MyMedR

Metastasis to the sinonasal tract from sigmoid colon adenocarcinoma

bin Sabir Husin Athar PP, bte Ahmad Norhan N, bin Saim L, bin Md Rose I, bte Ramli R

Ann Acad Med Singap, 2008 Sep;37(9):788-3.

INTRODUCTION: Metastatic adenocarcinoma from the gastrointestinal tract to the sinonasal tract is rare. The histological morphology of this lesion is indistinguishable from the colonic variant of primary sinus adenocarcinoma or intestinal-type adenocarcinoma (ITAC).

CLINICAL PICTURE: This is a report of a case of metastatic adenocarcinoma of colorectal origin to the paranasal sinuses in a 52-year-old female who was previously treated for adenocarcinoma of the sigmoid colon. A histologic study of the surgical specimen from the sinonasal cavity demonstrated a tumour identical to the patient's prior primary tumour of the colon. The sinonasal neoplastic tissue showed marked positivity for carcinoembryonic antigen and expressed cytokeratin 20, which differentiates metastatic colonic adenocarcinoma from ITAC.

TREATMENT/OUTCOME: The patient received palliative radiation but died 3 months after the diagnosis.

CONCLUSION: Distinguishing metastatic adenocarcinoma from gastrointestinal tract from ITAC can be difficult. In view of the resemblance, immunohistochemical staining can help in differentiating them. It is important to recognise these as metastatic lesions as the treatment is mainly palliative.

Matched MeSH terms: Paranasal Sinus Neoplasms/metabolism; Paranasal Sinus Neoplasms/radiotherapy; Paranasal Sinus Neoplasms/secondary*; Colorectal Neoplasms/pathology*

Metachronous inflammatory myofibroblastic tumour in the temporal bone: case report

Goh BS, Tan SP, Husain S, Rose IM, Saim L

J Laryngol Otol, 2009 Oct;123(10):1184-7.

PMID: 19192318 DOI: 10.1017/S0022215109004642

We report an extremely rare case of metachronous inflammatory myofibroblastic tumour in the temporal bone.

Matched MeSH terms: Neoplasms, Muscle Tissue/pathology; Neoplasms, Muscle Tissue/surgery*; Skull Neoplasms/pathology; Skull Neoplasms/surgery*

Fulltext p63 as a complimentary basal cell specific marker to high molecular weight-cytokeratin in distinguishing prostatic carcinoma from benign prostatic lesions

Shiran MS, Tan GC, Sabariah AR, Rampal L, Phang KS

Med J Malaysia, 2007 Mar;62(1):36-9.

PMID: 17682568 MyJurnal

The diagnosis of prostatic carcinoma (Pca) on routine biopsies may be challenging, and to date the commonly used marker to distinguish prostate carcinoma from benign prostatic lesions has been High Molecular Weight-Cytokeratin (HMW-CK). However, the antigen of HMW-CK is susceptible to the effect of formalin fixation and causes frequent loss or patchy staining in the obviously benign glands. More recently, antibodies to p63 have been reported to be more sensitive than HMW-CK for the detection of prostatic basal cells. p63, a homologue of tumour suppressor gene p53, is essential for prostate development and is selectively expressed in the nuclei of basal cells of normal prostate glands. The objective of this study is to compare the sensitivity and specificity of HMW-CK and p63 in distinguishing prostatic carcinomas from benign prostatic lesions, as well as determining their positive predictive values. Seventy-two cases from HUKM (comprising 29 prostatic carcinomas and 43 benign prostatic hyperplasias) were stained for both HMW-CK and p63. The sensitivity of p63 and HMW-CK in identifying basal cells in benign glands was 88.37% and 90.70% respectively. The specificity of both reagents was 100%, and the positive predictive value for both reagents was also 100%. Thus, p63 is a useful complementary basal cell specific stain to HMW-CK, and would be very helpful to practicing pathologists in dealing with difficult cases.

Matched MeSH terms: Neoplasms/diagnosis*; Prostatic Neoplasms/physiopathology; Neoplasms, Basal Cell/diagnosis*

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/pathology*; Kidney Neoplasms/surgery; Vascular Neoplasms/secondary*; Vascular Neoplasms/surgery

Fulltext Intermittent respiratory obstruction secondary to a solitary fibrous tumour

Shashinder S, Kuljit S, Rahmat O, Usha DA, Gopala GK

Med J Malaysia, 2006 Oct;61(4):501-2.

