MyMedR

Report of a rare case of carcinosarcoma of the maxillary sinus with sternal metastasis

Cheong JP, Rahayu S, Halim A, Khir A, Noorafidah D

Ear Nose Throat J, 2014 Jun;93(6):E1-4.

Carcinosarcoma is a highly aggressive and infiltrative tumor. A finding of this tumor in a paranasal sinus is exceedingly rare. We describe the case of a 61-year-old man who presented with a mass on the left side of his face. The mass was excised via a total maxillectomy with a modified radical neck dissection. Histologic analysis identified a mixture of carcinomatous and sarcomatous components. Within 1 month of surgery, the patient developed a sternal metastasis, and he died within a short period of time. The aggressive nature of this tumor and its metastases demand early diagnosis and prompt treatment.

Matched MeSH terms: Bone Neoplasms/secondary*; Maxillary Sinus Neoplasms/pathology*; Maxillary Sinus Neoplasms/surgery

The feasibility of using Patients Concerns Inventory (PCI) in managing Malaysian oral cancer patients

Hatta JM, Doss JG, Rogers SN

Int J Oral Maxillofac Surg, 2014 Feb;43(2):147-55.

PMID: 24074487 DOI: 10.1016/j.ijom.2013.08.006

The feasibility of using the Patients Concerns Inventory (PCI) to identify oral cancer patient concerns during consultation in oral and maxillofacial specialist clinics in Malaysia was assessed. A cross-sectional study was conducted using a consecutive clinical sampling technique of all new and follow-up oral cancer patients. Surgeons and counter staff were also recruited. Two-thirds of patients were elderly, 63.9% female, 55.6% Indian, 63.9% of lower-level education, and half had the lowest level household income. Patient status was mostly post-treatment (87.5%) and most were at cancer stage III/IV (63.9%); 59.7% had surgery. Patients took an average 5.9 min (95% CI 5.1-6.7 min) to complete the PCI. Physical domain appeared highest (94.4%); social/family relationship issues (4.2%) were lowest. Significant associations included patient age-personal function (P=0.02); patient education level-emotional status (P=0.05) and social/family relationship issues (P=0.04), and patient TNM staging-personal function (P=0.03). The patients' mean feasibility score for the PCI was 5.3 (95% CI 5.1-5.5) out of 6. Patients (93.1%) and surgeons (90%) found the PCI to be feasible. Only 57.1% of counter staff agreed on the use of the PCI during patient registration. Overall, the PCI was considered feasible, thus favouring its future use in routine oral cancer patient management.

Matched MeSH terms: Mouth Neoplasms/epidemiology; Mouth Neoplasms/pathology; Mouth Neoplasms/psychology*; Mouth Neoplasms/therapy

Fulltext Functional roles of fibroblast growth factor receptors (FGFRs) signaling in human cancers

Tiong KH, Mah LY, Leong CO

Apoptosis, 2013 Dec;18(12):1447-68.

PMID: 23900974 DOI: 10.1007/s10495-013-0886-7

The fibroblast growth factor receptors (FGFRs) regulate important biological processes including cell proliferation and differentiation during development and tissue repair. Over the past decades, numerous pathological conditions and developmental syndromes have emerged as a consequence of deregulation in the FGFRs signaling network. This review aims to provide an overview of FGFR family, their complex signaling pathways in tumorigenesis, and the current development and application of therapeutics targeting the FGFRs signaling for treatment of refractory human cancers.

Matched MeSH terms: Neoplasms/drug therapy; Neoplasms/genetics; Neoplasms/metabolism*; Neoplasms/physiopathology

The effects of metformin on ovarian cancer: a systematic review

Dilokthornsakul P, Chaiyakunapruk N, Termrungruanglert W, Pratoomsoot C, Saokaew S, Sruamsiri R

Int. J. Gynecol. Cancer, 2013 Nov;23(9):1544-51.

