MyMedR

Fulltext Ossifying fibromyxoid tumour in a child

Aminudin CA, Sharaf I, Hamzaini AH, Salmi A, Aishah MAS

Med J Malaysia, 2004 Dec;59 Suppl F:49-51.

Ossifying fibromyxoid tumor (OFMT) is a rare benign tumor, most of which occurs in adults with localization in the subcutaneous tissue or muscle of the extremities. A five-year-old girl presented with a mass in her right upper thigh. Due to the large size of the mass (10 x 7 cm), our provisional diagnosis was a soft tissue sarcoma. A tru-cut biopsy showed that the lesion was benign. The mass was excised and has not recurred since. To the best of our knowledge, this patient is the youngest case of OFMT reported in the English literature.

Matched MeSH terms: Diagnosis, Differential

An unusual presentation of acute cholecystitis: biliary ascariasis

Amjad N, Nor AM, Singh H

Hosp Med, 2001 Jun;62(6):370-1.

PMID: 11436449

Matched MeSH terms: Diagnosis, Differential

Isolation of a Plesiomonas shigelloides in Malaysia

Ampalam SD, Fang L

Med J Malaya, 1971 Jun;25(4):282-4.

PMID: 4261301

Matched MeSH terms: Diagnosis, Differential

Primary sinonasal Ewing sarcoma: A case report

Amri MF, Abdullah A, Azmi MI, Mohd Zaki F, Md Pauzi SH

Malays J Pathol, 2021 Aug;43(2):319-325.

PMID: 34448796

BACKGROUND: Ewing sarcoma (ES) is an aggressive tumour which is typically skeletal in origin. ES involving the head and neck region is uncommon and can be easily confused with other small round blue cell tumours. We herein present a rare case of ES involving the sinonasal area.

CASE PRESENTATION: A 5-year-old Somalian boy with no known medical illness presented with progressive nasal blockage associated with clear nasal discharge and intermittent spontaneous epistaxis for three months. CT paranasal sinus and neck region revealed poorly enhancing expansile mass in the right maxillary sinus with areas of necrosis within. Initial radiological differential diagnoses were lymphoma and rhabdomyosarcoma. The mass was biopsied and histologically showed diffuse sheets of small round blue cells that was positive to CD99, NSE and vimentin. The muscle and lymphoid markers were negative. Fluorescence in-situ hybridisation (FISH) study revealed the presence of EWSR1 gene rearrangement thus diagnosis of ES was rendered.

CONCLUSIONS: ES of sinonasal tract is a rare entity and its pathological features significantly overlap with others small round blue cells tumour. Demonstration of EWSR1 gene translocation is recommended for the diagnosis of ES particularly at uncommon sites.

Matched MeSH terms: Diagnosis, Differential

Acute myocarditis mimicking ST-elevation myocardial infarction: A diagnostic challenge for frontline clinicians

Ang KP, Quek ZQ, Lee CY, Lu HT

Med J Malaysia, 2019 12;74(6):561-563.

PMID: 31929492

The clinical presentation of acute myocarditis is highly variable ranging from no symptoms to cardiogenic shock. Despite considerable progress, it remains a challenge for frontline physicians to discriminate between acute myocarditis and myocardial infarction, especially in the early phase. Our case serves as a reminder that acute presentation of myocarditis could resemble ST elevation myocardial infarction potentially misdirecting the therapeutic decision. The clinical presentation, electrocardiographic and laboratory findings of the patient are not specific enough to distinguish acute myocarditis from myocardial infarction. The gold standard tests such coronary angiography and cardiovascular magnetic resonance (CMR) can reliably differentiate the two entities.

Matched MeSH terms: Diagnosis, Differential

Fulltext Calcified vertical plate of the cricoid--a rare pitfall in the diagnosis of an oesophageal foreign body

Arasaratnam S, Abdullah BJJ, Fernandez V

Med J Malaysia, 1998 Sep;53(3):290-2.

