MyMedR

Sinonasal inverted papilloma with malignant transformation in the middle ear: a multicentric origin?

Mazlina S, Shiraz MA, Hazim MY, Amran AR, Zulkarnaen AN, Wan Muhaizan WM

J Laryngol Otol, 2006 Jul;120(7):597-9.

PMID: 16672089

Inverted papilloma is a rare, benign tumour representing only 0.5 to 4 per cent of all sinonasal neoplasms; its involvement of the middle ear is extremely rare. We present a case of multicentric inverted papilloma in the sinonasal region and middle ear in a 54-year-old man. The patient later developed neck metastasis secondary to malignant transformation of the inverted papilloma in the middle ear.

Matched MeSH terms: Ear Neoplasms/pathology*; Maxillary Sinus Neoplasms/pathology*

Fulltext Challenges in the treatment of sinonasal undifferentiated carcinoma: a ray of hope

Norleza AN, Gendeh BS

Med J Malaysia, 2005 Aug;60(3):281-5.

PMID: 16379180 MyJurnal

We studied nine cases of SNUCs presented to the Department of Otorhinolaryngology, Hospital University Kebangsaan Malaysia from 1999 to 2003. There were 8 males and 1 female with ages ranging from 24 to 78 years (mean 46.5y). The racial distribution consisted of 5 Chinese (55.5%), 3 Malays (33.3%) and 1 Indian (11.1%). Three patients were Kadish B (33.3%) and six were Kadish C (66.6%) by classification. In our series 2 years survival was 26.3% and median survival time was 14.2 months.

Matched MeSH terms: Nose Neoplasms/pathology; Paranasal Sinus Neoplasms/pathology

Extramammary Paget's disease: a report of 2 cases and a review of the literature

Khoo JJ, Choon SE

Malays J Pathol, 2003 Jun;25(1):73-8.

PMID: 16196382

Extramammary Paget's disease (EMPD) is a rare disorder and may be found in the vulva, scrotum, penile area, perianal region and the groin. Frequently, it is associated with an underlying regional neoplasm or internal malignancy. We report 2 cases of EMPD; one involving the scrotal area and the other the vulva. Both were elderly patients who presented to the dermatologists with chronic eczematous lesions in the perineum that did not respond to topical treatment. Skin biopsies confirmed extramammary Paget's disease. Investigations for internal malignancies were negative. However, one of the patients defaulted treatment before surgery. The other patient had two excision surgeries with skin grafting to try to achieve tumour free margins. A long term follow-up was planned for him to look for recurrences. These cases emphasise that EMPD can mimic exudative dermatitis and present as a chronic non-healing lesion in the perineum for many years. Clinicians should have a high index of suspicion to pick up the disease early by biopsy. Various immunohistochemical markers not only can help differentiate other histological diagnoses but also help predict the presence of underlying malignancies. Management of EMPD included thorough search for occult or underlying malignancy followed by complete excision surgery with intraoperative frozen sections. Even then, recurrences are high for this disease and long term follow-up is advocated.

Matched MeSH terms: Skin Neoplasms/pathology*; Vulvar Neoplasms/pathology

Fulltext Gender-Specific Molecular and Clinical Features Underlie Malignant Pleural Mesothelioma

De Rienzo A, Archer MA, Yeap BY, Dao N, Sciaranghella D, Sideris AC, et al.

Cancer Res, 2016 Jan 15;76(2):319-28.

PMID: 26554828 DOI: 10.1158/0008-5472.CAN-15-0751

Malignant pleural mesothelioma (MPM) is an aggressive cancer that occurs more frequently in men, but is associated with longer survival in women. Insight into the survival advantage of female patients may advance the molecular understanding of MPM and identify therapeutic interventions that will improve the prognosis for all MPM patients. In this study, we performed whole-genome sequencing of tumor specimens from 10 MPM patients and matched control samples to identify potential driver mutations underlying MPM. We identified molecular differences associated with gender and histology. Specifically, single-nucleotide variants of BAP1 were observed in 21% of cases, with lower mutation rates observed in sarcomatoid MPM (P < 0.001). Chromosome 22q loss was more frequently associated with the epithelioid than that nonepitheliod histology (P = 0.037), whereas CDKN2A deletions occurred more frequently in nonepithelioid subtypes among men (P = 0.021) and were correlated with shorter overall survival for the entire cohort (P = 0.002) and for men (P = 0.012). Furthermore, women were more likely to harbor TP53 mutations (P = 0.004). Novel mutations were found in genes associated with the integrin-linked kinase pathway, including MYH9 and RHOA. Moreover, expression levels of BAP1, MYH9, and RHOA were significantly higher in nonepithelioid tumors, and were associated with significant reduction in survival of the entire cohort and across gender subgroups. Collectively, our findings indicate that diverse mechanisms highly related to gender and histology appear to drive MPM.