PMID: 17243534 MyJurnal

There have been fourteen cases of solitary fibrous tumour reported as originating from the paranasal sinuses. Here we report a case of solitary fibrous tumour that involved the right nasal cavity with extension into the oropharynx causing stertor and intermittent respiratory obtruction. Histopathology examination revealed the tumuor cells expressed CD34 turnout marker.

Matched MeSH terms: Paranasal Sinus Neoplasms/complications*; Paranasal Sinus Neoplasms/pathology; Neoplasms, Fibrous Tissue/complications*; Neoplasms, Fibrous Tissue/pathology

Fulltext Kimura's disease: an unusual cause of cervical tumor

Asma A, Maizaton AA

Med J Malaysia, 2005 Aug;60(3):373-6.

PMID: 16379197

Kimura's disease (KD) is an angiolymphoid proliferative disease of soft tissue with peripheral blood eosinophilia and elevated serum immunoglobulin (Ig) E. The treatment options range from conservative observation for the asymptomatic patient to surgical excision, steroid therapy and radiotherapy for symptomatic patients. Surgical excision is the most common diagnostic measure and is the treatment of choice. A case of KD in a 13-year-old Malay girl is presented. Clinically there was painless right jugular digastric mass measuring 3cm by 3cm. Her blood investigation showed pronounced eosinophilia. She underwent excision biopsy uneventfully. The biopsy from the swelling showed reactive follicular hyperplasic with prominent eosinophilia. There was no evidence of malignant change. Postoperatively after 3 years follow up, she was asymptomatic and no signs of tumor recurrence.

Matched MeSH terms: Uterine Cervical Neoplasms/etiology*; Uterine Cervical Neoplasms/pathology; Neoplasms/etiology*; Neoplasms/pathology

Sinonasal inverted papilloma with malignant transformation in the middle ear: a multicentric origin?

Mazlina S, Shiraz MA, Hazim MY, Amran AR, Zulkarnaen AN, Wan Muhaizan WM

J Laryngol Otol, 2006 Jul;120(7):597-9.

PMID: 16672089

Inverted papilloma is a rare, benign tumour representing only 0.5 to 4 per cent of all sinonasal neoplasms; its involvement of the middle ear is extremely rare. We present a case of multicentric inverted papilloma in the sinonasal region and middle ear in a 54-year-old man. The patient later developed neck metastasis secondary to malignant transformation of the inverted papilloma in the middle ear.

Matched MeSH terms: Ear Neoplasms/pathology*; Maxillary Sinus Neoplasms/pathology*; Neoplasms, Multiple Primary/pathology

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/diagnosis*; Cranial Nerve Neoplasms/surgery; Meningeal Neoplasms/diagnosis*; Meningeal Neoplasms/surgery

Fulltext Metastatic cervical carcinoma in the caecum

Marjmin O, Badrulhisham B, Teoh CM, Sukumar N, Ahmad Zakuan K

Med J Malaysia, 2005 Mar;60(1):97-8.

PMID: 16250290

A patient who presented with acute intestinal obstruction had a right hemicolectomy for a caecal tumour. The histopathology report confirmed metastatic carcinoma in the caecum from the cervical carcinoma. Caecum is a very rare site of metastasis from cervical carcinoma. From our literature review, there have been no such cases reported.

Matched MeSH terms: Cecal Neoplasms/complications; Cecal Neoplasms/secondary*; Uterine Cervical Neoplasms/complications; Uterine Cervical Neoplasms/pathology*

Extramammary Paget's disease: a report of 2 cases and a review of the literature

Khoo JJ, Choon SE

Malays J Pathol, 2003 Jun;25(1):73-8.

PMID: 16196382

Extramammary Paget's disease (EMPD) is a rare disorder and may be found in the vulva, scrotum, penile area, perianal region and the groin. Frequently, it is associated with an underlying regional neoplasm or internal malignancy. We report 2 cases of EMPD; one involving the scrotal area and the other the vulva. Both were elderly patients who presented to the dermatologists with chronic eczematous lesions in the perineum that did not respond to topical treatment. Skin biopsies confirmed extramammary Paget's disease. Investigations for internal malignancies were negative. However, one of the patients defaulted treatment before surgery. The other patient had two excision surgeries with skin grafting to try to achieve tumour free margins. A long term follow-up was planned for him to look for recurrences. These cases emphasise that EMPD can mimic exudative dermatitis and present as a chronic non-healing lesion in the perineum for many years. Clinicians should have a high index of suspicion to pick up the disease early by biopsy. Various immunohistochemical markers not only can help differentiate other histological diagnoses but also help predict the presence of underlying malignancies. Management of EMPD included thorough search for occult or underlying malignancy followed by complete excision surgery with intraoperative frozen sections. Even then, recurrences are high for this disease and long term follow-up is advocated.

