MyMedR

Asian perspective on debulking surgery for advanced ovarian cancer: An E-survey

Park SJ, Lee EJ, Lee TS, Wang KL, Okamoto A, Ochiai K, et al.

Eur J Surg Oncol, 2021 05;47(5):1111-1116.

PMID: 33303297 DOI: 10.1016/j.ejso.2020.11.012

PURPOSE: We performed an E-survey to evaluate the practice patterns in debulking surgery for advanced ovarian cancer in Asia.

METHODS: We designed a questionnaire, including 50 questions related to debulking surgery for advanced ovarian cancer. The questionnaire was sent to Gynecologic Oncologic Groups in Asia from December 2016 to February 2017.

RESULTS: A total of 253 gynecologic oncologists from Japan (58.9%), the Republic of Korea (19%), Taiwan (12.6%), and the other counties including China (7.5%), Malaysia (0.8%), Indonesia (0.8%), and Thailand (0.4%) participated in this E-survey. The median number of debulking surgeries per year was 20, and 46.8% of the respondents preferred <1 cm as the criterion for optimal debulking surgery (ODS). The most common barrier and surgical finding precluding ODS were performance status (74.3%) and disease involving the porta hepatis (71.5%). Moreover, 63.2% had a fellowship program, and only 15% or less had opportunities to receive additional training courses in general, thoracic, or urologic surgery. The median percentage of patients receiving neoadjuvant chemotherapy (NAC) was 30%, and the achieved rate of ODS in primary debulking surgery (PDS) and interval debulking surgery (IDS) was 65% and 80%, respectively. Most of the respondents required three to 6 h for PDS (48.6%) and IDS (58.9%). Moreover, more than 50% depended on ultra-radical surgery conducted by specialists.

CONCLUSIONS: The ODS criteria are relatively lenient with a preference for NAC in 30% of the respondents in Asia. This trend might be associated with the dependence on aggressive surgery performed by specialists.

Matched MeSH terms: Ovarian Neoplasms/surgery*

Oncological outcomes following robotic-assisted radical prostatectomy in a multiracial Asian population

Alvin LW, Gee SH, Hong HH, Christopher CW, Henry HS, Weber LK, et al.

J Robot Surg, 2015 Sep;9(3):201-9.

PMID: 26531200 DOI: 10.1007/s11701-015-0516-1

This study evaluates the oncological outcomes of RARP in a multiracial Asian population from a single institution. All suitable patients from 1st January 2003-30th June 2013 were identified from a prospectively maintained cancer registry. Peri-operative and oncological outcomes were analysed. Significance was defined as p < 0.05. There were n = 725 patients identified with a mean follow-up duration 28 months. The mean operative time, EBL and LOS were 186 min, 215 ml and 3 days, respectively. The pathological stage was pT2 in 68.6% (n = 497/725), pT3 in 31.3% (n = 227/725) and n = 1 patient with pT4 disease. The pathological Gleason scores (GS) were 6 in 27.9% (n = 202/725), GS 7 in 63.6% (n = 461/725) and GS ≥ 8 in 8.0 % (n = 58/725). The node positivity rate was 5.8% (n = 21/360). The positive margin rates were 31.0% (n = 154/497) and 70.9% (n = 161/227) for pT2 and pT3, respectively, and decreasing PSM rates are observed with surgical maturity. The biochemical recurrence rates were 9.7% (n = 48/497) and 34.2% (n = 78/228) for pT2 and pT3/T4, respectively. On multivariate analysis, independent predictors of BCR were pathological T stage and pathological Gleason score. Post-operatively, 78.5% (n = 569/725) of patients had no complications and 17.7% (n = 128/725) had minor (Clavien grade I-II) complications. This series, representing the largest from Southeast Asia, suggests that RARP can be a safe and oncologically feasible treatment for localised prostate cancer in an institution with moderate workload.

Matched MeSH terms: Prostatic Neoplasms/surgery*

Fulltext Mature cystic teratoma: unusual presentation as anterior neck swelling

Rahman MT, Jaafar H, Naik VR, Ghazali MZ, Hassan S

Singapore Med J, 2004 Mar;45(3):130-1.

