Displaying all 19 publications

    Med J Malaya, 1955 Jun;9(4):276-80.
    PMID: 13253127
    Matched MeSH terms: Thoracic Wall*
  2. Lim PJ, Peh WC
    Med J Malaysia, 2014 Oct;69(5):231-3.
    PMID: 25638239
    The scapula is a flat, triangular bone overlying the posterior chest wall and forming the posterior aspect of the shoulder girdle. To the best of our knowledge, there is no previous description of a notch of the medial aspect of the superior border of the scapula in the literature. The imaging findings of a supero-medial scapula border notch mimicking a bone tumour are presented in this case report.
    Matched MeSH terms: Thoracic Wall
  3. Tiong WH, Basiron NH
    Case Rep Med, 2014;2014:942078.
    PMID: 25161670 DOI: 10.1155/2014/942078
    Reverse abdominoplasty was originally described for epigastric lift. Since the work by Baroudi and Huger in the 1970s, it has become clear that reverse abdominoplasty application can be extended beyond just aesthetic procedure. Through the knowledge of anterior abdominal wall vascularity, its application had included reconstructive prospect in the coverage of various chest wall defects. To date, reverse abdominoplasty flap has been used to reconstruct unilateral anterior chest wall defect or for larger defect but only in combination with other reconstructive techniques. Here, we presented a case where it is used as a standalone flap to reconstruct bilateral anterior chest wall soft tissue defect post-bilateral mastectomies in oncological resection. In conclusion, reverse abdominoplasty flap provided us with a simple, faster, and satisfactory reconstructive outcome.
    Matched MeSH terms: Thoracic Wall
  4. Kosai, N.R., Aznan, M., Taher, M.M., Reynu, R.
    Medicine & Health, 2014;9(1):85-88.
    Breast augmentation using silicone implant is a common and popular aesthetic procedure with a high safety profile. Infection of silicone breast implants is a rare clinical entity, with skin commensal organisms often implicated as causative pathogen. Surgical treatment often involves removal of the implant with salvage procedures limited to selected cases. This case highlights a delayed presentation of an infected silicone breast implant presenting as a chest wall abscess 15 years after initial surgery.
    Matched MeSH terms: Thoracic Wall
  5. Kuan YC, Tan F
    Med J Malaysia, 2014 Dec;69(6):231-3.
    PMID: 25934952 MyJurnal
    We describe the clinical presentation, investigation and management of an eventually fatal case of hypercalcemic crisis due to primary hyperparathyridism (PHPT). A 60 year-old lady with history of urolithiasis presented with worsening generalized bone pain, spinal scoliosis and a limp. Laboratory data showed hypercalcemia and raised alkaline phosphatase. Left hip x-ray revealed a subcapital femoral neck fracture. Intact parathyroid hormone was elevated, 187.6 pmol/L (1.6 – 6.9) and ultrasound showed an enlarged right parathyroid gland. Despite initial reduction of serum calcium with saline infusion and multiple doses of intravenous pamidronate, her calcium increased to 4.14 mmol/L a week following application of Buck’s traction for persistent left hip pain. She succumbed eventually with serum calcium peaking at 6.28 mmol/L despite multiple therapeutic interventions.
    KEY WORDS: Primary hyperparathyroidism, hypercalcemic crisis, pathological fracture, urolithiasis
    Matched MeSH terms: Thoracic Wall
  6. Poovaneswaran S, Lee ZEJ, Lim WY, S Raja Gopal N, Mohd Dali F, Mohamad I
    Med J Malaysia, 2013 Apr;68(2):168-70.
    PMID: 23629568 MyJurnal
    Male breast cancer accounts for only 1% of cancers in men and 1% of breast cancers. Cutaneous metastases occur less than 10% of all patients with visceral malignancies and are considered a rare and late event in progression of metastatic disease. A 45-year-old man presented with a lump in the left breast which was confirmed to be infiltrating ductal carcinoma. He underwent a left mastectomy and axillary clearance followed by chemotherapy and radiotherapy to the left chest wall. However, he was non-compliant to adjuvant tamoxifen due to hot flushes. One year later, he presented with biopsy proven cutaneous metastases. Initially he had complete excision of the lesions, however, two months later more skin lesions appeared predominantly over the chest wall and back. Hormonal therapy failed to control the metastases as such he was treated with systemic chemotherapy. He is currently on third line chemotherapy.