PMID: 10968170

We present a case of rare pitfall in the diagnosis of an oesophageal foreign body due to the calcified vertical plate of the cricoid to highlight the need to be aware of this entity to avoid unnecessary morbidity.

Matched MeSH terms: Diagnosis, Differential

Fulltext Biliary cystadenoma - computed tomography findings

Ariff A, Hassan H, John G

Malays J Med Sci, 2002 Jan;9(1):49-51.

PMID: 22969318

Biliary cystadenoma is a rare neoplasm of the biliary ductal system. Surgical management yields an excellent result. We present a case of recurrent biliary cystadenoma in the left lobe of the liver. The cyst was successfully treated with hepatic segmentectomy. The lobulated smoothly marginated septated cystic lesion noted on computed tomography (CT) were highlighted and the other imaging studies, differential diagnosis and management were reviewed.

Matched MeSH terms: Diagnosis, Differential

An Expansile Well-defined Radiolucency in Anterior Mandible: Case Presentation with Treatment Approach and Literature Update

Arora S, Urs AB, Choudhary Z

Gulf J Oncolog, 2017 Jan;1(23):77-81.

PMID: 28272008

A 15-year-old Indian male patient presented with a history of pain and swelling in left mandible. Imaging studies revealed a well-defined unilocular radiolucency in the body of the mandible. Patient also gave the past history of the surgery of the jaws, which was histopathologically diagnosed as dentigerous cyst. Following this patient underwent incisional biopsy and later excisional biopsy. The histopathologic diagnosis for incisional biopsy was unicystic ameloblastoma but final diagnosis was dentinogenic ghost cell tumor for the excised tissue. To the best of our knowledge, this appears o be the first case of dentigerous cyst transforming into dentinogenic ghost cell tumor. The clinical presentation of the case, differential diagnosis and treatment modalities are being discussed.

Matched MeSH terms: Diagnosis, Differential

Kimura's disease of parotid gland presenting as solitary parotid swelling

Arshad AR

Head Neck, 2003 Sep;25(9):754-7.

PMID: 12953311

Kimura's disease is a chronic inflammatory disorder of unknown etiology commonly seen among orientals and characterized histologically by lymphatic follicles, vascular proliferation, and marked eosinophilic infiltration. It has a predilection for the head and neck region. The lesion is benign but can be mistaken to be a malignant lesion.

Matched MeSH terms: Diagnosis, Differential

Fulltext Pilomatrixoma: a diagnostic pitfall on fine-needle aspiration cytology of benign ‘Neck Metastases’

Asha’ari ZA, Shiyuti MI, Abdullah K, Selimin A, Sathananthar KS

International Medical Journal Malaysia, 2014;13(2):63-66.

MyJurnal

Pilomatrixoma is a benign tumour that originates from the matrix of the hair root. This rare tumour is usually managed by the dermatologists. The commonest location of this tumour is in the head and neck region; hence, it can be encountered by any doctors with interest in this area. When presented in the neck, this hard tumour may pose a diagnostic challenge. A case report of pilomatrixoma misdiagnosed as a metastatic neck disease from fine-needle aspiration cytology is presented. The mistake in the diagnosis has led to a more aggressive and high morbidity surgery than necessary. It is important that head and neck doctors be aware of this condition and includes it in the differential diagnosis of hard masses presenting in the neck.

Matched MeSH terms: Diagnosis, Differential

Fulltext Intramedullary cervical spine germinoma: a case report

Ashraf S

Med J Malaysia, 2012 Apr;67(2):207-9.

PMID: 22822645 MyJurnal

Primary intramedullary germinoma arising in the cervical spinal cord is a very rare entity. We present one such case arising in a young man who presented with radiculopathy and myelopathy, which was partially excised. Upon histological confirmation, he was treated successfully with radiotherapy alone. To our knowledge, this is only the second reported case worldwide which is histologically confirmed. Although extremely rare, differential diagnosis for intramedullary spinal cord tumor should include germinoma.

