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Fulltext Extracardiac Rhabdomyoma Mimicking Plunging Ranula

Hakim I, Yunus MRM

Medeni Med J, 2020;35(3):271-275.
PMID: 33110681 DOI: 10.5222/MMJ.2020.88120

Histopathologically adult extracardiac rhabdomyoma is a benign tumour of mature striated muscle. It is a slow- growing tumour with predilection to occur in head and neck region. They appear mainly as a solitary lesion, and about 15% of them can be multicentric. A 56-year-old man presented to us with the floor of mouth swelling persisted for one year and the right neck swelling for three years mimicking a plunging ranula. Radiological imaging revealed enhancing mass at the floor of mouth and submandibular region. The mass represented a nonvascular benign tumour. Subsequently, the patient underwent excision of the mass via transcervical and transoral method. Histopathological examination revealed adult type of extracardiac rhabdomyoma. Adult type of extracardiac rhabdomyoma should be considered in the differential diagnosis for the head and neck masses. A complete excision will reduce the risk of recurrence.
A rare case of cervical hypoglossal nerve neurofibromas in a patient with type 1 neurofibromatosis

Lum SG, Baki MM, Yunus MRM

Braz J Otorhinolaryngol, 2021 Feb 25.
PMID: 33707119 DOI: 10.1016/j.bjorl.2021.01.006

BACKGROUND: Neurofibromas are benign peripheral nerve sheath tumours. Hypoglossal nerve neurofibromas in cervical region are relatively rare, bilateral occurrence is extremely rare.
METHODS: A 32-year-old man with type 1 neurofibromatosis presented with bilateral neck masses. Magnetic resonance imaging showed parapharyngeal masses consistent with neurogenic tumours, most likely neurofibromas.
RESULTS: Surgical exploration through lateral cervical approach revealed unexpected finding of the tumour that arose from the hypoglossal nerve. The tumour had totally engulfed the nerve with no normal nerve fascicles identifiable, thus resected in toto. In the postoperative course, the patient developed right hypoglossal palsy and vocal fold palsy treated with augmentation of the paralysed vocal fold with temporary injection material.
CONCLUSIONS: The authors described a patient with type 1 neurofibromatosis with neurofibroma originating from cervical part of hypoglossal nerve. This paper discussed this rare condition and the management on how to improve the treatment outcome.
Primary Lymphoepithelial Carcinoma of the Submandibular Gland in A Young Patient: A Case Report

Ishak AI, Kong LS, Yunus MRM, Bakar MZA

Indian J Otolaryngol Head Neck Surg, 2023 Sep;75(3):2577-2580.
PMID: 37636741 DOI: 10.1007/s12070-023-03663-y

Lymphoepithelial carcinoma (LEC) is a rare entity of malignancy. It has been associated with Epstein-Barr virus (EBV), and in regions where it is endemic, such as Southeast Asia, EBV is typically associated with nasopharyngeal carcinoma. The incidence of such malignancies in the young population is unusual. Here we report a 17-year-old with a 5-year history of a painless right submandibular mass presenting with a sudden increase in size for one month before surgery. Neck examination revealed a firm right submandibular gland measuring five by five cm, with an irregular surface, non-tender with normal overlying skin. We performed a fine needle aspiration cytology (FNAC), and he underwent computed tomography (CT) scan of the neck. He underwent a right submandibulectomy. Lymph nodes from levels I and II were also removed. The final histopathology was reported as LEC. Following this tissue diagnosis, another follow-up surgery, a modified radical neck dissection, was carried out for locoregional clearance. Postoperatively, he completed chemoradiotherapy treatment and is now on regular follow-up.
Laryngeal giant cell tumour presenting as a tongue base lesion causing severe dysphagia

Saud MRM, Salahuddin Z, Hassan A, Yunus MRM, Mohamad I, Zulkifli MM

J Taibah Univ Med Sci, 2018 Apr;13(2):201-204.
PMID: 31435324 DOI: 10.1016/j.jtumed.2017.10.002

Giant cell tumours are benign lesions that are uncommonly found in the larynx. Patients with these tumours may present with dysphagia, hoarseness and anterior neck swelling. Giant cell tumours are extremely rare and only a few cases have been reported. We present a case of an elderly woman who presented with severe dysphagia and a mass at the base of her tongue. The mass was found to be a laryngeal giant cell tumour and was successfully treated with chemotherapy.
Fulltext Primary Nonselective Laryngeal Reinnervation in Iatrogenic Acute Recurrent Laryngeal Nerve Injury: Case Series and Literature Review

Mansor WNW, Azman M, Remli R, Yunus MRM, Baki MM

Ear Nose Throat J, 2023 Mar;102(3):164-169.
PMID: 33559496 DOI: 10.1177/0145561321993605

