MyMedR

Benign parotid lesions: is near total parotidectomy justified?

Arshad AR

Ann Acad Med Singap, 2006 Dec;35(12):889-91.

PMID: 17219001

INTRODUCTION: Benign tumours of the parotid gland constitute about 80% of parotid tumours. The most common benign tumour of the parotid gland is pleomorphic adenoma. Other conditions, like Kimura's disease, may mimic a tumour when they present as a parotid mass. Various modes of treatment have been advocated for the treatment of benign parotid lesions, ranging from enucleation to near-total parotidectomy.

MATERIAL AND METHODS: This is an audit of an 18-year period where 173 lesions of the parotid gland (34 malignant and 139 benign lesions) were treated by the author.

RESULTS: There were 139 benign lesions, of which 123 were benign tumours and 16 non-tumour conditions. Fourteen cases of recurrent pleomorphic adenoma of parotid that had been treated elsewhere were also operated on. Near-total parotidectomy was performed on all these cases with benign lesions.

CONCLUSIONS: There has been no recurrence in all the patients who was treated this way. Near-total parotidectomy should be considered when there is a need to treat benign parotid swellings.

Matched MeSH terms: Lymphoma/surgery; Adenoma, Pleomorphic/surgery; Parotid Gland/surgery*; Parotid Neoplasms/surgery*

Unusual clinical presentation of a severely protruding premaxilla in patient with bilateral clefts

Burezq H, Bang RL, George A, Mukhtar A

J Craniofac Surg, 2007 Jul;18(4):971-4.

PMID: 17667698

Prominent premaxilla is one of the problems encountered when dealing with bilateral complete cleft lip and palate patients. Secondary alveolar bone grafting with these patients would achieve filling of the osseous defect, supports the alar base, eliminate the oro-nasal fistula and enhance the maxillary instability. This article describes the management of a bilateral cleft lip and palate patient with an extremely protruding premaxilla done in one stage surgery. To our knowledge, this is the first report of such degree of severity in the English literature.

Matched MeSH terms: Cleft Lip/surgery*; Cleft Palate/surgery*; Malocclusion, Angle Class II/surgery; Maxilla/surgery

Fulltext Renal angiomyolipoma with inferior vena caval involvement

Haritharan T, Sritharan S, Bhimji S

Med J Malaysia, 2006 Oct;61(4):493-5.

PMID: 17243531 MyJurnal

Renal angiomyolipomas are innocuous benign tumours which rarely behave aggressively. This is a case of a 48 year old Malay lady presenting with right sided abdominal pain associated with a large right sided abdominal mass. She was diagnosed with renal angiomyolipoma of the right kidney complicated by inferior vena caval tumour thrombosis. She successfully underwent a radical nephrectomy and inferior vena caval thrombectomy using cardiopulmonary bypass and deep hypothermic circulatory arrest.

Matched MeSH terms: Kidney Neoplasms/surgery; Vena Cava, Inferior/surgery; Angiomyolipoma/surgery; Vascular Neoplasms/surgery

Fulltext Screw osteosynthesis of displaced lateral humeral condyle fractures in children: a mid-term review

Loke WP, Shukur MH, Yeap JK

Med J Malaysia, 2006 Feb;61 Suppl A:40-4.

PMID: 17042228

Displaced humeral condyle fractures in children are traditionally fixed with smooth Kirschner wire at the expense of a risk of secondary displacement following removal of wire. Screw fixation of such fractures has recently been advocated as it provides stable fixation. We have been using screw osteosynthesis for treatment of displaced lateral humeral condyle fractures in children in our institution since the turn of this century. This study provides a midterm review of treatment of such injuries with special regards to growth disturbances after screw osteosynthesis and to assess rate of union with a view to formulate guidelines for screw removal. We review the outcomes of screw osteosynthesis for displaced lateral condyle fracture of the humerus (19 Milch type-1 and 15 Milch type-II) in 34 children treated in our institution from January 2000 to March 2004. The average age of the patients was 6.1 years. The average follow up was 24.5 months. Screw osteosynthesis led to union (average 6.9 weeks) in all patients with excellent results in 28 patients. Growth disturbances in the form of lateral condyle overgrowth (2 patients), valgus deformity secondary to lateral condyle avascular necrosis (2 patients) and fishtail deformity ((3 patients) were recognized. The implants should not be removed until fracture union is established. Screw osteosynthesis of the lateral humeral condyle fracture prevents secondary fracture redisplacement and lateral condyle overgrowth is probably related to hyperemic response to metaphyseal fixation and early removal of implant before radiological union.

