytosis with 72% blasts. Bone marrow assessment confirmed a diagnosis of B-ALL with presence of double Philadelphia (Ph) chromosomes. As she was very ill, she was initially treated with an attenuated regimen of induction chemotherapy consisting of rituximab, cyclophosphamide, vincristine and prednisolone (R-CVP) along with intrathecal chemotherapy comprising methotrexate, cytarabine and hydrocortisone. Bone marrow examination post-induction chemotherapy showed >5% blasts. She was subsequently re-induced with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) along with intrathecal chemotherapy, following which she went into complete remission. Consolidation chemotherapy consisting of methotrexate, methylprednisolone, cytarabine, intrathecal chemotherapy and imatinib was subsequently administered followed by maintenance chemotherapy consisting of vincristine, prednisolone and imatinib (IDEAMOP). She developed spontaneous bruises and relapsed four months into her maintenance chemotherapy with 90% blasts in the bone marrow which was treated with fludarabine, cytarabine and granulocyte colony stimulating factor (FLAG). Unfortunately she developed neutropenic sepsis which was complicated by invasive lung aspergillosis. Bone marrow examination post-FLAG showed 80% blasts. Despite aggressive antifungal therapy, her lung infection worsened and she finally succumbed to her illness 13 months after the initial diagnosis. We highlight a rare case of elderly B-ALL with double Ph chromosomes which carries a poor prognosis despite aggressive treatment for the disease and its complications.
    Matched MeSH terms: Fatal Outcome
  16. Fulltext Pregnancy-related hemophagocytic lymphohistiocytosis associated with cytomegalovirus infection: A diagnostic and therapeutic challenge
    Tumian NR, Wong CL
    Taiwan J Obstet Gynecol, 2015 Aug;54(4):432-7.
    PMID: 26384065 DOI: 10.1016/j.tjog.2014.11.023
    Hemophagocytic lymphohistiocytosis (HLH) is a disorder characterized by uncontrolled mature histiocyte proliferation, hemophagocytosis, and hypercytokinemia. We describe a previously healthy pregnant patient who presented in the third trimester of pregnancy with HLH.
    Matched MeSH terms: Fatal Outcome
  17. Fulltext C1 and C2 vertebrae osteomyelitis: A misleading presentation leading to a fatal outcome.
    Radhiana, H., Win Mar Salmah, J.
    International Medical Journal Malaysia, 2009;8(1):49-51.
    MyJurnal
    Cervical vertebral osteomyelitis is rare. While an early and correct diagnosis is critical to prevent catastrophic neurological injury, the diagnosis of cervical vertebral osteomyelitis is often difficult because of its rarity and variable symptoms. We present a case of C1 and C2 vertebrae osteomyelitis with a misleading presentation and its fatal outcome.
    Matched MeSH terms: Fatal Outcome
  18. Two fatal cases of unsuspected rupture of the spleen
    Wilson F
    Lancet, 1927;209:1236-7.
    DOI: 10.1016/S0140-6736(00)73647-6
    Matched MeSH terms: Fatal Outcome
  19. Cardiac metastasis: a rare involvement of primitive neuroectodermal tumour of the lung
    Ngow HA, Wan Khairina WM
    Pathol Oncol Res, 2011 Sep;17(3):771-4.
    PMID: 21213128 DOI: 10.1007/s12253-010-9328-9
    A 15 year-old adolescent was referred with 2 month history of worsening of breathlessness and haemoptysis. He also reported constitutional symptoms of fever, poor appetite and weight loss. The chest roentgenogram showed a massive right pleural effusion with apparent cardiomegaly. The cardiac silhouette over the right heart border was obliterated and the mediastinum was widened. Computed tomogram of the thorax showed a bulky heterogeneous mass in the right lung with extension to the heart. Subsequent CT guided lung biopsy revealed Primitive Neuroectodermal tumour (PNET). Here, we illustrate the clinical course of an aggressive pulmonary PNET with lethal cardiac metastasis.
    Matched MeSH terms: Fatal Outcome
  20. Isolated right atrium tuberculoma causing complete heart block
    Ngow HA, Wan Khairina WM
    Postgrad Med J, 2010 Oct;86(1020):624-6.
    PMID: 20971714 DOI: 10.1136/pgmj.2010.102236
    Matched MeSH terms: Fatal Outcome
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