MyMedR

Fulltext Abdominal aorta and inferior vena cava thromboses in advanced stage of malignant fibrous histiocytoma

Faisham WI, Zulmi W, Ezane AM, Biswal BM

Med J Malaysia, 2005 Oct;60(4):495-7.

Asymptomatic simultaneous thrombosis of abdominal aorta and inferior vena cava is a rare complication in advanced malignancy. We described an incidental finding of this clinical entity in our patient who presented with advance stage of malignant fibrous hystiocytoma of soft tissue and pathological fracture. The radiological evaluation with spiral computed tomography scan of abdominal aorta and inferior vena cava are presented and the subsequent management highlighted.

Matched MeSH terms: Tomography, Spiral Computed

Fulltext The dilemma of a lateral pharyngeal mass causing stridor in a neonate

Dipak RN, Kailesh P, Sherry MJ, Anindya C

Med J Malaysia, 2005 Oct;60(4):520-2.

PMID: 16570723

Neonatal stridor resulting from intrinsic or extrinsic aberration in the upper respiratory tract often poses not only a diagnostic problem, but also a difficult airway and a dilemma as to the necessity / timing of surgical intervention. A 45 day old female child with increasing stridor since birth was managed by emergency intubation and CT scan followed by excision biopsy of the cystic left sided parapharyngeal mass via a transcervical approach. On histopathology, the excised specimen was reported as cystic salivary choristoma.

Matched MeSH terms: Tomography, X-Ray Computed

Endoscopic ultrasound-guided drainage of a biloma: a novel approach

Ponnudurai R, George A, Sachithanandan S, Abdullah A, Ganesaligam K, Sanker L, et al.

Endoscopy, 2006 Feb;38(2):199.

PMID: 16479434

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Accuracy of the funnel technique of thoracic pedicle screws insertion in scoliosis surgery--an evaluation by CT-scans

Wong CC, Ting F, Wong B, Lee PI

Med J Malaysia, 2005 Jul;60 Suppl C:35-40.

PMID: 16381281

Pedicle screw system has increasingly been used for correction of thoracic scoliosis. It offers several biomechanical advantages over hook system as it controls all three-column of the spine with enhanced stability. Of many techniques of pedicle screw placement in the thoracic spine, the funnel technique has been used in Sarawak General Hospital since 2002. This prospective study aims to assess the accuracy of the placement of thoracic pedicle screws using the funnel technique in the corrective surgery of idiopathic scoliosis. A total of 88 thoracic pedicle screws were inserted into the T4 to T12 vertebrae of 11 patients. Post-operative CT-scan was performed to evaluate the position of the pedicle screw. Seventy six (86.4%) screws were noted to be totally within the pedicle. There was no screw with medial violation of the pedicle, 8 (9.1%) screws breeching the lateral wall of the pedicle and 4 (4.5%) screws with anterior and lateral penetration of the vertebral body. No clinical sequel with the mal-positioned screws was noted. In conclusion, the funnel technique enabled simple, accurate and reliable insertion of pedicle screw even in the scoliotic thoracic spine without the need of any imaging guidance. It is however imperative for the surgeon to have a thorough knowledge of the thoracic spine anatomy, and to be familiar with the technique to insert these screws diligently.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext CT appearances of Marjolin's ulcer in the left gluteal region of a young man

Mohamed S, Abdullah B, Singh DA, Heng KS

Biomed Imaging Interv J, 2006 Jul;2(3):e26.

PMID: 21614240 DOI: 10.2349/biij.2.3.e26

Chronic wounds and scar tissues are prone to skin cancer. In 1828, Jean-Nicholas Marjolin described the occurrence of tumours in post-traumatic scar tissue. He did not, however, identify the warty ulcers he described as malignant. It was Dupuytren, who about two years later, noted that these lesions were cancerous. The eponym was bestowed by Da Costa in 1903. Marjolin's ulcer no longer refers only to carcinomas secondary to burns and is classified as a malignancy that arises from previously traumatised, chronically inflamed, or scarred skin. It has been reported in relation to osteomyelitis, venous stasis ulcer, tropical ulcers, chronic decubitus ulcer, frostbite, pilonidal sinus, vaccination site, urinary fistula, hidradenitis suppurativa, skin graft donor site, gunshot wounds, puncture wounds, dog bites, and lupus rash. Early arising Marjolin's ulcer has rarely been described in literature. In this case report, we present the CT appearances of Marjolin's ulcer in the left gluteal region of a young man.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Mesocolic hernia: a rare cause of intestinal obstruction in childhood

Kihne M, Ramanujam TM, Sithasanan N

Med J Malaysia, 2006 Jun;61(2):251-3.

PMID: 16898325 MyJurnal

Mesocolic hernia is a rare cause of intestinal obstruction in children. The diagnosis involves a high index of suspicion and prompt intervention to prevent strangulation and a high morbidity. The embryological basis of the condition is of paramount importance to assist the eventual surgical correction.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Congenital rubella syndrome with positive serology and virus isolation

Ooi HL, Cheong SM, Yogeswery S, Norizah I, Zuridah H, Kumarasamy V, et al.