Matched MeSH terms: Humeral Fractures/surgery*; Humerus/surgery*; Fractures, Malunited/surgery; Fractures, Bone/surgery

Fulltext The pudendal thigh fasciocutaneous flap for vaginal atresia reconstruction

Azman WS, Halim AS, Samad IA

Med J Malaysia, 2005 Oct;60(4):505-7.

PMID: 16570718

Vaginal defects can either be congenital or acquired due to tumor or trauma. The reconstructions are aimed in producing a good physical and functional result with the least donor site morbidity. The pudendal thigh flap is a sensate fasciocutaneous flap based on the terminal branch of the superficial perineal artery, the continuation of the internal pudendal artery. Although various flaps have been described for vaginal reconstruction, the pudendal thigh flap offers a very attractive alternative.

Matched MeSH terms: Constriction, Pathologic/surgery; Hematocolpos/surgery*; Thigh/surgery*; Vagina/surgery*

Fulltext Sino-nasal hemangiopericytoma--a rare tumor

Vikneswaran T, Gendeh BS, Tan VES, Phang KS, Saravanan K

Med J Malaysia, 2005 Oct;60(4):485-8.

PMID: 16570712

Hemangiopericytoma is a very rare angiogenic tumor. In the nasal cavity, it can be considered malignant. It occurs in various parts of the body but those in the nasal cavity account for only 5% of total cases. Less than 200 cases have been reported worldwide involving the nose and paranasal sinuses. Due to its rarity a proper line of management has not been established to tackle this tumour. This article highlights two cases of hemangiopericytoma (HPC), one in an adult and the other in a child, presenting as an intranasal mass.

Matched MeSH terms: Hemangiopericytoma/surgery; Nasopharyngeal Neoplasms/surgery; Nose Neoplasms/surgery; Paranasal Sinus Neoplasms/surgery

Fulltext Large fungating thyroid cancers: a unique surgical challenge

Harjit KD, Hisham AN

Asian J Surg, 2005 Jan;28(1):48-51.

PMID: 15691799

Large goitres are common in the developing world, particularly in Asia and Africa. Nonetheless, large fungating goitres are extremely rare and represent a unique challenge to surgeons. Surgery should always be considered, when the general condition of the patient permits, to provide a better quality of life as it offers the only hope of long-term survival. The potential gain with surgery is that it allows maximum benefit for more effective radioactive iodine ablation and radiotherapy treatment. We report two cases of large fungating thyroid cancers complicated by anaemia and foul-smelling discharge.

Matched MeSH terms: Carcinoma, Papillary/surgery*; Goiter/surgery; Thyroid Neoplasms/surgery*; Carcinoma, Medullary/surgery*

Management of iatrogenic facial nerve palsy and labyrinthine fistula in mastoid surgery

Long YT, bin Sabir Husin Athar PP, Mahmud R, Saim L

Asian J Surg, 2004 Jul;27(3):176-9.

PMID: 15564156

A 6-year review of complications of mastoid surgery between June 1995 and June 2001 revealed five cases with serious iatrogenic complications from mastoid surgery, of which four were facial nerve palsy and two were labyrinthine fistula. One of these patients had concomitant facial nerve palsy and labyrinthine fistula. There were two cases of complete facial nerve palsy (House Brackmann grade VI) and two cases of incomplete palsy (House Brackmann grades IV and V). The second genu was the site of injury in three of the four cases. Of the four cases with facial nerve palsy, two patients had full recovery (House Brackmann grade I), one recovered only to House Brackmann grade III, and one was lost to follow-up. Both patients with labyrinthine fistula had postoperative vertigo and profound sensorineural hearing loss. The site of iatrogenic fenestration was the lateral semicircular canal in both cases.