Treating an acutely injured recurrent laryngeal nerve by primary nonselective laryngeal reinnervation (LR) during thyroidectomy is encouraged to minimize postoperative morbidity. Performing a concurrent transoral temporary injection laryngoplasty (IL) may improve the patient's voice while waiting for the effect of successful reinnervation. Chronological multidimensional voice outcomes (qualitative and quantitative) and combination of the primary nonselective LR with concurrent transoral IL were not explicitly demonstrated in previous cases that published the literature. In this study, the authors presented the multidimensional voice parameters of 3 patients undergoing primary nonselective LR with concurrent IL during thyroidectomy. The parameters were measured at different time points (2 weeks and 1, 3, 6, and 12 months) following the surgery. Laryngeal electromyography was done at 1 to 2 months and 12 months postsurgery. The results showed that the voices, qualitatively and quantitatively, were within normal range at within 3 months postintervention. The parameters were slightly beyond the normal limit at 3 months and returned to normal at 6 months postintervention and beyond. The LEMG depicted evidence of successful reinnervation in which the motor unit was normal comparable to the opposite normal vocal fold.
Fulltext Management of a Rare Lymphoepithelial Carcinoma of the Submandibular Gland in Elderly

Sairin ME, Yahya N, Kuan CY, Yunus MRM, Abdullah MK

Indian J Otolaryngol Head Neck Surg, 2019 Oct;71(Suppl 1):18-20.
PMID: 31741921 DOI: 10.1007/s12070-015-0940-6

Lymphoepithelial carcinoma (LEC) of salivary glands is a rare malignant salivary gland tumour and demonstrates genetic and regional distribution. It commonly occurs in major salivary gland especially parotid gland. We report a case of LEC of submandibular gland occurring in a 70 year-old lady.
Fulltext The Role of Cyclin d1 in Radiotherapy Resistance of Advance Stage Nasopharyngeal Carcinoma: A Systematic Review

Romdhoni AC, Rajanagara AS, Albab CF, Waskito LA, Wibowo IN, Yunus MRM

Asian Pac J Cancer Prev, 2024 Jul 01;25(7):2211-2218.
PMID: 39068551 DOI: 10.31557/APJCP.2024.25.7.2211

OBJECTIVE: One of the biggest therapy challenges for nasopharyngeal cancer (NPC) is still radioresistance. The radioresistance in NPC is thought to be caused by cyclin D1 overexpression. The purpose of this study was to determine how cyclin D1 contributes to radiation resistance in NPC.
METHODS: Adhering to the PRISMA guidelines, we systematically reviewed studies on cyclin D1-associated radioresistance in NPC from 2012 until 2023. From our search, 15 studies were included.
RESULTS: Cyclin D1's role in radiotherapy resistance is elucidated through several mechanisms, notably SHP-1 and B-catenin. Overexpression of SHP-1 led to an increase in cyclin D1, a higher proportion of cells in the S-phase, and radioresistance. Conversely, inhibiting β-catenin and cyclin D1 expression enhances radiation sensitivity.
CONCLUSION: In conclusion, Cyclin D1 has a strong correlation with radiation resistance; downregulation of the protein increases radiosensitivity, while overexpression of the protein promotes radioresistance.
Practising transoral robotic surgery in a middle-income country: surgical outcomes and early challenges

Mahmud KA, Ghazali FNF, Zahari MNI, Halim HA, Khalid AK, Toh ST, et al.

J Robot Surg, 2023 Apr;17(2):613-618.
PMID: 36183030 DOI: 10.1007/s11701-022-01456-z

Transoral robotic surgery is a minimally invasive surgical technique that recently debuted in Malaysia. However, there are concerns over its cost, practicality, and feasibility in local settings. Our study aims to evaluate the surgical outcomes of transoral robotic surgery and discuss its learning curves. The clinical records of all patients who underwent transoral robotic surgery in a university hospital were reviewed. 25 patients were identified with a mean age of 43.9 years. The commonest indication was obstructive sleep apnoea (OSA) (76%), followed by base of tongue carcinoma (16%), recurrent tonsilitis and Wharton's duct cyst (4% each). For excision of tongue base in obstructive sleep apnoea without epiglottectomy, the mean operating time was 2.3(±0.9) hours with an average of 2.8(±0.4) days of hospital stay. The success rate for OSA surgery was seen in 78.9% of cases. The mean operating time for transoral excision of tongue base carcinoma was 4.3(±2.5) hours, whereas the mean hospital stay was 9(±3.6) days. All surgical margins were cleared with no recurrence except for one patient. The recurrent tumour was successfully excised via transoral robotic surgery, and he remained disease free after one year. The most frequent post-operative complaints were dysphagia, post-nasal drip, and hypogeusia. Transoral robotic surgery in Malaysia is in the commencement phase, where some pitfalls are expected. Opportunities should be given for more surgeons to acquire this technique so that minimally invasive surgery for head and neck diseases is readily available for patients in middle-income countries.