Leiomyomas are the most common benign tumour of the uterus, occurring in 20-40% of women in reproductive age.Most of the myomas arise in the uterus, however extrauterine sites include fallopian tubes, cervix, round ligament, ovary and urethra. A single or polypoidal mass in the vagina is usually a leiomyomatous polyp arising from the cervix or from the cavity of the uterus. Leiomyoma developing de novo from the fibromuscular elements of the vagina is a rare entity. When such a tumour arises from anterior wall of the vagina it is often mistaken for a cervical fibroid. Parasitic leiomyoma is the rarest type of leiomyoma and develop when a leiomyoma attaches itself to another organ. Vaginal leiomyomas usually arise from anterior vaginal wall. We report a case of parasitic leiomyoma in the vagina together with uterine leiomyoma in a 48 year old lady presented with palpable mass perabdomen and anaemic symptoms. The size and location of the tumours necessitated abdominal and vaginal approach for better surgical access.
Ameloblastoma is a slow growing benign tumour of the jaw and patients usually present late after the tumour achieved considerable size to cause facial disfigurement. Diagnosis mainly from tissue biopsy and characteristic findings on plain X-rays does assist in differentiating between types of ameloblastoma. The challenges in the management of this tumour are to provide complete excision as recurrence may occur in incomplete removal and also to reconstruct the bony defect in order to give reasonable cosmetic and functional outcome to the patient.
Introduction: Gastrointestinal stromal tumour (GIST) is relatively rare. The clinical behaviour of GIST ranges
from benign to frank sarcoma. The diagnosis is established through histopathological examination and
immunohistochemistry profile. In Malaysia, the number of publications related to GIST is relatively rare. This
study was therefore conducted to examine the demographic, histopathological and immunohistochemical
features of GIST cases diagnosed in the Department of Pathology, Hospital Tengku Ampuan Afzan, Kuantan,
Pahang from 2009 until 2014. Methods: Past histopathological records were reviewed. Demographic and
histopathological and immunohistochemical data of patients diagnosed were collected. Results: There were
28 cases (14 males and 14 females) diagnosed as GIST. Mean age was 56.4 years, and the majority were
above 40 years of age (85.7%). Stomach was the most common location (42.9%), followed by small intestine
(28.6%). In 23 cases (82%), the tumours exhibited spindle cell morphology, while epithelioid cell and mixed
cell types were seen in 3 cases (11%) and 2 cases (7%), respectively. Five cases were categorised as very low
risk to low risk behaviour, while 18 cases were intermediate to high. None of the histological parameters
analysed which include tumour morphology, necrosis, haemorrhage, nuclear atypia and mean number of
mitoses showed significance difference between the different risk behaviour groups. Positivity with KIT
(CD117), considered to be the defining immunohistochemistry feature, was negative in 2 cases. Conclusion:
Although this study is a retrospective study, the findings contribute to the knowledge on GISTS in Malaysia.
Future research related to GISTs in Malaysia should focus on molecular analyses for KIT and PDGFRA
mutations for diagnostic confirmation especially in KIT-negative cases and also for the purpose of
therapeutic response correlations.
PURPOSE: This review was performed to determine the association between demographic characteristics and the histopathological findings of colorectal cancer (CRC) patients operated in Hospital Tengku Ampuan Afzan (HTAA) Kuantan Pahang Malaysia. METHODS: We retrospectively reviewed the histopathological reports of 119 CRC cases operated in HTAA from January 2001 to December 2005 which met the inclusion criteria of histologically proven adenocarcinoma. The following demographic characteristics which include age, gender, and ethnicity were assessed. The histopathological related variables which include the site of primary tumor, Astler and Coller stage, tumor differentiation and lymph node metastasis were analyzed. Chi square test was used for categorical variables. Data with low expected counts were assessed using Fisher’s exact tests. RESULTS: There were 59 males and 60 females with age ranging from 23 to 93 years. 81.5% of the patients were older than 50 years (p=0.038). Malays accounted for 58.8% of the total cases, followed by Chinese (36.1%) and Indian (5%). Rectosigmoid region and rectum were the most common sites for primary tumor (55.6%). Cancer in male predominantly occurred in the rectum (p=0.023). Malays were commonly diagnosed with stage C2 (54.3%) while Chinese were diagnosed with stage B2 (58.1%) (p=0.011). Fifty percent of the patients who are less than 50 years old were diagnosed with stage C2 (p=0.024). There was significant change from well to moderately differentiated adenocarcinoma (p=0.000). Sixty percent of female patients diagnosed to have cancer with lymph node metastasis (p=0.044). Significant lymph node metastasis was also observed among Malay patients (p=0.022). CONCLUSION: The findings from the present review suggest that there are several associations between demographic distribution and histopathological characteristics of CRC. More than fifty per cent of CRC are found in the rectosigmoid region and the rectum. CRC are more common in Malay race and rectal cancer is predominantly affecting the male. About forty five percent of patients harbor metastases in the lymph nodes and fifty percent of the younger age group were presenting with nodal metastases.
We report a case of an inflammatory pseudotumour (IP) involving the floor of the skull base, which demonstrated aggressive behavior both clinically and radiologically. In this case, the diagnosis was established by clinical presentation, magnetic resonance imaging (MRI), histopathological examination (HPE) and the dramatic response towards high dose steroid therapy. The clinical features improved with oral cyclophosphamide in combination with oral steroid, which were given for a period of three months.
Medical thoracoscopy has gain its popularity in Malaysia recently. This paper presents our early experience in thoracoscopy using semi-rigid fiberoptic thoracoscope. All thoracoscopy records since October 2006 were retrieved. The patients' records, thoracocentesis investigations results, thoracoscopic findings and all pleural biopsy results were reviewed. Twenty-four thoracoscopic procedures on 22 patients in whom two patients had repeated thoracoscopy. Ten patients were confirmed carcinoma. Eight patients had inconclusive thoracoscopic pleural biopsy results. Three patients underwent pleurodesis for malignant effusion. One patient had adhesiolysis for empyema. There was no procedure-related deaths or intraoperative accidents. Thoracoscopy is a relatively safe procedure.
In Malaysia, transbronchial needle aspiration (TBNA) is a relatively new procedure performed only in a handful of respiratory centres. We reviewed TBNA of mediastinal lymph node performed in Hospital Tengku Ampuan Afzan (HTAA) to determine the yield and its complications. Data was retrieved from endoscopy databases and patients' records, CT thorax images and all cytological and histological slides were reviewed. Twenty-five patients had TBNA performed. TBNA was positive in 15 patients (60%). Overall, 80% had confirmed malignancy after bronchoscopy. Only four patients had documented bleeding after TBNA and in two of them, bleeding stopped spontaneously and another two patients required diluted adrenaline to stop the bleed. No mortality was reported from this procedure. Hence, TBNA is a safe procedure.