Matched MeSH terms: Facial Paralysis/surgery; Fistula/surgery; Labyrinth Diseases/surgery; Mastoid/surgery*

Hypoglossal nerve tumor: A rare primary extracranial meningioma of the neck

Zulkiflee AB, Prepageran N, Rahmat O, Jayalaskhmi P, Sharizal T

Ear Nose Throat J, 2012 Nov;91(11):E26-9.

PMID: 23288802

We report a case of primary extracranial meningioma arising from the hypoglossal nerve in a 54-year-old man who presented with a 9-month history of hoarseness and progressive dysphagia. He had also noticed that his tongue was deviated to the left and, as a result, he was having difficulty pronouncing words. Examination revealed fasciculation and muscle wasting on the left side of the tongue. Other cranial nerve functions were normal. Contrast-enhanced computed tomography detected a heterogeneous mass that had arisen above the bifurcation of the left common carotid artery and had extended to near the skull base. Transcervical excision of the tumor was performed, and histopathology identified it as a meningioma of the hypoglossal nerve. The patient recovered uneventfully, and he was without recurrence at more than 2 years of follow-up. A primary extracranial meningioma is extremely rare, and its presentation may be subtle. A thorough investigation is necessary to avoid fatal compressive symptoms.

Matched MeSH terms: Cranial Nerve Neoplasms/surgery; Meningeal Neoplasms/surgery; Meningioma/surgery; Hypoglossal Nerve Diseases/surgery

Fulltext An uncommon and insidious presentation of renal cell carcinoma with tumor extending into the inferior vena cava and right atrium: a case report

Lu HT, Chong JL, Othman N, Vendargon S, Omar S

J Med Case Rep, 2016 May 03;10(1):109.

PMID: 27142514 DOI: 10.1186/s13256-016-0888-5

BACKGROUND: Renal cell carcinoma is a potentially lethal cancer with aggressive behavior and it tends to metastasize. Renal cell carcinoma involves the inferior vena cava in approximately 15% of cases and it rarely extends into the right atrium. A majority of renal cell carcinoma are detected as incidental findings on imaging studies obtained for unrelated reasons. At presentation, nearly 25% of patients either have distant metastases or significant local-regional disease with no symptoms that can be attributed to renal cell carcinoma.

CASE PRESENTATION: A 64-year-old Indian male with a past history of coronary artery bypass graft surgery, congestive heart failure, and diabetes mellitus complained of worsening shortness of breath for 2 weeks. Incidentally, a transthoracic echocardiography showed a "thumb-like" mass in his right atrium extending into his right ventricle through the tricuspid valve with each systole. Abdomen magnetic resonance imaging revealed a heterogenous lobulated mass in the upper and mid-pole of his right kidney with a tumor extending into his inferior vena cava and right atrium, consistent with our diagnosis of advanced renal cell carcinoma which was later confirmed by surgical excision and histology. Radical right nephrectomy, lymph nodes clearance, inferior vena cava cavatomy, and complete tumor thrombectomy were performed successfully. Perioperatively, he did not require cardiopulmonary bypass or deep hypothermic circulatory arrest. He had no recurrence during the follow-up period for more than 2 years after surgery.

CONCLUSIONS: Advanced extension of renal cell carcinoma can occur with no apparent symptoms and be detected incidentally. In rare circumstances, atypical presentation of renal cell carcinoma should be considered in a patient presenting with right atrial mass detected by echocardiography. Renal cell carcinoma with inferior vena cava and right atrium extension is a complex surgical challenge, but excellent results can be obtained with proper patient selection, meticulous surgical techniques, and close perioperative patient care.

Matched MeSH terms: Carcinoma, Renal Cell/surgery; Heart Atria/surgery; Kidney Neoplasms/surgery; Vena Cava, Inferior/surgery

Fulltext Peroneal nerve palsy secondary to proximal fibular osteochondroma--a case report

Hazmy W

Med J Malaysia, 2001 Jun;56 Suppl C:89-90.

PMID: 11814260

The author reports a case of a 11-year old child presented with peroneal nerve entrapment secondary to proximal fibular osteochondroma, with complete recovery of function following the excision of the tumor.

Matched MeSH terms: Bone Neoplasms/surgery*; Fibula/surgery*; Osteochondroma/surgery*; Peroneal Neuropathies/surgery*

Fulltext A rare case of bleeding in a cerebellopontine angle epidermoid cyst

Zamzuri I, Abdullah J, Madhavan M, Ariff AR

Med J Malaysia, 2002 Mar;57(1):114-7.