Matched MeSH terms: Genital Neoplasms, Male/pathology*; Skin Neoplasms/pathology*; Vulvar Neoplasms/pathology

Fulltext Gender-Specific Molecular and Clinical Features Underlie Malignant Pleural Mesothelioma

De Rienzo A, Archer MA, Yeap BY, Dao N, Sciaranghella D, Sideris AC, et al.

Cancer Res, 2016 Jan 15;76(2):319-28.

PMID: 26554828 DOI: 10.1158/0008-5472.CAN-15-0751

Malignant pleural mesothelioma (MPM) is an aggressive cancer that occurs more frequently in men, but is associated with longer survival in women. Insight into the survival advantage of female patients may advance the molecular understanding of MPM and identify therapeutic interventions that will improve the prognosis for all MPM patients. In this study, we performed whole-genome sequencing of tumor specimens from 10 MPM patients and matched control samples to identify potential driver mutations underlying MPM. We identified molecular differences associated with gender and histology. Specifically, single-nucleotide variants of BAP1 were observed in 21% of cases, with lower mutation rates observed in sarcomatoid MPM (P < 0.001). Chromosome 22q loss was more frequently associated with the epithelioid than that nonepitheliod histology (P = 0.037), whereas CDKN2A deletions occurred more frequently in nonepithelioid subtypes among men (P = 0.021) and were correlated with shorter overall survival for the entire cohort (P = 0.002) and for men (P = 0.012). Furthermore, women were more likely to harbor TP53 mutations (P = 0.004). Novel mutations were found in genes associated with the integrin-linked kinase pathway, including MYH9 and RHOA. Moreover, expression levels of BAP1, MYH9, and RHOA were significantly higher in nonepithelioid tumors, and were associated with significant reduction in survival of the entire cohort and across gender subgroups. Collectively, our findings indicate that diverse mechanisms highly related to gender and histology appear to drive MPM.

Matched MeSH terms: Lung Neoplasms/genetics*; Lung Neoplasms/pathology; Pleural Neoplasms/genetics*; Pleural Neoplasms/pathology

Follicular adenoma with squamous metaplasia and cystic change: report of a case with fine needle aspiration cytological and histological features

Jayaram G, Jayalakshmi P

Malays J Pathol, 1999 Dec;21(2):101-4.

PMID: 11068414

Squamous metaplasia (SM) of thyroid follicular epithelium is known to occur in a variety of non-neoplastic lesions as well in thyroid neoplasms, notably papillary carcinoma (PC). In follicular thyroid tumors, on the other hand, SM is very rare. This case describes cytological and pathological findings in a follicular adenoma (FA) that presented as a cystic lesion with extensive SM. The fine needle aspiration (FNA) cytology sample in this case yielded only necrotic material from the cystic area and squamous cells, which being mostly of immature type, were not recognised as squamous in the cytological smears. The needle missed the solid (neoplastic) component of the lesion and on the whole the cytological picture was considered to be equivocal. FA can now be added to the spectrum of thyroid lesions that can show SM. Awareness of this will enable cytopathologists to consider non-papillary lesions in the differential diagnosis of thyroid nodules that yield squamous cells.

Matched MeSH terms: Thyroid Neoplasms/pathology*; Thyroid Neoplasms/surgery; Neoplasms, Squamous Cell/pathology*; Neoplasms, Squamous Cell/surgery

Metastatic osteosarcoma of the ethmoid: an unusual cause of recurrent epistaxis and proptosis

Sharma HS, Reddy SC, Mohamad A, Kamal MZ, Halder D

J Laryngol Otol, 1996 Jul;110(7):676-8.

PMID: 8759546

Osteosarcoma is the most common primary malignant tumour of bone and it usually metastasises to the lung. In the nasal cavity metastatic disease is extremely rare. We describe a case of osteosarcoma presenting with recurrent epistaxis, and proptosis due to secondaries in the nasal cavity. To our knowledge such a case has not been reported previously in the available English literature.

