A case of carotid body tumour is presented. Pathology, diagnostic investigations, modalities of treatment and prognosis are discussed. With greater awareness of this condition and improvement in diagnostic investigations and surgical techniques, the outlook in managing this condition should be better.
A 45-year-old Malay lady who presented with intermittent abdominal pain and a left hypochondrial mass was found to have a 10 x 8 x 5 cm duodenal tumour without local invasion at laparotomy. En bloc resection of the tumour with adequate margin of clearance was done and histopathological diagnosis of low grade leiomyosarcoma was made. Fourteen months later, she returned with multiple metastases in the liver and needed palliative chemotherapy for pain relief. Duodenal leiomyosarcomata are very rare tumour. Their prognostic indicators include biological grading, tumour size and presence of metastases. Recognition of its high malignant potential calls for close surveillance calls even after apparent curative surgery.
Two cases of oral speckled leukoplakia with differing behaviour are presented. This precancerous lesion of unknown aetiology requires early diagnosis for proper management. Candida albicans are frequently found in these lesions. The significance of epithelial dysplasia in relation to treatment is discussed. Surgical removal is the treatment of choice.
A rare case of gestational trophoblastic disease (GTD) in a 54-year old Malay woman is described. A total abdominal hysterectomy with bilateral salphingo-oopherectomy was done. She was given methotrexate therapy as she had persistent high levels of serum B hCG.
A 60 year old male presented with pruritus, excoriations and enlargement of several groups of lymph nodes associated with constitutional symptoms following the intake of an aspirin preparation. Lymph node biopsy established the diagnosis of angioimmunoblastic lymphadenopathy. The need to be aware of this condition is highlighted when patients present with clinical features suspicious of lymphoma.
Chronic lymphocytic leukaemia (CLL) is rare locally. Seven CLL patients which constituted 0.9% of the total 747 cases of leukaemic patients were diagnosed over a 5 year period. They had similar haematological profiles as Western patients though most of them had advanced disease at presentation. Treatment of CLL patients was palliative and should be reserved for symptomatic patients and/or patients with progressive disease.
Myelodysplastic syndromes appear to be a rare group of blood disorders in Malaysia. It usually affects the elderly and some of the cases were reported to evolve into acute leukemia. We describe our experience with five cases, seen and managed by us over a 5-year period. All patients receiving supportive therapy died with one of them definitely known to transform to acute leukemia. The patient who survives till the time of writing received low dose continuous cytosine arabinoside infusion.
Central nervous system involvement in melioidosis is rare. We describe a 48 year old woman who developed septicaemia and a brain abscess due to Pseudomonas pseudomallei. Since there is a continuing practical problem in bacteriological confirmation of the aetiological agent, diagnosis of melioidosis has to be made on clinical suspicion.
child and two elderly females with benign migratory glossitis (BMG) are presented. The aetiology is unknown, but emotional stress, mechanical and chemical trauma are important in the production of pain in an initially asymptomatic BMG. Treatment consists of reassurance, avoidance of hot, spicy and highly-seasoned foods. Any underlying reactive depression must be treated.