PMID: 24172091 DOI: 10.1097/IGC.0b013e3182a80a21

OBJECTIVE: The potential therapeutic effects of metformin on several cancers were reported. However, the evidence of the effects of metformin on ovarian cancer is still limited and inconclusive. This systematic review and meta-analysis study aim to summarize the existing evidence of the therapeutic effects of metformin on ovarian cancer.

METHODS: We performed systematic searches using electronic databases including PubMed and EMBASE until December 2012. Key words included "metformin" AND ("ovarian cancer" OR "ovary tumor"). All human studies assessing the effects of metformin on ovarian cancer were eligible for inclusion. All articles were reviewed independently by 2 authors with a standardized approach for the purpose of study, study design, patient characteristics, exposure, and outcomes. The data were pooled using a random-effects model.

RESULTS: Of 190 studies retrieved, only 3 observational studies and 1 report of 2 randomized controlled trials were included. Among those studies, 2 reported the effects of metformin on survival outcomes of ovarian cancer, whereas the other 2 reported the effects of metformin on ovarian cancer prevention. The findings of studies reporting the effects on survival outcomes indicated that metformin may prolong overall, disease-specific, and progression-free survival in ovarian cancer patients. The results of studies reporting the effects of metformin on ovarian cancer prevention were meta-analyzed. It indicated that metformin tended to decrease occurrence of ovarian cancer among diabetic patients with the pooled odds ratio of 0.57 (95% confidence interval, 0.16-1.99).

CONCLUSIONS: Our findings showed the potential therapeutic effects of metformin on survival outcomes of ovarian cancer and ovarian cancer prevention. However, most of the evidence was observational studies. There is a call for further well-conducted controlled clinical trials to confirm the effects of metformin on ovarian cancer survival and ovarian cancer prevention.

Matched MeSH terms: Ovarian Neoplasms/diagnosis; Ovarian Neoplasms/drug therapy*; Ovarian Neoplasms/mortality; Ovarian Neoplasms/epidemiology

Fulltext Cardiac mass in a patient with sigmoid adenocarcinoma: a metastasis?

Ngow HA, Khairina WM

Cardiovasc J Afr, 2012 Aug;23(7):e10-2.

PMID: 22915057 DOI: 10.5830/CVJA-2012-027

Cardiac metastasis from a bowel malignancy seldom occurs and there is a limited number of case reports published on this subject. Although colorectal cancer is the third commonest malignancy in Malaysia, the incidence of cardiac metastasis has never been reported. We report a case of an elderly man with recently diagnosed adenocarcinoma of the sigmoid colon, who presented with congestive cardiac failure secondary to mechanical obstruction by a right atrial mass. The intractable shock led to his sudden death before any intervention could be planned. If an intra-cavity cardiac mass is detected in a patient with an underlying metastatic malignancy, cardiac metastasis should be suspected. However, primary cardiac tumour or thrombus could also be the differential diagnosis. In our case, the definitive cardiac pathology remained unsolved as an autopsy was refused.

Matched MeSH terms: Heart Neoplasms/diagnosis; Heart Neoplasms/secondary*; Sigmoid Neoplasms/pathology*

Fulltext Myeloid sarcoma of the urinary bladder with cutaneous tumour seeding after percutaneous suprapubic catheterization

Geok Chin T, Masir N, Noor Hussin H, Mohd Sidik S, Boon Cheok L, Yean T

Malays J Pathol, 2011 Jun;33(1):47-51.

PMID: 21874752 MyJurnal

Myeloid sarcoma (MS) is a rare extramedullary myeloid tumour. It has been reported in various sites, including lymph node, bone, skin, soft tissue, various organs and the CNS. It may precede or occur concurrently with acute myeloid leukemia. Urinary bladder involvement is extremely uncommon. We report a 70-year-old female who had MS of the urinary bladder, presented with frank and persistent hematuria associated with lower abdominal pain. She subsequently had tumour seeding in the abdominal skin via percutaneous suprapubic catheter. Tumours from both the urinary bladder and skin showed immature cells that were immunoreactive toward LCA (focal), MPO (strong), CD99 (weak) and CD117 (weak). Summary of cases in the literature is presented. The potential of its misdiagnosis and the useful markers for the diagnosis of MS are discussed.