PMID: 14569729

Epidermoid cysts of the central nervous system are described as rare, benign, slow growing lesions with a history of high rate of recurrence even after surgical removal. This lesion is rarely located at the cerebellopontine angle and is found to be composed of solid and cystic components with close adherence to vital neurovascular structures that might complicate its removal. We present a rare case of a twenty-five year old housewife with signs and symptoms of increased intracranial pressure due to the above pathology after multiple episodes of intra-tumoral bleeding. Microneurosurgical techniques were used for tumour dissection and excision. The patient recovered well after a three-year follow-up. This is the fourth example in the index medicus of bleeding seen in a histopathologically proven cerebellopontine angle intraepidermoid cyst.

Matched MeSH terms: Cerebellar Diseases/surgery; Cerebellopontine Angle/surgery; Epidermal Cyst/surgery; Intracranial Hemorrhages/surgery

Fulltext Limb reconstruction surgery with external fixators--university hospital experience

Aik S, Sengupta S

Med J Malaysia, 2000 Sep;55 Suppl C:86-92.

PMID: 11200049

We are describing 21 limb reconstruction procedures performed in 18 patients with the use of external fixators from 1996 to 1998. The average age of patients was 21, ranging from 1 to 50 years old. Indications for surgery included short limb, non-union, pseudoarthrosis and bone or soft tissue deformities. Average length obtained for cases of limb lengthening was 6 cm. All the seven clubfoot deformities in five children were fully corrected. Equinus deformity recurred in one foot and was treated with supramalleolar osteotomy. Out of the seven cases with infected nonunion and bone loss, three failed to achieve union and required additional bone grafting procedures. One patient with unilateral external fixator for the correction of tibia shortening developed valgus deformity.

Matched MeSH terms: Clubfoot/surgery; Extremities/surgery*; Fractures, Ununited/surgery; Limb Deformities, Congenital/surgery

Cytological analysis of breast lesions: a review of 780 cases

Jayaram G, Alhady SF, Yip CH

Malays J Pathol, 1996 Dec;18(2):81-7.

PMID: 10879227

780 breast cytology samples obtained over a one year period at the Breast Clinic of the University Hospital, Kuala Lumpur were reviewed. These included 745 fine needle aspirates (FNA's) and 35 nipple smears. The broad categories of cytodiagnoses were as follows: malignant: 95, suspicious or equivocal: 26, benign: 543, no proliferative lesion: 58 and inadequate: 58. The benign and malignant lesions were also subcategorized on cytological basis. The suspicious or equivocal lesions were subjected to biopsy and 17 of these proved to be malignant. 194 cases that were subjected to histological confirmation and 34 cases that were considered to be undisputably malignant (on the basis of clinical features, recurrences, metastases, etc.) were subjected to statistical analysis (total 228 cases). If the cytologically suspicious/equivocal category was considered as "test positive" the sensitivity of cytodiagnosis was 97.4% and the specificity 92%. The high degree of cytodiagnostic sensitivity and specificity make breast cytology a valuable adjunct in the evaluation of breast lesions.

Matched MeSH terms: Adenocarcinoma/surgery; Breast Neoplasms/surgery; Neoplasm Recurrence, Local/surgery; Nipples/surgery

Unicystic ameloblastoma: a late recurrence with pseudo-glandular features. A case report

Khoo SP, High AS, Awang MN

Singapore Dent J, 1995 Jul;20(1):21-3.

PMID: 9582685

A case of unicystic ameloblastoma which recurred after 15 years showing unusual histological features is reported. The prominent pseudo-glandular features present are described. This case highlights the importance of extensive histological examination for more characteristic features of ameloblastoma to reach a correct diagnosis.

Matched MeSH terms: Ameloblastoma/surgery; Mandible/surgery; Mandibular Neoplasms/surgery; Neoplasm Recurrence, Local/surgery

Fulltext The pectoralis major myocutaneous flap in the primary reconstruction of oro-facial defects

Krishnan MMS, Canaganayagam A

Med J Malaysia, 1983 Jun;38(2):126-30.