Matched MeSH terms: Diagnosis, Differential

Hypersexuality As a Neuropsychiatric Disorder: The Neurobiology and Treatment Options

Asiff M, Sidi H, Masiran R, Kumar J, Das S, Hatta NH, et al.

Curr Drug Targets, 2018;19(12):1391-1401.

PMID: 28325146 DOI: 10.2174/1389450118666170321144931

Hypersexuality refers to abnormally increased or extreme involvement in any sexual activity. It is clinically challenging, presents trans-diagnostically and there is extensive medical literature addressing the nosology, pathogenesis and neuropsychiatric aspects in this clinical syndrome. Classification includes deviant behaviours, diagnosable entities related to impulsivity, and obsessional phenomena. Some clinicians view an increase in sexual desire as 'normal' i.e. psychodynamic theorists consider it as egodefensive at times alleviating unconscious anxiety rooted in intrapsychic conflicts. We highlight hypersexuality as multi-dimensional involving an increase in sexual activity that is associated with distress and functional impairment. The aetiology of hypersexuality is multi-factorial with differential diagnoses that include major psychiatric disorders (e.g. bipolar disorder), adverse effects of treatments (e.g. levodopatreatment), substance-induced disorders (e.g. amphetamine substance use), neuropathological disorders (e.g. frontal lobe syndrome), among others. Numerous neurotransmitters are implicated in its pathogenesis, with dopamine and noradrenaline playing a crucial role in the neural reward pathways and emotionally- regulated limbic system neural circuits. The management of hypersexuality is determined by the principle of de causa effectu evanescent, if the causes are treated, the effect may disappear. We aim to review the role of pharmacological agents causing hypersexuality and centrally acting agents treating the associated underlying medical conditions. Bio-psycho-social determinants are pivotal in embracing the understanding and guiding management of this complex and multi-determined clinical syndrome.

Matched MeSH terms: Diagnosis, Differential

Fulltext Infected aneurysm after returning from Southeast Asia: think Burkholderia pseudomallei!

Auvens C, Neuwirth C, Piroth L, Blot M

BMJ Case Rep, 2019 May 22;12(5).

PMID: 31122956 DOI: 10.1136/bcr-2018-228856

Melioidosis is a protean disease which is endemic to Southeast Asia and northern Australia. Here, we report a case of infected aortic aneurysm due to Burkholderia pseudomallei in an immunocompetent man 6 months after a trip to northern Malaysia. This patient initially received inappropriate surgical and antibiotic treatment, leading to a peri-prosthetic aortic infection with lumbar spondylitis and contiguous psoas muscle abscess. This case highlights the difficulty of diagnosing melioidosis given its diverse clinical manifestations and the limits of routine microbiological methods to identify B. pseudomallei Melioidosis should be considered a possible diagnosis in individuals with unexplained fever subsequent to travel in an endemic area.

Matched MeSH terms: Diagnosis, Differential

Fulltext Systemic lupus erythematosus presenting as parotitis and secondary Sjogren's syndrome

Azarisman Shah MS, Heselynn H

Singapore Med J, 2007 Feb;48(2):e60-1.

PMID: 17304382

A 38-year-old woman presented with right-sided parotid swelling, dry mouth and dry eyes of one year duration. Her Schirmer's test and sialometry were positive and histopathology showed lymphoplasmacytic infiltration. She also had concomitant normochromic , normocytic anaemia and mild haematuria. Her anti-nuclear antibody titre was also positive, 1:640, with a speckled pattern on immunofluorescence. We discuss the atypical presentation of systemic lupus erythematosus, particularly parotitis and secondary Sjogren's syndrome.

Matched MeSH terms: Diagnosis, Differential

Fulltext Acardius amorphus: magnetic resonance imaging (MRI) can be helpful in the diagnosis when ultrasound (US) is inconclusive

Azian AA, Roslani AL

Med J Malaysia, 2011 Dec;66(5):510-2.