Matched MeSH terms: Urinary Bladder Neoplasms/pathology*; Skin Neoplasms/etiology*; Skin Neoplasms/pathology

Fulltext Duodenal intussusception of Brunner's gland adenoma mimicking a pancreatic tumour

Limi L, Liew NC, Badrul RH, Faisal MJ, Daniel YP

Med J Malaysia, 2010 Dec;65(4):311-2.

PMID: 21901954

Brunner's gland adenoma is a rare benign tumour of the duodenum. It is usually asymptomatic but may occasionally present with gastrointestinal haemorrhage and obstruction. We report a 40-year old lady, presenting with upper gastrointestinal bleeding and was found to have prolapsed and intussuscepted Brunner's gland adenoma of the duodenum, which mimicked the appearance of a tumour in the head of pancreas.

Matched MeSH terms: Duodenal Neoplasms/complications; Duodenal Neoplasms/diagnosis*; Pancreatic Neoplasms/diagnosis

Fulltext Isolated late chest wall recurrence after mastectomy for breast cancer

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: Breast Neoplasms/pathology*; Breast Neoplasms/surgery; Thoracic Neoplasms/diagnosis*

Fulltext Recurrent multiple myeloma presenting as a breast plasmacytoma

Kalyani A, Rohaizak M, Cheong SK, Nor Aini U, Balasundaram V, Norlia A

Med J Malaysia, 2010 Sep;65(3):227-8.

PMID: 21939175

We describe a patient with multiple myeloma, who initially responded to chemotherapy and went into remission. She presented 10 months later with a right breast lump which was confirmed by core biopsy to be a plasmacytoma. Further treatment with radiotherapy, thalidomide and later second line chemotherapy appeared unsuccessful and she showed rapid disease progression with rising paraproteins and new extramedullary plasmacytoma lesions in the forehead, supraclavicular region, nasopharynx, liver, spleen, pancreas and paraaortic lymph nodes.

Matched MeSH terms: Breast Neoplasms/drug therapy; Breast Neoplasms/pathology*; Breast Neoplasms/radiotherapy; Breast Neoplasms/secondary

Dural metastasis mimicking meningioma: an interesting case

Hamid HA, Gee KY, Muhammad R, Abd Rahman ZA, Das S

Acta Medica (Hradec Kralove), 2009;52(1):19-22.

PMID: 19754003

Dural metastasis is a rare entity in clinical practice. We report a case of dural metastasis secondary to thyroid carcinoma, which on both preoperative CT and MRI and at surgery had the typical appearance of a meningioma. Histopathological findings confirmed metastatic follicular thyroid carcinoma as a primary site. Although rare, dural metastases can mimic a meningioma. Our experience in this case has led us to consider metastasis as a differential diagnosis even when a meningioma is suspected. We believe that reporting of the case of dural metastasis mimicking a meningioma may help clinicians in future.

Matched MeSH terms: Meningeal Neoplasms/diagnosis*; Meningeal Neoplasms/secondary*; Thyroid Neoplasms/pathology*

Large retrosternal parathyroid carcinoma with primary hyperparathyroidism

Tan GC, Shiran MS, Swaminathan M, Phang KS, Rohaizak M

Asian J Surg, 2007 Oct;30(4):286-9.

PMID: 17962134

Parathyroid carcinoma is an uncommon cause of parathyroid hormone (PTH)-dependent hypercalcaemia, accounting for less than 1% of all cases of hyperparathyroidism. Parathyroid carcinoma is an indolent tumour with rather low malignant potential. Consideration of parathyroid carcinoma in the differential diagnosis of hypercalcaemic disorders is important because the morbidity and mortality are substantial and the best prognosis is associated with early recognition and surgical resection. Clinical indicators favouring parathyroid carcinoma over benign disease include markedly raised serum calcium levels, PTH and alkaline phosphatase. A palpable neck mass with both kidney and skeletal manifestations also give a high index of suspicion of parathyroid carcinoma. Histopathology alone is not sufficient to diagnose parathyroid cancer; it has to be correlated with the clinical findings. The initial and most effective treatment for parathyroid carcinoma is complete resection of the primary lesion, and repeated operations for recurrence are useful. The prognosis of parathyroid carcinomas is quite variable; 5-year survival rates vary from 40% to 86%, while the 10-year survival rate is approximately 49%. We report a case of parathyroid carcinoma occurring in a 55-year-old woman who presented with bone pain and hypercalcaemia.