Matched MeSH terms: Nose Neoplasms/complications; Nose Neoplasms/secondary*; Skull Neoplasms/complications; Skull Neoplasms/secondary*

Desmoplastic variant of ameloblastoma in Malaysians

Ng KH, Siar CH

Br J Oral Maxillofac Surg, 1993 Oct;31(5):299-303.

PMID: 8218083

Seventeen cases are reported of desmoplastic variant of ameloblastoma of the jaws observed during the years 1967-1991. There were 12 females and 5 males, and these consisted of 7 Chinese, 6 Malays, 2 Indians, 1 Sikh and 1 Kadazan. Their ages at diagnosis ranged from 21-60 years with a mean of 36.6 years. There were 10 mandibular and 7 maxillary tumours. Of these, 14 cases involved the anterior segment with extension to the premolar region in 5 cases. 60% of cases were radiologically suggestive of fibro-osseous lesions. The main mode of treatment was resection and 1 case presented with recurrence. The findings of this study were compared with those of previous reports.

Matched MeSH terms: Mandibular Neoplasms/pathology*; Maxillary Neoplasms/pathology*; Neoplasms, Fibrous Tissue/pathology*

Adjuvant chemotherapy and radiotherapy in the management of colorectal cancer

Lim Kok Hooi A

Gan To Kagaku Ryoho, 1992 Jul;19(8 Suppl):1233-5.

PMID: 1514837

Matched MeSH terms: Colonic Neoplasms/drug therapy; Colonic Neoplasms/radiotherapy*; Rectal Neoplasms/drug therapy; Rectal Neoplasms/radiotherapy*

Fulltext Viruses and cancer

Yasmin AM

Med J Malaysia, 1997 Jun;52(2):105-7.

PMID: 10968066

Matched MeSH terms: Uterine Cervical Neoplasms/etiology; Liver Neoplasms/etiology; Neoplasms/etiology*

Tumefactive fibroinflammatory lesion of the head and neck

Said H, Razi Hadi A, Akmal SN, Lokman S

J Laryngol Otol, 1988 Nov;102(11):1064-7.

PMID: 3209947 DOI: 10.1017/s0022215100107297

The term tumefactive fibroinflammatory lesion is used to describe an unusual fibrosclerosing disorder that behaves in a malignant way clinically but is histologically benign. Lesions in the head and neck are believed to be part of the broader fibrosclerosing syndrome which include pseudotumour of the orbit, Reidel's thyroiditis, sclerosing cholangitis and mediastinal fibrosis. Clinical diagnosis is often difficult and relies heavily on histopathology. Steroid therapy is suggested as the first line of management, while surgery or radiation therapy is reserved for failures.

Matched MeSH terms: Nose Neoplasms/pathology; Nose Neoplasms/surgery*; Paranasal Sinus Neoplasms/pathology; Paranasal Sinus Neoplasms/surgery*

Fulltext Choledochal cyst and cholangiocarcinoma

Yeoh NT, Somasundaram K, Alhady SF, Paramsothy M

Med J Malaysia, 1986 Dec;41(4):365-9.

PMID: 2823084

Carcinoma of the biliary tract is a rare complication of choledochal cysts. Furthermore, the greater predisposition of the cyst wall to neoplastic change has been cited as additional justification for cyst excision rather than on-site internal drainage as the primary choice of operation. The report concerns a patient who developed cholangiocarcinoma despite excision of a choledochal cyst and presented with symptoms of biliary obstruction within one year of the operation. Although this is a rare complication, the need for careful long-term follow-up is supported by this observation.

Matched MeSH terms: Bile Duct Neoplasms/etiology*; Bile Duct Neoplasms/pathology; Liver Neoplasms/etiology*; Liver Neoplasms/pathology

Fulltext Malignant non-Hodgkin's lymphomas of the nose and paranasal sinuses

Tan J, Said H, Chong SM

Med J Malaysia, 1988 Mar;43(1):49-54.

PMID: 3244320

Matched MeSH terms: Nose Neoplasms/diagnosis; Nose Neoplasms/pathology*; Paranasal Sinus Neoplasms/diagnosis; Paranasal Sinus Neoplasms/pathology*

Fertility control and the risk of gynecological malignancies

Sivanesaratnam V

Obstet Gynecol Surv, 1991 Mar;46(3):131-7.

PMID: 1849623

Matched MeSH terms: Breast Neoplasms/chemically induced*; Genital Neoplasms, Female/chemically induced*; Trophoblastic Neoplasms/chemically induced

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