PMID: 6621442

Pectoralis major myocutaneous flap reconstruction of the defect following surgery for oral cancer in fourteen patients is described. The problems and complications encountered have been found to be minimal. Functional and cosmetic results were acceptable.

Matched MeSH terms: Facial Neoplasms/surgery*; Mouth Neoplasms/surgery*; Surgery, Plastic*

Ciliary-block glaucoma treated by posterior capsulotomy

Lockie P

Aust N Z J Ophthalmol, 1987 Aug;15(3):207-9.

PMID: 3675913

Ciliary-block glaucoma occurred in one eye of a 65-year-old-male, following a combined trabeculectomy and extracapsular lens extraction for long-standing angle-closure glaucoma. After pupillary block was excluded as a cause, a posterior capsulotomy resolved the condition. This procedure was repeated successfully when a flat anterior chamber recurred on spontaneous closure of the initial capsulotomy. The ciliary block appeared to be caused by the residual zonule and lens capsule.

Matched MeSH terms: Glaucoma/surgery*; Iris/surgery; Lens Capsule, Crystalline/surgery*; Lens, Crystalline/surgery*

Fournier's gangrene: its aetiology and management

Thambi Dorai CR, Kandasami P

Aust N Z J Surg, 1991 May;61(5):370-2.

PMID: 2025192

The clinical features and management of 12 patients with Fournier's gangrene are described. The patients differed from the usual description of Fournier's gangrene in that they were older, the disease had a less abrupt onset and a definite predisposing factor was identified in 10 of the 12 patients. The importance of early diagnosis and excision of necrotic tissue is emphasized.

Matched MeSH terms: Bacterial Infections/surgery; Genital Diseases, Male/surgery; Penis/surgery; Scrotum/surgery

Fulltext Surgical experience with cardiac tumours at the General Hospital, Kuala Lumpur

Awang Y, Sallehuddin A

Med J Malaysia, 1991 Mar;46(1):28-34.

PMID: 1836035

Fifteen patients underwent surgery for cardiac tumours in General Hospital Kuala Lumpur between October 1984 and June 1989. Twelve of the patients had cardiac myxomas and underwent excision under cardiopulmonary bypass. Two patients had sarcoma, of which one was excised. The other was inoperable. Another patient had a metastalic malignant melanoma which was inoperable. Of the patients 10 were female and five male. Their ages ranged from 16 to 60 years. All were symptomatic and the commonest mode of presentation was exertional dyspnoea and palpitations. Two presented with cerebral embolisation. The three patients with malignant tumours had constitutional symptoms at the time of surgery. All patients had echocardiography pre-operatively to confirm the diagnosis of cardiac tumour. Only one patient underwent preoperative cardiac catheterisation and angiography. The surgical approach in all patients was through a median sternotomy and all except one were operated under cardiopulmonary bypass. There was no intraoperative embolisation. There was one perioperative death. Fourteen patients were followed up for periods ranging from one to 44 months. Three patients with malignant cardiac tumours died. One had recurrence of myxoma 21 months after the initial surgery. We conclude that excision of cardiac myxomas carry a very small risk following which patients have good prognosis. Malignant tumours carry a bad prognosis. From our experience, we conclude that echocardiography is an extremely accurate tool in the diagnosis of cardiac tumours.

Matched MeSH terms: Heart Atria/surgery; Heart Neoplasms/surgery*; Myxoma/surgery*; Sarcoma/surgery*

The elastic flap for lip repair

Goldstein MH

Plast Reconstr Surg, 1990 Mar;85(3):446-52.

PMID: 2304997

These cases illustrate a new concept in lip repair. This approach recognizes the great inherent elasticity of the oral cavity and takes advantage of the florid blood supply of the region. Recent laboratory studies of Taylor et al., as well as the works of Manchot and Salmon, are combined with anthropologic observations of tribal customs to formulate another way of looking at lip reconstruction. Triangularization of surgical defects, lip switching, and mobilization of distant flaps are avoided by taking advantage of stretched local tissues. Preoperative expansion is discussed as a future option.

Matched MeSH terms: Hemangioma, Cavernous/surgery; Lip/surgery*; Lip Neoplasms/surgery; Maxillofacial Injuries/surgery

Displaying publications 261 - 280 of 2700 in total