Matched MeSH terms: Parathyroid Neoplasms/complications*; Parathyroid Neoplasms/diagnosis; Parathyroid Neoplasms/pathology; Parathyroid Neoplasms/surgery

Laryngeal metastasis from a rectal carcinoma

Ramanathan Y, Rajagopalan R, Rahman NA

Ear Nose Throat J, 2007 Nov;86(11):685-6.

PMID: 18225631

Metastases to the larynx from distant primaries are rare. We report a case of a laryngeal metastasis from a rectal carcinoma.

Matched MeSH terms: Laryngeal Neoplasms/radiography; Laryngeal Neoplasms/secondary*; Rectal Neoplasms/pathology*

Caecal tumour with hepatic metastases?

Rajendra S, Kutty K

Gut, 2005 Feb;54(2):178, 200.

PMID: 15647173

Matched MeSH terms: Cecal Neoplasms/diagnosis*; Liver Neoplasms/diagnosis; Liver Neoplasms/secondary*

Intraventricular squamous papillary craniopharyngioma: report of a case with intraoperative imprint cytology

Madhavan M, P JG, Abdullah Jafri J, Idris Z

Acta Cytol., 2005 Jul-Aug;49(4):431-4.

PMID: 16124175

BACKGROUND: Squamous papillary craniopharyngioma is a distinct entity, and its cytologic features may be misleading. Because of the rarity of this tumor, this case is being reported with a note on the cytologic features.

CASE: A 56-year-old Malay man who had 1-month history of generalized lethargy was admitted for altered sensorium. On examination, he was found to have neck stiffness, bilateral papilledema and generalized atrophy of muscles, with reduced power in all limbs. Magnetic resonance imaging of the brain showed a solid mass in the third ventricle causing obstructive hydrocephalus. Intraoperative cytology of the mass diagnosed intraventricular meningioma. However, the final histopathologic examination revealed squamous papillary craniopharyngioma.

CONCLUSION: Craniopharyngioma, squamous papillary type, is a rare entity and usually occurs in adults as an intraventricular solid tumor. Awareness of this entity will aid in arriving at the correct cytologic diagnosis.

Matched MeSH terms: Meningeal Neoplasms/diagnosis*; Pituitary Neoplasms/diagnosis*; Pituitary Neoplasms/pathology

Fulltext Secondary mucoepidermoid carcinoma of the orbit

Siuw CP, Tan SW, Abdul Wahid AB, Vasudevan S

Indian J Ophthalmol, 2016 Mar;64(3):238-41.

PMID: 27146939 DOI: 10.4103/0301-4738.181748

A 40-year-old man presented with right eye axial proptosis and ophthalmoplegia for 3 months. Imaging study showed a right intraconal mass with the erosion of the orbital floor. Incisional biopsy revealed mucoepidermoid carcinoma. Nasal endoscopy was normal and systemic tumor screening was negative for a primary source. The patient underwent right orbital exenteration, uncinectomy, nasal and maxillary mucosal biopsy. Malignant cells were found present in the mucosa of maxillary sinus roof and uncinate bone. The postoperative positron emission tomography scan showed residual active lesion in right orbital apex and maxilla but no primary lesion elsewhere. The patient subsequently underwent 35 cycles of postoperative radiotherapy. Primary mucoepidermoid carcinoma of the orbit is rare and typically arises from the lacrimal gland or sac. Those tumors not arising from lacrimal apparatus should be presumed metastatic in origin, and the thorough systemic survey should be undertaken in the search for the primary tumor.