PMID: 15029417

The unusual presentation of a mature mediastinal cystic teratoma as an anterior neck swelling in a 29-year-old Malay woman is reported.

Matched MeSH terms: Head and Neck Neoplasms/surgery

Fulltext Phaeochromocytoma of the urinary bladder

Naqiyah I, Rohaizak M, Meah FA, Nazri MJ, Sundram M, Amram AR

Singapore Med J, 2005 Jul;46(7):344-6.

PMID: 15968447

The occurrence of urinary bladder paragangliomas is rare. A 12-year-old Chinese girl who presented with history of blurring of vision was found to have grade IV hypertensive retinopathy. Investigations revealed a phaeochromocytoma on the posterior wall of the urinary bladder. A partial cystectomy with right ureter reimplantation was undertaken and her hypertension was promptly controlled. The diagnosis and management of this rare tumour is discussed.

Matched MeSH terms: Urinary Bladder Neoplasms/surgery*

Fulltext Malignant rhabdoid tumour of the brain

Abdullah JM, Rahman ZA, Ariff AR, Jaafar H, Phang KS

Singapore Med J, 2004 Jun;45(6):286-8.

PMID: 15181525

Rhabdoid tumour is a rare childhood tumour with poor prognosis. We report a 13-month-old Malay girl suffering from this tumour that was located at the left fronto-temporo-parietal region of the brain. Computed tomography showed a large irregular enhancing mass that caused obstructive hydrocephalus. The tumour did not reduce in size after three operations and finally the patient succumbed to the disease four months after diagnosis.

Matched MeSH terms: Brain Neoplasms/surgery

Fulltext Large lower segment myoma--myomectomy at lower segment caesarean section--a report of two cases

Omar SZ, Sivanesaratnam V, Damodaran P

Singapore Med J, 1999 Feb;40(2):109-10.

PMID: 10414171

Uterine leiomyoma is found in approximately 2% of pregnant women. One in ten women will have complications related to myoma in pregnancy. Myomectomy during pregnancy especially at Caesarean section is much discouraged in the literature. We present here 2 cases of large uterine myoma, situated in the anterior aspect of the lower segment, complicating pregnancy at term. Myomectomy in both instances allowed delivery of the fetus through the lower segment, making vaginal delivery in subsequent pregnancies possible.

Matched MeSH terms: Uterine Neoplasms/surgery*

Fulltext Cystic hygroma: anaesthetic considerations and review

Sharma S, Aminuldin AG, Azlan W

Singapore Med J, 1994 Oct;35(5):529-31.

PMID: 7701380

A 3-day-old child presented with a gross swelling on the right side of the neck extending beyond the midline and inability to swallow. It was diagnosed to be cystic hygroma and decision was made to excise the swelling as an emergency operation to enable the child to swallow and thrive better. During the gaseous induction, difficulty was encountered in maintaining the airway and subsequently to intubate the patient. Intraoperatively the surgeon was not able to excise the tumour completely. Postoperatively it was decided to ventilate the child electively because of the intubation difficulties encountered and not so firm floor of the mouth because of surgical excision. The stay in the neonatal ICU was marked with infection and facial nerve palsy.

Matched MeSH terms: Tongue Neoplasms/surgery*

Fulltext Omental transposition flap and split skin graft for locally advanced breast carcinoma

Lee SH, Cheah DS, Krishnan MM

Singapore Med J, 1990 Jun;31(3):217-20.

PMID: 2392698

Locally advanced or recurrent carcinoma of the breast poses difficult management problems. These fungating and discharging tumours severely impair the quality of life in these unfortunate patients. We report two cases successfully treated with omental transposition flaps and split skin grafts. The operation is described in detail and the results discussed. This technique was found to be safe, effective and rewarding.

Matched MeSH terms: Breast Neoplasms/surgery*

Fulltext Parathyroid carcinoma with steroid-suppressible plasma immunoreactive parathyroid hormone and human chorionic gonadotrophin

Chng SL, Krishnan MM, Ramachandran, Chan CH, Zain Z

Singapore Med J, 1990 Feb;31(1):83-4.