Matched MeSH terms: Lung Neoplasms/pathology; Pleural Neoplasms/pathology

Retroperitoneal malignant fibrous histiocytoma causing profuse bleeding per rectum

Sim PH, Pathmanathan R, Jalleh RP

Aust N Z J Surg, 1995 Jan;65(1):68-70.

PMID: 7818432

A case is reported of retroperitoneal malignant fibrous histiocytoma (MFH) invading into the colon, causing fresh bleeding per rectum. It illustrates the difficulty encountered in the pre-operative diagnosis of this condition, especially in a patient with an atypical presentation of profuse lower gastrointestinal bleeding.

Matched MeSH terms: Colonic Neoplasms/pathology; Retroperitoneal Neoplasms/pathology

Intraoral spindle-cell lipoma: report of a case and literature review

Khoo SP, Lian CB

Ann Dent, 1995 Summer;54(1-2):53-5.

PMID: 8572549

Spindle-cell lipoma (SCL) of the oral cavity is very rare. There are only four such reported cases in the literature. A concise literature review of SCL and a case report of a SCL affecting the cheek and lip of a 23-year-old man is presented.

Matched MeSH terms: Lip Neoplasms/pathology; Mouth Neoplasms/pathology*

Desmoplastic variant of ameloblastoma in Malaysians

Ng KH, Siar CH

Br J Oral Maxillofac Surg, 1993 Oct;31(5):299-303.

PMID: 8218083

Seventeen cases are reported of desmoplastic variant of ameloblastoma of the jaws observed during the years 1967-1991. There were 12 females and 5 males, and these consisted of 7 Chinese, 6 Malays, 2 Indians, 1 Sikh and 1 Kadazan. Their ages at diagnosis ranged from 21-60 years with a mean of 36.6 years. There were 10 mandibular and 7 maxillary tumours. Of these, 14 cases involved the anterior segment with extension to the premolar region in 5 cases. 60% of cases were radiologically suggestive of fibro-osseous lesions. The main mode of treatment was resection and 1 case presented with recurrence. The findings of this study were compared with those of previous reports.

Matched MeSH terms: Mandibular Neoplasms/pathology*; Maxillary Neoplasms/pathology*

Aggressive (malignant?) epithelial odontogenic ghost cell tumour of the maxilla

Siar CH, Ng KH

J Laryngol Otol, 1994 Mar;108(3):269-71.

PMID: 8169519

A case is described of ameloblastoma of the mandible presenting with multiple recurrences and subsequent extension to the maxilla with resultant transformation into an aggressive (malignant?) epithelial odontogenic ghost cell tumour. The latter is a rare, biologically virulent entity that affects mainly males, exhibits a preference for the maxilla and is histologically characterized by atypical malignant odontogenic epithelium associated with areas of ghost cell formation and varying amounts of dentinoid.

Matched MeSH terms: Mandibular Neoplasms/pathology*; Maxillary Neoplasms/pathology*

Tumefactive fibroinflammatory lesion of the head and neck

Said H, Razi Hadi A, Akmal SN, Lokman S

J Laryngol Otol, 1988 Nov;102(11):1064-7.

PMID: 3209947 DOI: 10.1017/s0022215100107297

The term tumefactive fibroinflammatory lesion is used to describe an unusual fibrosclerosing disorder that behaves in a malignant way clinically but is histologically benign. Lesions in the head and neck are believed to be part of the broader fibrosclerosing syndrome which include pseudotumour of the orbit, Reidel's thyroiditis, sclerosing cholangitis and mediastinal fibrosis. Clinical diagnosis is often difficult and relies heavily on histopathology. Steroid therapy is suggested as the first line of management, while surgery or radiation therapy is reserved for failures.

Matched MeSH terms: Nose Neoplasms/pathology; Paranasal Sinus Neoplasms/pathology

Fulltext Choledochal cyst and cholangiocarcinoma

Yeoh NT, Somasundaram K, Alhady SF, Paramsothy M

Med J Malaysia, 1986 Dec;41(4):365-9.

