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Fulltext Actinomycosis of Distal Phalanx Twenty Years after Flap Reconstruction of Index Finger: A Case Report

Prashant N, Azuhairy A

Malays Orthop J, 2018 Mar;12(1):48-50.

PMID: 29725514 MyJurnal DOI: 10.5704/MOJ.1803.011

Actinomycosis is a chronic granulomatous suppurative infection caused by anaerobic bacteria from genus Actinomyces which are normal flora of mouth, colon and vagina. Actinomycosis of upper extremity is rare. We report a case of actinomycosis of the distal phalanx of finger many years after flap reconstruction. The patient presented with two months' history of chronic discharging sinus from the tip of his right index finger, which had sustained a degloving injury 20 years previously. It had been treated with an anterior chest wall flap which had healed uneventfully but was bulky due to excess tissue from the donor site. Radiograph revealed osetomyelitis changes of distal phalanx. Debulking surgery with curettage of the distal phalanx was done. Wound healing was uneventful. He was treated with six weeks of metronidazole and ciprofloxacin. The discharge from the distal phalanx cultured actinomycosis odontolyticus. Histopathology of the debrided tissue showed chronic inflammation. As far as we are aware, there are no reports of actinomycosis in a flap involving the finger treated previously with a chest wall skin flap. The infection was probably dormant for many years before manifesting as a discharging sinus. Although the finger flap was bulky, it was not problematic until it started to have serous discharge. With a thorough debridement of all infected tissue, six weeks of antibiotic was adequate. Ciprofloxacin was prescribed based on discharge culture sensitivity. Metronidazole was added as actinomycosis is anaerobic. Response was prompt as patient was not immunocompromised. At follow-up six months post-surgery the finger had recovered with good function. If not for the discharging sinus, patient would probably have tolerated his bulky finger for the rest of his life.

Fulltext Giant sacral chondrosarcoma in an elderly male: a case report

Chan, H. Z., Wang, C. S., Azuhairy, A., Hau, A., Zulkiflee, O.

Malays Orthop J, 2014;8(1):79-81.

MyJurnal

Primary sacral tumours are rare, therefore experience of managing their associated complications are very limited. Effective surgical treatment of pelvic chondrosarcoma remains a major challenge for orthopaedic surgeons, due to the complex anatomic structure of the pelvis, the lack of defined compartment borders, the close vicinity to vital structures, and the risk of jeopardizing pelvic structural stability. We report a rare case of a giant sacral chondrosarcoma (100cm x 80cm) in an elderly male who successfully underwent tumour resection with good functional outcome and recovery. Long term follow up is essential in view of the possibility of local tumour recurrence.

Fulltext A rare presentation of metachronous multicentric pelvic and extracranial chondrosarcoma : a case report

Choong, C. Y. L., Chan, H. Z., Azuhairy, A., Anwar Hau, M., Zulkiflee, O.

Malays Orthop J, 2014;8(2):55-58.

MyJurnal

Conventional chondrosarcomas rarely metastasize and it is extremely unusual to see multicentric- behaviour in malignant cartilage tumour. We report a 40 year old lady with presentation of two non-contiguous metachronous foci of low to intermediate grade of chondrosarcoma over left pelvic bone and right scalp respectively in the absence of pulmonary or visceral metastasis.

Fulltext Giant Chondrosarcoma of Proximal Humerus in an Adult Female Patient: A Case Report

Ng CK, Azuhairy A, Tan LH, Nordin A

Malays Orthop J, 2015 Jul;9(2):51-53.

PMID: 28435611 MyJurnal DOI: 10.5704/MOJ.1507.001

Chondrosarcoma is the third most common primary tumour of the bone, after myeloma and osteosarcoma. Most of the chondrosarcoma grow slowly and rarely metastasize, and they have an excellent prognosis after adequate surgery. However most of them are chemo or radio-resistant. We report a case of primary chondrosarcoma of proximal humerus in a 36-year-old female who presented with a six years history of left shoulder swelling and restricted range of motion. Trucut biopsy showed a well-differentiated chondrosarcoma. The patient underwent forequarter amputation of left upper limb and was started on chemotherapy following operation.

Fulltext Giant sacral chondrosarcoma in an elderly male : a case report

Chan H, Wang C, Azuhairy A, Hau A, Zulkiflee O

Malays Orthop J, 2014 Mar;8(1):79-81.

PMID: 25347391 DOI: 10.5704/MOJ.1403.007

Primary sacral tumours are rare, therefore experience of managing their associated complications are very limited. Effective surgical treatment of pelvic chondrosarcoma remains a major challenge for orthopaedic surgeons, due to the complex anatomic structure of the pelvis, the lack of defined compartment borders, the close vicinity to vital structures, and the risk of jeopardizing pelvic structural stability. We report a rare case of a giant sacral chondrosarcoma (100cm x 80cm) in an elderly male who successfully underwent tumour resection with good functional outcome and recovery. Long term follow up is essential in view of the possibility of local tumour recurrence.

KEY WORDS: Giant Chondrosarcoma, Sacrum, Surgery, Elderly Male.

Fulltext Rare presentation of metachronous multicentric pelvic and extracranial chondrosarcoma : a case report

Choong C, Chan H, Azuhairy A, Hau MA, Zulkiflee O

Malays Orthop J, 2014 Jul;8(2):55-8.

PMID: 25279096 DOI: 10.5704/MOJ.1407.006

Conventional chondrosarcomas rarely metastasize and it is extremely unusual to see multicentric- behaviour in malignant cartilage tumour. We report a 40 year old lady with presentation of two non-contiguous metachronous foci of low to intermediate grade of chondrosarcoma over left pelvic bone and right scalp respectively in the absence of pulmonary or visceral metastasis.

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