    Matched MeSH terms: Thoracic Wall
  7. Tata MD, Kwan KC, Abdul-Razak MR, Paramalingam S, Yeen WC
    Ann Thorac Surg, 2009 May;87(5):1613-4.
    PMID: 19379926 DOI: 10.1016/j.athoracsur.2008.10.019
    A 39-year-old Indian man presented with necrotizing soft tissue infection of his right forearm and previously undiagnosed diabetes mellitus. The infection progressively worsened to involve his right lateral chest wall despite multiple debridements and systemic antibiotics. His right arm was eventually disarticulated along with wide debridement of the surrounding tissue. Aggressive wound debridement, mechanical scrubbing, and irrigation were then initiated every 8 hours. A superoxidized solution was later introduced as a wound irrigant and dressing agent. The large defect was suitable for split-thickness skin grafting after 16 days of a strict wound management routine with the superoxidized solution.
    Matched MeSH terms: Thoracic Wall/microbiology; Thoracic Wall/pathology; Thoracic Wall/surgery
  8. Siti Kamariah, C.M.
    A Mondor’s disease is a rare, benign and self-limiting condition. It is due to thrombophlebitis of the superficial veins of the breast and chest wall. It usually occurs in middle-aged women who present with a palpable cordlike structure, often painful in the acute phase. The aetiology is unknown, and may be related to trauma, surgery, infection or tight clothing. The finding of a superficial vessel seen as a linear opacity on mammography and a tubular structure on ultrasound is typical. An intra-luminal thrombus may be seen on ultrasound, and there may be absent flow on Doppler imaging. Conservative treatment is usually instituted, although surgery may be indicated in certain circumstances.
    Matched MeSH terms: Thoracic Wall
  9. Malays Orthop J, 2011;5(1):71-74.
    This report describes an unusual case of multidrug resistant tuberculosis (MDR-TB), involving the right clavicle and multicentric aytpical spine involvement without any neurological deficit. The female patient presented with acute onset of right clavicular pain associated with a one-monthhistory of lower backache with constitutional symptoms. The clavicular lesion and MRI spine findings were highly suggestive of TB. Anti TB drugs (ATD) were started empirically as Sabah, Malaysia the patient’s home, is anendemic area for TB. Despite, 2 months of ATD administration, the patient did not respond well clinically and developed left sided chest wall abscesses arising from the left 3rd and 6th ribs. She was then treated for MDR-TB infection and has responded well to this treatment.
    Matched MeSH terms: Thoracic Wall
  10. Adli Azam MR, Raja Amin RM
    Malays J Med Sci, 2015 Jan-Feb;22(1):70-3.
    PMID: 25892952 MyJurnal
    Malignant chest wall tumour is rare. The presentation is usually aggressive that requires extensive resection to prevent recurrence. However, the extensive resection is to the expense of causing defect on the chest wall and hence, respiratory mechanics. Two cases of chest wall tumour are discussed including the surgical approach of radical tumour resection which was combined with placement of titanium mesh and Tranverse Rectus Abdominis Myocutaneus (TRAM) flap to cover the defect and preserve respiratory mechanical functions. The morbidity of using titanium mesh demonstrated in the case series were infection and injury to surrounding tissue due to its rigidity and large size which required its removal. However the formation of 'pseudopleura' made the thoracic cage return back as closed cavity even after the removal of the titanium mesh and allow normal respiratory functions.
    Matched MeSH terms: Thoracic Wall
  11. Azrif M, Saladina JJ, Nani ML, Shahrunniza AS, Norlia A, Rohaizak M
    Med J Malaysia, 2011 Aug;66(3):255-6.
    PMID: 22111452 MyJurnal
    An isolated late chest wall recurrence after mastectomy for breast cancer is rare. We present a case of a lady with a T2N1M0 right breast cancer who developed an isolated local recurrence on the chest wall 11 years after mastectomy. Staging investigations excluded distant metastases. She underwent an excisional biopsy and was started on an aromatase inhibitor. Radiotherapy was given to the chest wall followed by a boost to the site of excision. Although most chest wall recurrences fare poorly, a favourable subgroup can be identified and should be treated aggressively in a multidisciplinary approach.
    Matched MeSH terms: Thoracic Wall*
  12. Yap E, Wan Jamaluddin WF, Tumian NR, Mashuri F, Mohammed F, Tan GC, et al.
    Malays J Pathol, 2014 Dec;36(3):201-5.