PMID: 2823084

Carcinoma of the biliary tract is a rare complication of choledochal cysts. Furthermore, the greater predisposition of the cyst wall to neoplastic change has been cited as additional justification for cyst excision rather than on-site internal drainage as the primary choice of operation. The report concerns a patient who developed cholangiocarcinoma despite excision of a choledochal cyst and presented with symptoms of biliary obstruction within one year of the operation. Although this is a rare complication, the need for careful long-term follow-up is supported by this observation.

Matched MeSH terms: Bile Duct Neoplasms/pathology; Liver Neoplasms/pathology

Fulltext Malignant non-Hodgkin's lymphomas of the nose and paranasal sinuses

Tan J, Said H, Chong SM

Med J Malaysia, 1988 Mar;43(1):49-54.

PMID: 3244320

Matched MeSH terms: Nose Neoplasms/pathology*; Paranasal Sinus Neoplasms/pathology*

Optic nerve involvement in nasopharyngeal carcinoma

Prasad U, Doraisamy S

Eur J Surg Oncol, 1991 Oct;17(5):536-40.

PMID: 1936303

Five rare cases of nasopharyngeal carcinoma with optic nerve involvement are reported. Computerised Tomographic Scan (CT Scan) studies were performed in four of them. Evidence of intracranial spread of the tumour, from the roof of the fossa of Rosenmuller to the apex of the orbit through the cavernous sinus, was noted in three patients. In one of them there was extracranial extension of the tumour, to the orbit through the posterior ethmoid.

Matched MeSH terms: Cranial Nerve Neoplasms/pathology*; Nasopharyngeal Neoplasms/pathology*

Anorectal melanoma

Jalleh RP, Pathmanathan R, Krishnan MM, Mukherjee A

Postgrad Med J, 1988 Sep;64(755):669-71.

PMID: 3251217

Four cases of anorectal melanoma are presented. The authors believe that this is the first report of the occurrence of this tumour in Malays. Advanced disease at initial presentation accounts for the poor prognosis observed in this series. Surgery remains the principal treatment modality, although controversy exists regarding optimal extent of resection.

Matched MeSH terms: Anus Neoplasms/pathology; Rectal Neoplasms/pathology

Childhood neuroblastoma in the University Hospital, Kuala Lumpur: a study into features of prognostic value

Looi LM, Lin HP, Cherian R, Sinniah D

Malays J Pathol, 1986 Aug;8:49-56.

PMID: 3682944

Matched MeSH terms: Abdominal Neoplasms/pathology; Mediastinal Neoplasms/pathology

Intrahepatic cholangiocarcinoma and portal hypertension developing in a patient with multicystic biliary microhamartomas

Sugawara T, Shindoh J, Hoshi D, Hashimoto M

Malays J Pathol, 2018 Dec;40(3):331-335.

PMID: 30580365

INTRODUCTION: We report a case of intrahepatic cholangiocarcinoma and portal hypertension developing in a liver with biliary microhamartomas (von Meyenburg's complex).

CASE REPORT: The patient was a 55-year-old man who had a past medical history of diffuse multiple liver abscesses. During follow-up examination, a hypovascular nodule measuring 2.1 cm in diameter was incidentally found in segment 8 of the liver. Surgical resection was performed based on a suspected diagnosis of hepatocellular carcinoma. A gastrofiberscopy examination detected characteristic findings of portal hypertensive gastropathy. During the laparotomy, multiple tiny cystic lesions were observed in a diffuse pattern across the liver surface. The liver parenchyma was slightly fibrotic and haemorrhagic. A histopathological examination revealed intrahepatic cholangiocarcinoma with vascular invasions in von Meyenburg's complex. Multiple biliary adenomas were also observed among the biliary microhamartomas adjacent to the main tumour, suggesting that the malignant transformation of the biliary adenomas might have been responsible for the development of the intrahepatic cholangiocarcinoma. The histopathologic examination also revealed sinusoidal dilation and abnormal spacing of the portal tracts and central veins as evidence of portal hypertension.

Matched MeSH terms: Bile Duct Neoplasms/pathology*; Liver Neoplasms/pathology*

Colon carcinoma with endobronchial metastasis masquerading as bronchial asthma causing ball valve effect

Kho SS, Yong MC, Chan SK, Tie ST, Voon PJ

Med J Malaysia, 2018 12;73(6):403-404.