Med J Malaysia, 2006 Jun;61(2):248-50.

PMID: 16898324 MyJurnal

An effective live attenuated rubella vaccine was available since 1969 and congenital rubella syndrome can be prevented with appropriate vaccination. We report a baby with congenital rubella syndrome born in Klang valley to indicate that the Universal Rubella Vaccination Programme adopted by the Ministry of Health Malaysia since 2002 has yet to achieve its effect of eliminating transmission of rubella and preventing congenital rubella infection in the community. To our knowledge, the virus isolate represents the first successful isolation of rubella virus in this country and will serve as the reference strain for future comparison in molecular epidemiological tracking of rubella virus activity this country.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext A rare case of Von Hippel Lindau disease

Abdul Ghani R, Norazmi MK, Norlaila M

Med J Malaysia, 2006 Jun;61(2):254-7.

PMID: 16898326 MyJurnal

Pheochromocytoma is a rare catecholamine-secreting tumour typically arising within the adrenal medulla. It may occur sporadically or be associated as part of a tumour syndrome including Von Hippel Lindau (VHL), Multiple Endocrine Neoplasia (MEN) 2 and Neurofibromatosis Type 1. VHL is associated with multi-organ involvement of benign and malignant tumours characterized by the presence of retinal angiomas, hemangioblastomas of the cerebellum and spinal cord, renal cell carcinomas, pheochromocytomas and other cystic lesions in the kidneys, pancreas, and epididymis. It is a rare disorder with prevalence estimated at 2-3 per 100,000. This case report describes a 37 years old Chinese gentleman who presented to our institution for further management of bilateral pheochromocytoma and retinal angioblastoma with problems of duodenal ulcer and anaemia. There was no family history of similar problems. With these features the criteria for the diagnosis of von Hippel Lindau disease was established.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Third ventricular cavernous angioma

Zakaria MA, Abdullah JM, George JP, Mutum SS, Lee NN

Med J Malaysia, 2006 Jun;61(2):229-32.

PMID: 16898318 MyJurnal

Third ventricular cavernous angiomas are rare vascular malformations of the brain. We report an eight-year old boy with a rare third ventricular cavernous angioma that hemorrhaged presenting with symptoms of acute hydrocephalus. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) showed a heterogenous ill-defined, solid and cystic intraventricular mass in the third ventricle which was mildly enhanced with contrast and there was associated hydrocephalus. The mass was removed with success and follow up after two years revealed no neurological abnormalities.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Bilateral maxillary sinus cholesterol granuloma: a rare entity

Marina MB, Gendeh BS

Med J Malaysia, 2006 Jun;61(2):226-8.

PMID: 16898317

Cholesterol granuloma in the paranasal sinuses is rare. It is more common in the mastoid antrum and temporal bone air cells in chronic middle ear disease. A case of bilateral maxillary sinus cholesterol granuloma that mimics chronic maxillary sinusitis is reported. This is the first reported case of cholesterol granuloma of the maxillary sinus in the Malaysian Literature.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Rare bone disorder affecting the temporal bone

Sreetharan SS, Hazim M, Saim L

Med J Malaysia, 2006 Mar;61(1):103-5.

PMID: 16708745 MyJurnal

Fibrous dysplasia is an uncommon benign disorder of unknown etiology. Rarely, it presents isolated in the temporal bone. We present three cases of monostotic fibrous dysplasia that involved the entire temporal bone.

Matched MeSH terms: Tomography, X-Ray Computed

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: Tomography, X-Ray Computed

Fulltext Adrenal cortical carcinoma masquerading as pheochromocytoma: a case report

Ni H, Htet A

Ecancermedicalscience, 2012;6:277.

PMID: 23152728 DOI: 10.3332/ecancer.2012.277

Adrenocortical carcinoma (ACC) is a malignant tumour arising from the adrenal cortex, while pheochromocytoma is a catecholamine secreting tumour of the adrenal medulla or extra adrenal sites. Both conditions are very rare, with incidence of approximately 1-2 cases per million adults annually. Most adrenocortical tumours are functioning. ACC can be associated with clinical Cushing syndrome and virilisation due to excessive production of cortisol and androgens, respectively. However, it is rare for ACC to present clinically as pheochromocytoma. We report a case of a 28-year-old lady who presented with paroxysmal hypertension and palpitations associated with raised urinary vanillyl mandelic acid. On examination, there was postural hypotension and ballotable mass in right lumbar region with no obvious features suggestive of Cushing syndrome or virilisation. A huge right suprarenal mass with areas of necrosis and calcification was noted on the abdomen CT. A right adrenalectomy was done. The histology was consistent with ACC. There are reported cases of ACC presenting with clinical features of pheochromocytoma but limited in number, accounting for barely a dozen cases in the literature. This pseudopheochromocytoma may be due to the presence of neuroendocrine features in ACC.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Hashimoto's thyroiditis: a rare cause for rhinosinusitis

Jeevanan J, Gendeh BS, Satpal S

Med J Malaysia, 2004 Aug;59(3):428-30.

