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  1. Ting XW, Sothiraghagan S, W Md Kasim WM, Muhammed J
    Cureus, 2020 May 24;12(5):e8259.
    PMID: 32596077 DOI: 10.7759/cureus.8259
    Objective To describe the patient demographics, clinical findings, investigations, surgical outcomes, and histopathological findings of seven cases of orbital solitary fibrous tumours. Method This was a retrospective review of seven cases of orbital solitary fibrous tumour, which were followed up in Hospital Serdang, a national oculoplastic centre, from years 2008-2017. Results This study included seven patients with ages between 21 and 35 years old; two were males and five were females. All seven patients presented with painless chronic unilateral proptosis. Radiological imaging of the orbit showed a localized contrast enhancing intraorbital mass. All patients underwent orbitotomy and excisional biopsy. Intraoperative findings showed a well-encapsulated and vascularized mass. Histological findings of spindle-shaped cells were noted. All cases had positive staining for cluster of differentiation (CD) 34, five were positive for CD 99, four were positive for B-cell lymphoma (BCL-2), and five patients had positive staining for S-100. Three of the patients did not have clear margins during the primary operation and subsequently had a recurrence within two years. Conclusion A solitary fibrous tumour is a rare mesenchymal tumour with a pleural origin. The orbit is the most common extrapleural site of the tumour and they are usually benign. Immunohistochemistry is important to differentiate it from other, more aggressive forms of orbital tumours. Regular follow-up is important to monitor for recurrence.
  2. Teoh CY, W Md Kasim WM, Norlaila T
    Cureus, 2022 Nov;14(11):e31105.
    PMID: 36475154 DOI: 10.7759/cureus.31105
    INTRODUCTION: Choroidal melanoma is one of the subtypes of uveal melanoma and a relatively rare ophthalmic malignancy worldwide. However, it is scarce in Asian countries like Malaysia.

    PURPOSE: We present eight cases of patients with choroidal melanoma referred to Hospital Serdang, a tertiary centre for oculoplastic issues, from 2021 to 2022.

    METHOD:  A retrospective case series of patients diagnosed with choroidal melanoma and referred to the Oculoplastic Clinic, Department of Ophthalmology, Hospital Serdang, was undertaken.

    RESULTS: A total of eight cases of choroidal melanoma were identified, with a median age of 65 years. Six of them were female, and two were male. There were five of Malay ethnicity, and three were Chinese. Progressive reduced vision (n = 6), noticeable ocular mass (n = 3), and visual field defect (n = 2) were the most common presenting symptoms. The mean tumour thickness was 21.25 mm (range = 10-56 mm), and the largest basal diameter ranged from 10 mm to 53 mm (mean = 22.5 mm). Most were large tumours (n = 7) and above the T3a stage. The level of lactate dehydrogenase (LDH) was elevated in three cases. Histopathologically, five of the tumours were epithelioid, while the other three were mixed types. All patients underwent enucleation (n = 5) and exenteration (n = 3) with one recurrence. One patient had liver metastasis on the diagnosis of choroidal melanoma.

    CONCLUSION: In Malaysia, there is an increasing number of cases of choroidal melanoma. Clinical evaluation remained the mainstay of diagnosis. Treatment should be based on multifactorial prognostication in addition to tumour size. The LDH level may be necessary for providing inexpensive but valuable prognostication and monitoring markers.

  3. Redzuwan NS, Barr Kumarakulasinghe AL, W Md Kasim WM, Mohd Khialdin S
    Cureus, 2023 Jun;15(6):e40483.
    PMID: 37461781 DOI: 10.7759/cureus.40483
    A middle-aged man with multiple comorbidities including uncontrolled diabetes mellitus presented with shortness of breath and lethargy for six days. He was treated for COVID-19 pneumonia, requiring high cumulative steroid therapy. After 15 days of treatment, he developed right orbital apex syndrome with central retinal artery occlusion secondary to invasive mucormycosis. The infection progressed rapidly despite aggressive medical treatment, systemic anti-fungal therapy along with local transcutaneous retrobulbar amphotericin B injection. We report our battle in fighting this vicious disease. Judicious use of immunomodulators in COVID-19 treatment and close monitoring is crucial, especially in high-risk patients.
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