    PMID: 25500520 MyJurnal
    NK/T cell lymphoma, nasal type is an aggressive and uncommon malignancy. Disease that occurs outside of the aerodigestive tract exhibits an even more aggressive clinical behaviour and does not respond as well to conventional therapy compared to its nasal counterpart. We report such a case of NK/T cell lymphoma, nasal type, that presented as an anterior chest wall mass, arising from the left pectoralis muscle. An interesting feature we wish to highlight is the associated eosinophilia that corresponded to disease activity, exhibiting fluctuations with surgical resection and chemotherapy. To the best of our knowledge this is the third reported case of NK/T cell lymphoma that is associated with peripheral eosinophilia. Our case highlights the role of certain NK cell subsets that play a major role in eosinophilic activation in NK/T lymphomas and calls for more research into further classification of this disease by virtue of its NK cell subsets.
    Matched MeSH terms: Thoracic Wall/pathology*; Thoracic Wall/radiography
  13. Vikram, M., Joseph, Leonard H., Kamaria, K.
    Emphysematous pyelonephritis is a form of infection of the kidney. Chest physiotherapy was executed on a 15-year-old girl who had complications such as secretion retention and pleural effusion following percutaneous pigtail nephrostomy in addition to oxygen therapy and medical management to promote respiratory functions. The processes to increase chest wall mobility includes particular passive stretching and mobilization. Chest mobility exercises composed of an intercostal stretch on a determined intercostal space using index fingers, thoracic rotation and anterior compression with stretching in sitting position to improve respiratory functions. These exercises were suggested to the patient as a regular daily treatment along with low-level incentive spirometry breathing exercises. Following 9th sessions of treatment patient demonstrated satisfactory improvement by means of increasing in chest expansion and reduction in dyspnea level without using supplemental oxygen. The results expressed a substantial clinical improvement in reduction of dyspnea level and improvement in chest expansion
    Matched MeSH terms: Thoracic Wall
  14. Bin Samsuddin MF, Bin Omar MA
    Asian J Neurosurg, 2019 4 3;14(1):283-285.
    PMID: 30937055 DOI: 10.4103/ajns.AJNS_332_17
    Malignant peripheral nerve sheath tumors (MPNSTs) are uncommon, biologically aggressive soft tissue sarcomas of neural origin that poses tremendous challenges to effective therapy. MPNSTs are among the most challenging mesenchymal malignancies to treat with poor prognosis. They usually affect young and middle-aged adults, tend toward early metastasis, and often demonstrate resistance to chemotherapy. We present a case of a 23-year-old female who initially presented with the right temporal swelling for 1 month associated with constitutional symptom which progressively worsening. The right craniotomy and excision biopsy were done with histopathological examination results suggestive of MPNST. Thorax-abdominal-pelvic computed tomography and magnetic resonance imaging further revealed multiple metastatic lesions involving spine, retroperitoneal, pelvic, chest wall, and lungs. This case illustrates the typical presentation of MPNST with its known poorly outcome.
    Matched MeSH terms: Thoracic Wall
  15. Rahman NA, Das S, Maatoq Sulaiman I, Hlaing KP, Haji Suhaimi F, Latiff AA, et al.
    Clin Ter, 2009;160(2):129-31.
    PMID: 19452102
    The sternalis is an anomalous muscle located in the anterior wall of thorax and several past reports have described its presence with clinical implications. The sternalis muscle may be incidentally detected during routine cadaveric dissections and autopsies. We observed the presence of anomalous sternalis muscle on both sides of the anterior chest wall in 25 cadavers (n = 50), over a span of three years. Out of a 50 cases, we observed a single case of sternalis on the right side of the 55-year-old male cadaver (2%). The sternalis was found to be absent in the rest 49 cases (98%). The sternalis muscle displayed an oblique course in the anterior wall of the thorax. The muscle originated near the seventh costal cartilage extending obliquely upwards to insert into the second costal cartilage close to the sternum. The originating portion of the muscle was located at a distance of 3.5 cm lateral to the mid-sternal plane. The vertical length and the maximum width of the anomalous sternalis muscle measured 9 cm and 1.9 cm, respectively. The fibers of the muscle vertically ascended upwards. No other associated anomalies were observed in the same cadaver. The presence of sternalis muscle is considered to be a rare variation with no earlier studies being performed in the Malaysian population. The anomalous sternalis muscle may be important for reconstructive surgeons performing mastectomy and radiologists interpreting mammograms. Thus, the sternalis muscle may be academically, anthropologically and surgically important.