PMID: 15727394

Rhinosinusitis is a common disorder with various etiological factors. In our clinical practice allergy seems to be a predominant cause followed by other less common causes like infection, drugs and aspirin hypersensitivity. We present a case of chronic rhinosinusitis secondary to hypothyroidism. Although hormonal causes like hypothyroidism have been proven to cause nasal congestion and rhinosinusitis, this is the first reported case of chronic rhinosinusitis in Hashimoto's thyroiditis in our center. This is a diagnosis of exclusion for chronic rhinosinusitis not responding to optimal medical therapy.

Matched MeSH terms: Tomography, X-Ray Computed

Diagnostic cerebral angiography in spontaneous intracranial haemorrhage: a guide for developing countries

Abu Bakar I, Shuaib IL, Mohd Ariff AR, Naing NN, Abdullah JM

Asian J Surg, 2005 Jan;28(1):1-6.

PMID: 15691788

OBJECTIVE: Spontaneous intracranial haemorrhage constitutes 18-40% of all stroke cases. Indications for cerebral angiography to find underlying potentially treatable vascular abnormalities are not clear. This study determined which intracranial haemorrhage patients need cerebral angiography by correlating computed tomography (CT) findings, age and hypertension history with cerebral angiography findings.

METHODS: A total of 54 patients (8-79 years) with intracranial haemorrhage who underwent both CT examination and six-vessel cerebral angiography were studied over a 2-year period. Cerebral angiography was repeated within 6 weeks if the first angiogram was negative.

RESULTS: Angiography detected vascular lesions in 50% of cases (aneurysm 38.9% and arteriovenous malformation, AVM, 11.1%). In the aneurysm group, angiographic yield was 34.3% whereas in the AVM group, it was 37.9%. Subarachnoid haemorrhage (SAH) combined with other types of haemorrhage (such as intracerebral haemorrhage, ICH) was not significantly correlated with the likelihood of finding a vascular lesion, both aneurysm and AVM (p = 0.157). Age less than 50 years had significant correlation (p = 0.021) in the AVM group as well as in the aneurysm group (p < 0.001). A history of hypertension was associated with both aneurysm (p = 0.039) and AVM (p = 0.008). No patients with deep intracerebral haematoma had vascular lesions. The presence of an intravascular haemorrhage (IVH) had significant correlation with aneurysm (p = 0.008) but not AVM. There was no significant difference in mean age between patients with and without a vascular lesion (p = 0.134).

CONCLUSION: Cerebral angiography is justified in patients with ICH accompanied by pure SAH (p = 0.001). Other factors associated with finding a vascular lesion were a history of hypertension and the presence of IVH. Diagnostic cerebral angiography is indicated for patients with ICH and SAH and IVH with a history of hypertension, regardless of age.

Matched MeSH terms: Tomography, X-Ray Computed

Caecal tumour with hepatic metastases?

Rajendra S, Kutty K

Gut, 2005 Feb;54(2):178, 200.

PMID: 15647173

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Giant aneurysm or pituitary macroadenoma: a diagnostical misconstrue

Pany A, Sobri M, Valarmathi S, Nazihah M, Latif AZ, Adnan JS

Med J Malaysia, 2004 Mar;59(1):123-5.

PMID: 15535350

We describe a case of a giant thrombosed intrasellar internal carotid artery aneurysm initially diagnosed as pituitary macroadenoma. The differentiating neuroimaging features were discussed.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Spontaneous closure of a persistent post-traumatic pancreatic fistula in a child: incidental therapeutic effect of ERCP

Thambidorai CR, Ismail S, Chan KY, Haron A, Zulfiqar A

Med J Malaysia, 2004 Mar;59(1):120-2.

PMID: 15535349

A child with a post-tramatic pancreatic pseuodocyst developed pancreatic fistula, following percutaneous drainage of the cyst. The fistula output was about 120ml/day and lasted for a month. A diagnostic ERCP revealed main pancreatic duct disruption. The fistula output ceased over the next two days following the ERCP. The patient has been well for the past four years. This patient's immediate recovery after ERCP could possibly be due to dislodgement of a mucus plug by the contrast injected during ERCP. Such a mechanism can explain the previous sporadic reports of spontaneous cure of persistent pancreatic fistulae in children.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Rare cause of Horner's syndrome: pseudoaneurysm of right subclavian artery in an intravenous drug user

Lee SK, Zainal A

Med J Malaysia, 2004 Mar;59(1):115-7.

PMID: 15535347

Pseudoaneurysms of the subclavian artery are extremely rare lesions despite the overall increase in the frequency of septic pseudoaneurysms caused by illicit parenteral drug abuse. A case of subclavian artery pseudoaneurysm presenting with Horner's syndrome in an intravenous drug user is discussed.

Matched MeSH terms: Tomography, X-Ray Computed

Bilateral occipital infarction: an uncommon cause of bilateral visual loss

Chang KM, Subrayan V, Patel DK

J Emerg Med, 2013 Mar;44(3):668-9.

PMID: 23312775 DOI: 10.1016/j.jemermed.2012.07.079

Matched MeSH terms: Tomography, X-Ray Computed

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