PMID: 2333552

A 31-year old male presented with bone pain, polyuria and a palpable nodule in the neck. Radiological examination showed generalised osteopenia, subperiosteal erosion and presence of bilateral renal stones. The essential chemical pathological changes were increased plasma calcium, mid-molecule immuno-reactive parathyroid hormone (iPTH), human chorionic gonadotrophin (hCG) levels. Surgical excision of the nodule revealed a parathyroid carcinoma. The uniqueness of this case is the steroid-suppressible plasma calcium, iPTH, and hCG levels. The diagnostic implications of the findings are discussed.

Matched MeSH terms: Parathyroid Neoplasms/surgery*

Fully Endoscopic Resection of Frontal Osteomas

Yousef W, Najibullah M, Shabbir Z, Shamo S, Azab WA

Adv Tech Stand Neurosurg, 2024;52:253-257.

PMID: 39017799 DOI: 10.1007/978-3-031-61925-0_18

BACKGROUND: Osteomas are the most common primary bone tumors of the calvaria, with an incidence of less than 0.5%. In skull vault osteomas, the exostotic form that grows from the outer table is more common than the enostotic ones which arise from the inner table and grow intracranially. Osteomas of the forehead are very noticeable and disfiguring; patients usually seek medical advice for cosmetic reasons. Forehead osteomas were traditionally excised via either a direct incision over the lesion using the naturally occurring creases or a conventional bicoronal flap. More recently, endoscopic approaches for excision of forehead osteomas were introduced. The results were very encouraging and the technique was adopted by many groups worldwide yet with many technical variations. In this chapter we elaborate on the surgical technique and nuances of the fully endoscopic resection of frontal osteomas.

METHODS: From a prospective database of endoscopic procedures maintained by the senior author, clinical data, imaging studies, operative charts, and videos of cases of forehead osteomas were retrieved and analyzed. The pertinent literature was also reviewed.

RESULTS: The surgical technique of the fully endoscopic resection of frontal osteomas was formulated.

CONCLUSION: The endoscopic technique has many advantages over the conventional procedures. In our hands, the technique has proven to be less time-consuming, efficient, and minimally invasive with excellent cosmetic results.

Matched MeSH terms: Skull Neoplasms/surgery

Endobronchial glomus tumor

Rashid Ali MR, Kannan KK

J Bronchology Interv Pulmonol, 2015 Jan;22(1):66-8.

PMID: 25590487 DOI: 10.1097/LBR.0000000000000128

We report a case of a 52-year-old patient who had undergone a bladder resection and an ileal conduit for a transitional cell carcinoma. He then presented with a short history of hemoptysis 3 months later. Rigid bronchoscopy was performed revealing an endobronchial lesion, which was removed via laser and debulking method without complications. Histopathologic examination confirmed it to be a benign endobronchial glomus tumor. On the basis of our literature search, this is the 34th reported case of glomus tumor arising from the respiratory tract, seventh reported case of an endobronchial glomus tumor treated bronchoscopically, and the first possibly coincidental finding in relation to a patient with primary transitional bladder cell carcinoma.

Matched MeSH terms: Urinary Bladder Neoplasms/surgery; Bronchial Neoplasms/surgery

Fulltext Resection and reconstruction of malignant tumor involving sternum

Faisham WI, Ziyadi MG, Azman WS, Halim AS, Zulmi W, Biswal BM

Med J Malaysia, 2012 Apr;67(2):224-5.

PMID: 22822652 MyJurnal

We present a series of four cases of chest wall tumor, which underwent sternum resection. The methods of resection and reconstruction chest wall defect are discussed and the final outcome highlighted.

Matched MeSH terms: Bone Neoplasms/surgery*; Thoracic Neoplasms/surgery*

Cytologic features and differential diagnosis in chondroma of the breast: a case report

Sivakumar S, Kaur G

Acta Cytol., 2009 May-Jun;53(3):303-5.

PMID: 19534271 DOI: 10.1159/000325312

BACKGROUND: Extraskeletal (soft tissue) chondromas are rare neoplasms. They are seen most frequently in the soft tissues of hands and feet. A chondroma occurring in the breast is exceedingly uncommon. We present a case of pure chondroma of the breast in a young woman in whom fine needle aspiration (FNA) cytologic features suggested a cartilaginous neoplasm.