    Matched MeSH terms: Thoracic Wall/anatomy & histology*
  16. Alzoubi AS, Kandaiya S, Shukri A, Elsherbieny E
    Australas Phys Eng Sci Med, 2010 Jun;33(2):137-44.
    PMID: 20309667 DOI: 10.1007/s13246-010-0011-y
    Second cancer induction in the contralateral breast (CB) is an issue of some concern in breast radiotherapy especially for women under the age of 45 years at the time of treatment. The CB dose from 2-field and 3-field techniques in post-mastectomy chest wall irradiations in an anthropomorphic phantom as well as in patients were measured using thermoluminescent dosimeters (TLDs) at the local radiotherapy center. Breast and chest wall radiotherapy treatments were planned conformally (3D-CRT) and delivered using 6-MV photons. The measured CB dose at the surface fell sharply with distance from the field edge. However, the average ratio of the measured to the calculated CB dose using the pencil beam algorithm at the surface was approximately 53%. The mean and median measured internal dose at the posterior border of CB in a phantom was 5.47+/-0.22 cGy and 5.44 cGy, respectively. The internal CB dose was relatively independent of depth. In the present study the internal CB dose is 2.1-4.1% of the prescribed dose which is comparable to the values reported by other authors.
    Matched MeSH terms: Thoracic Wall/radiation effects
  17. Firdaus Hayati, Nornazirah Azizan, Nik Amin Sahid, Hilal Zahabi Abdul Fattah, Rohamini Sibin, Andee Dzulkarnaen Zakaria
    Necrotizing fasciitis (NF) is a deadly soft tissue infection causing a significant morbidity and mortality. Abdominal and chest wall NF are unusual. We describe a 49-year-old male with anterior abdominal wall NF secondary to per- forated gastric ulcer (PGU). He was admitted in septic shock presenting an abdominal wall NF with severe metabolic acidosis requiring dialysis and admission to the intensive care unit. There was a patch of gangrene with surrounding skin discoloration at lower quadrant of the abdominal wall. Local debridement was done without a preoperative computed tomography that was performed after surgery. Adequate source control was not achieved after the second surgery and the patient had worsened resulting to death. We describe this rare presentation of NF and discuss the issues learnt from this unfortunate event.
    Matched MeSH terms: Thoracic Wall
  18. Dharmaraj B, Diong NC, Shamugam N, Sathiamurthy N, Mohd Zainal H, Chai SC, et al.
    Indian J Thorac Cardiovasc Surg, 2021 Jan;37(1):82-88.
    PMID: 33442211 DOI: 10.1007/s12055-020-00972-7
    Chest wall resection is defined as partial or full-thickness removal of the chest wall. Significant morbidity has been recorded, with documented respiratory failure as high as 27%. Medical records of all patients who had undergone chest wall resection and reconstruction were reviewed. Patients' demographics, length of surgery, reconstruction method, size of tumor and chest wall defect, histopathological result, complications, duration of post-operative antibiotics, and hospital stay were assessed. From 1 April 2017 to 30 April 2019, a total of 20 patients underwent chest wall reconstructive surgery. The median age was 57 years, with 12 females and 8 males. Fourteen patients (70%) had malignant disease and 6 patients (30%) had benign disease. Nine patients underwent rigid reconstruction (titanium mesh for sternum and titanium plates for ribs), 6 patients had non-rigid reconstruction (with polypropylene or composite mesh), and 5 patients had primary closure. Nine patients (45%) required closure with myocutaneous flap. Complications were noted in 70% of patients. Patients who underwent primary closure had minor complications. In total, 66.7% of patients who had closure with either fasciocutaneous or myocutaneous flaps had threatened flap necrosis. Two patients developed pneumonia and 3 patients (15%) had respiratory failure requiring tracheostomy and prolonged ventilation. There was 1 mortality (5%) in this series. In conclusion, chest wall resections involving large defects require prudent clinical judgment and multidisciplinary assessments in determining the choice of chest wall reconstruction to improve outcomes.
    Matched MeSH terms: Thoracic Wall
  19. 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.
    Matched MeSH terms: Thoracic Wall
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