PMID: 22390115 MyJurnal

An acardiac twin is rare and the diagnosis is commonly achieved from antenatal ultrasound (US) scans. However there have been cases where the appearances of the acardiac twin can be confusing and mimics a mass or tumour, for example, a teratoma. We experienced a case where the findings were unclear from the antenatal ultrasound scans and we had to resort to Magnetic Resonance Imaging (MRI), where we finally made the correct diagnosis based on the identification of two umbilical cords, supplying the normal fetus and the 'mass' (acardiac twin) respectively.

Matched MeSH terms: Diagnosis, Differential

Fulltext Case series of naturally acquired Plasmodium knowlesi infection in a tertiary teaching hospital

Azira NM, Zairi NZ, Amry AR, Zeehaida M

Trop Biomed, 2012 Sep;29(3):398-404.

PMID: 23018503 MyJurnal

Plasmodium knowlesi is a simian malaria parasite and is recently recognized as the fifth malaria parasite infecting humans. Manifestation of the infection may resemble other infection particularly dengue fever leading to inappropriate management and delay in treatment. We reported three cases of naturally acquired P. knowlesi in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. Clinical manifestations were quite similar in those cases. Microscopically, the diagnosis might be challenging. These cases were confirmed by polymerase chain reaction method which serves as a gold standard.

Matched MeSH terms: Diagnosis, Differential

Primary middle ear tuberculosis mimicking cholesteatoma

Aziz A, Md Daud MK

Malays Fam Physician, 2020;15(1):44-46.

PMID: 32284804

Tuberculous granuloma in the middle ear is an unusual entity. Herein, we report a case with short presentation of otitis media with mastoid abscess but with a CT scan showing widespread bone destruction. The cause was determined to be middle ear tuberculosis. Awareness of this entity is important, as it may cause a delay in referral to an otorhinolaryngology specialist and, subsequently, a delay in initiating treatment. Therefore, it should be considered in the differential diagnosis, especially when the usual treatment fails to produce the desired result.

Matched MeSH terms: Diagnosis, Differential

Fulltext Juvenile myelomonocytic leukaemia: a case series

Azma RZ, Zarina AL, Hamidah A, Jamal R, Sharifah NA, Ainoon O, et al.

Malays J Pathol, 2009 Dec;31(2):121-8.

PMID: 20514855 MyJurnal

Juvenile myelomonocytic leukaemia (JMML), previously known as juvenile chronic myeloid leukaemia (JCML) is a rare, myelodysplastic - myeloproliferative disease typically presenting in early childhood. This disorder is difficult to distinguish from other myeloproliferative syndrome such as chronic myeloid leukaemia (CML) because of the similarities in their clinical and bone marrow findings. However, because of its unique biological characteristics such as absolute monocytosis with dysplasia, absence of Philadelphia chromosome or BCR-ABL fusion protein, hypergammaglobulinaemia and raised fetal haemoglobin level, this disorder does not satisfy the criteria for inclusion in the CML or chronic myelomonocytic leukaemia (CMML) group, as seen in adult patients. We describe a series of three patients with JMML, who had almost similar clinical and laboratory findings, and discuss the difficulty in the classification and treatment of the disease.

Matched MeSH terms: Diagnosis, Differential

A typical clinical manifestation of atypical underlying diagnosis: Answers

B N, Cj NA, Mk AM, I MI

Pediatr Nephrol, 2023 Nov;38(11):3615-3617.

PMID: 37160459 DOI: 10.1007/s00467-023-05967-1

Matched MeSH terms: Diagnosis, Differential

A typical clinical manifestation of atypical underlying diagnosis: Questions

B N, Cj NA, Mk AM, I MI

Pediatr Nephrol, 2023 Nov;38(11):3611-3613.

PMID: 37160460 DOI: 10.1007/s00467-023-05962-6

Matched MeSH terms: Diagnosis, Differential