CASE: A 28-year-old woman presented with a mobile lump in the left breast. Mammography showed a high-density nodule without microcalcifications. A clinical diagnosis of fibroadenoma was made. A differential diagnosis was obtained on FNA. Excisional biopsy of the lump showed the histopathologic features of chondroma. There was no recurrence or appearance of new lesion during 13 months of follow-up.

CONCLUSION: Chondroma of the breast shows FNA cytologic features of cartilaginous tumor, but specific tumor typing may not be possible. This case highlights the difficulties that may arise in FNA diagnosis of cartilaginous tumor especially when it occurs at an unusual site. Awareness of the cytologic features combined with clinical and radiologic findings should guide the cytopathologist to make correct diagnosis of this neoplasm.

Matched MeSH terms: Breast Neoplasms/surgery; Soft Tissue Neoplasms/surgery

When should elective neck dissection be performed in maxillary gingival and alveolar squamous cell carcinoma with a cN0 neck? A systematic review

Tang L, Leung YY

Int J Oral Maxillofac Surg, 2016 Nov;45(11):1358-1365.

PMID: 27289248 DOI: 10.1016/j.ijom.2016.05.021

The purpose of this systematic review was to answer the clinical question "When should elective neck dissection be performed in maxillary gingival and alveolar squamous cell carcinoma with a cN0 neck?" A systematic review, designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, was conducted by two independent reviewers with three rounds of search and evaluation. Ten studies with 506 patients were included in the final review. The overall risk of cervical metastasis was 23.2% for those who did not receive an elective neck dissection (END), which was 3.4 times higher than that in the END group (6.8%). The 5-year survival rate was higher in those who had an END (80.3%) when compared to those who did not receive an END (67.4%). Overall, 14.1% of the cases with cN0 maxillary squamous cell carcinoma (SCC) presented with positive node(s) in pathological specimens after END. The risk of occult cervical metastasis in a cN0 maxillary SCC case with pathological stage pT1, pT2, pT3, and pT4 was 11.1%, 12.1%, 20%, and 36.1%, respectively. It is therefore concluded that END is recommended in patients with cN0 maxillary SCC, especially in stage T3 or T4 cases.

Matched MeSH terms: Gingival Neoplasms/surgery*; Maxillary Neoplasms/surgery*

Undifferentiated carcinoma of the sinuses and cranial basis successfully treated with radiochemotherapy. A case report

Chandrasekaran S, Baba AA, Othman N, Jayakumar CR

Chemotherapy, 1994 Sep-Oct;40(5):357-61.

PMID: 7956460

The frustration and disappointment in managing advanced cancers of the nose and paranasal sinuses are well known. We report a case of a successful treatment of such a tumour in a 37-year-old soldier, using a combination of therapy including surgery, chemotherapy and radiation. Each mode of treatment is discussed.

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

Syringomyelia associated with a cauda equina meningioma involving the conus medullaris

Chee CP, Tan CT, Nuruddin R

Br J Neurosurg, 1990;4(6):529-33.

PMID: 2076215

An unusual case of syringomyelia secondary to a cauda equina meningioma involving the conus medullaris is described. The tumour was totally removed with decompression of an adjacent cyst and syrinx resulting in resolution of the symptoms and radiological appearance.

Matched MeSH terms: Peripheral Nervous System Neoplasms/surgery; Spinal Cord Neoplasms/surgery

Recurrent occipital dermatofibrosarcoma protuberans tackled with wide local excision: A case report and current management

Kho JPY, Ng BHK, John R

Med J Malaysia, 2019 02;74(1):82-84.

PMID: 30846668

Dermatofibrosarcoma protuberans (DFSP) is a slowgrowing, locally invasive tumour of the dermis. It commonly presents in the trunks and proximal extremities but is seen to a lesser extent in the head and neck regions. We present a case report of a recurrent DFSP in a 48-year-old Iban woman at the occipital region. The patient underwent wide local excision and removal of outer table of cranium, dressing followed by split thickness skin graft. Histopathological examination confirmed dermatofibrosarcoma protuberans with clear lateral surgical margins and a deep margin of 0.5mm. She is currently undergoing radiotherapy and is planned for 50Grey 25cycles.