PMID: 30647213

Malignant central airway obstruction (CAO) with ball valve effect (BVE) in the lung is rare. We discuss a case of metastatic colon cancer who presented with asthma like symptoms which thoracic computed tomography and bronchoscopy revealed an intraluminal tumour obstructing the left main bronchus in a ball valve manner. Airway patency was restored urgently with immediate alleviation of symptoms. This illustrates the importance of recognizing subtle features of central airway obstruction to allow expedition of appropriate investigations and therapy.

Matched MeSH terms: Bronchial Neoplasms/pathology; Colonic Neoplasms/pathology*

Parotid gland oncocytic carcinoma: A rare entity in head and neck region

Wan Ahmad Kammal WS, Azman M, Salleh AA, Md Pauzi SH, Abd Shukor N

Malays J Pathol, 2020 Aug;42(2):283-286.

PMID: 32860383

Oncocytic carcinoma of the salivary gland is an uncommon tumour in the head and neck region. Owing to its rarity, identifying the histopathological features of a malignant tumour can be difficult and challenging. We report a case of a 70-year-old man who presented with a left facial weakness for six months in a background history of left parotid swelling over the past 10 years. Clinical examination revealed a 3x3cm left parotid mass and grade 4 facial nerve palsy. Fine needle aspiration of the mass showed scattered cohesive, monolayered sheets of uniform oncocytic cells. Subsequently, a left total parotidectomy and selective neck dissection were performed. Histological examination showed sheets of small oncocytes with minimal nuclear atypia. Evidence of nerve entrapment, capsular invasion and perivascular permeation were identified in focal areas. Thus, a final diagnosis of oncocytic carcinoma was rendered.

Matched MeSH terms: Head and Neck Neoplasms/pathology; Parotid Neoplasms/pathology

Clinical statistics of odontogenic cysts in West Malaysia

Rengaswamy V

Br J Oral Surg, 1977 Nov;15(2):160-5.

PMID: 271018

A study was made of the clinical statistics of odontogenic cysts treated at two hospitals in West Malaysia over a 6-year period. The general incidence of the individual cyst-types is similar to that reported in previous studies. A marked difference in the age distribution of radicular cysts emerged and 80% of the residual cysts in the survey occurred amongst the Chinese population. Reasons for the distribution variation are discussed.

Matched MeSH terms: Mandibular Neoplasms/pathology; Maxillary Neoplasms/pathology

Fulltext Numb chin syndrome: an ominous sign of mandibular metastasis

Razak A, Goh BS, Rajaran JR, Nazimi AJ

BMJ Case Rep, 2018 May 14;2018.

PMID: 29764822 DOI: 10.1136/bcr-2017-223586

A 51-year-old woman a known case of stage 2 breast carcinoma in 2006 and underwent left mastectomy performed in the same year presented with bilateral lower limb pain suggestive of spinal pathology, and left chin numbness, both of 2 weeks' duration. Examination revealed left mandibular hypoesthesia without any other sign or symptoms. Orthopantomogram was unremarkable apart from mild alveolar bone expansion at tooth 36 area, which was extracted 3 months earlier. Subsequently, a full-body positron emission tomography contrast enhanced computer tomography revealed hypermetabolic lesions of her axial (excluding skull) and appendicular skeleton. In the head and neck region, left mandibular foramen and oropharynx bilaterally showed increased metabolism suggestive of tumour metastasis. The diagnosis was numb chin syndrome secondary to mandibular metastasis. Apart from supportive treatment, she was started on palliative chemotherapy and radiotherapy. At the time of discharge, there were no active complaints other than the aforementioned hypoesthesia.

Matched MeSH terms: Breast Neoplasms/pathology; Mandibular Neoplasms/pathology

Vaginal Brenner tumor with literature review: does this tumour originate from Walthard nests?

Park S, Cho MS

Malays J Pathol, 2017 Apr;39(1):89-93.

PMID: 28413211

Vaginal Brenner tumor is extremely rare. Only five cases have been reported in the English literature to date. Here we report a vaginal Brenner tumor in a 76-year old postmenopausal woman, who presented with a 2.5cm-sized sessile vaginal polyp. Microscopically, it showed characteristic features of Brenner tumor consisting of three components; transitional islands, glands, and dense fibrous stroma. The epithelial tumor cells were positive for GATA-3, p63 and ER, but negative for PAX8. The origin of Brenner tumors in the vagina is unclear, but previous reports suggested of Müllerian origin. However, our case revealed that vaginal Walthard nests could be possible precursor lesions based on their immunohistochemical staining results.

Matched MeSH terms: Ovarian Neoplasms/pathology*; Vaginal Neoplasms/pathology*

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