Matched MeSH terms: Head and Neck Neoplasms/surgery*; Skin Neoplasms/surgery*

Surgical experiences in Malaysia

Balasegaram M

S Afr J Surg, 1972 Jun;10(2):79-87.

PMID: 4546544

Matched MeSH terms: Esophageal Neoplasms/surgery; Mouth Neoplasms/surgery

Clinicopathological Features and Prognostic Value of Incidental Prostatic Adenocarcinoma in Radical Cystoprostatectomy Specimens: A Systematic Review and Meta-Analysis of 13,140 Patients

Fahmy O, Khairul-Asri MG, Schubert T, Renninger M, Stenzl A, Gakis G

J Urol, 2017 02;197(2):385-390.

PMID: 27569436 DOI: 10.1016/j.juro.2016.08.088

PURPOSE: There is controversy in the literature about the oncologic significance of incidental prostate cancer detected at radical cystoprostatectomy for bladder cancer.

MATERIALS AND METHODS: An online search was done for studies reporting incidental prostate cancer in cystoprostatectomy specimens. After following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines we identified a total of 34 reports containing 13,140 patients who underwent radical cystoprostatectomy for bladder cancer with no previous history of prostate cancer. A cumulative analysis was performed on the available data regarding prevalence, clinicopathological features and oncologic outcomes. RevMan, version 5.3 was used for data meta-analysis.

RESULTS: Of the 13,140 patients incidental prostate cancer was detected in 3,335 (24.4%). Incidental prostate cancer was significantly associated with greater age (Z = 3.81, p = 0.0001, d = 0.27, 95% CI -0.14-0.68), lymphovascular invasion of bladder cancer (Z = 2.07, p = 0.04, r = 0.14, 95% CI 0.09-0.18) and lower 5-year overall survival (Z = 2.2, p = 0.03). Among patients with clinically significant and insignificant prostate cancer those with clinically significant prostate cancer significantly more frequently showed a positive finding on digital rectal examination (Z = 3.12, p = 0.002, r = 0.10, 95% CI 0-0.19) and lower 5-year overall survival (Z = 2.49, p = 0.01) whereas no effect of age was observed (p = 0.15). Of 1,320 patients monitored for biochemical recurrence prostate specific antigen recurrence, defined as prostate specific antigen greater than 0.02 ng/ml, developed in 25 (1.9%) at between 3 and 102 months.

CONCLUSIONS: This meta-analysis suggests that incidental prostate cancer detected during histopathological examination of radical cystoprostatectomy specimens might be linked with adverse characteristics and outcomes in patients with invasive bladder cancer.

Matched MeSH terms: Urinary Bladder Neoplasms/surgery*; Prostatic Neoplasms/surgery

A rare case of intussusception associated with metastasized small cell carcinoma of lung

Jarmin R, Azman A, Rahim R, Kosai NR, Das S

Acta Med Iran, 2012;50(11):782-4.

PMID: 23292632

Intussusception is common cause of bowel obstruction in the paediatric age group compared to the elderly population. Many times, the diagnosis may be difficult because of asymptomatic nature of this bowel disorder. We hereby describe the case of a 75-year-old male who presented with lethargy, weakness, loss of movement in the joints and was found to be anemic. The haemoglobin level was low so he was transfused with packed cells. On gastrointestinal (GI) endoscopy, upper GI bleed was observed. A mass was observed beyond ampulla at the 2nd and 3rd part of the duodenal junction. Computerized tomography (CT) scan also showed a mass at the head of pancreas and the lesion at the left lung. In view of persistent bleed, 'Whipple's procedure' was performed. Histopathological examination showed small cell carcinoma of the lungs with metastasis to the pancreas and the jejunum. We here discuss the case of intussusception with intestinal metastasis which presented with gastrointestinal bleeding.

Matched MeSH terms: Jejunal Neoplasms/surgery; Lung Neoplasms/surgery; Pancreatic Neoplasms/surgery

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