Matched MeSH terms: Orbital Neoplasms/diagnosis*; Orbital Neoplasms/surgery; Neoplasms, Second Primary*

An unusual cause of tremor in an elderly man

Fadilah SA, Raymond AA, Cheong SK

Postgrad Med J, 2001 Apr;77(906):268-269; discussion 277-8.

PMID: 11264499

Matched MeSH terms: Prostatic Neoplasms*; Bone Marrow Neoplasms/complications; Bone Marrow Neoplasms/secondary*

Fulltext COX-2 inhibitors: a potential target for drug therapy in the management of colorectal cancer

Ryan ARA, Rosita ARA, Kamarul AK, Qureshi A

Med J Malaysia, 1999 Sep;54(3):293-5.

PMID: 11045053

Colorectal cancer is currently the third most common cancer in Malaysia. Elevated expression of COX-2, an induced cyclooxygenase isoenzyme, has been seen in colonic adenomas and colorectal carcinoma. There is evidence that inhibition of this COX-2 can decrease the risk of colorectal cancer. Selective COX-2 inhibitors may have a role in reducing the risk of colorectal cancer in high-risk individuals.

Matched MeSH terms: Neoplasms/enzymology; Colorectal Neoplasms/drug therapy*; Colorectal Neoplasms/physiopathology

Thyroid cancer: The Kuala Lumpur experience

Abdullah M

ANZ J Surg, 2002 Sep;72(9):660-4.

PMID: 12269919

There have been few detailed studies on thyroid cancer (TC) in Malaysia, a multiethnic country with three major races - Malays, Chinese and Indians.

Matched MeSH terms: Thyroid Neoplasms/ethnology; Thyroid Neoplasms/epidemiology*; Thyroid Neoplasms/pathology; Thyroid Neoplasms/therapy

Epstein-Barr virus (EBV) in Malaysian upper-aerodigestive-tract lymphoma: incidence and sub-type

Peh SC, Sandvej K, Pallesen G

Int J Cancer, 1995 May 4;61(3):327-32.

PMID: 7729943

Epstein-Barr virus (EBV) type B, a less potent transformer of B lymphocytes than type A, has rarely been detected in EBV-associated neoplasms except in AIDS-related lymphomas, in which about 50% of the cases contained this sub-type. In this study we analyzed the association of EBV and the distribution of virus sub-types in Asian non-Hodgkin's lymphoma (NHL) of the upper aerodigestive tract. We studied archival material of 29 NHL cases from Malaysia. B- and T-cell associated antigens were demonstrated by immunohistochemistry, and EBV early RNA EBER-1 was demonstrated using the RNA in situ hybridization technique. EBV was detected in the majority of tumour cells in 11/13 T-NHL but in only 1/16 B-NHL. EBV was sub-typed by single-step polymerase chain reaction of the EBNA-2 gene. This was successful in 9/10 cases of EBER-1-positive tumours and all contained type-A virus only. Our results showed a preponderance of T-cell lymphoma of the upper aerodigestive tract in the ethnic Chinese group of Malaysian patients, and EBV was strongly associated with T-NHL but not with B-NHL. Our results suggest that type-A EBV is the prevalent sub-type in Asian NHL of the upper aerodigestive tract, similarly to findings in Asian nasopharyngeal carcinoma.

Matched MeSH terms: Nasopharyngeal Neoplasms/immunology; Nasopharyngeal Neoplasms/epidemiology; Nasopharyngeal Neoplasms/pathology; Nasopharyngeal Neoplasms/virology*; Oropharyngeal Neoplasms/immunology; Oropharyngeal Neoplasms/epidemiology; Oropharyngeal Neoplasms/pathology; Oropharyngeal Neoplasms/virology*; Palatal Neoplasms/immunology; Palatal Neoplasms/epidemiology; Palatal Neoplasms/pathology; Palatal Neoplasms/virology*; Paranasal Sinus Neoplasms/immunology; Paranasal Sinus Neoplasms/epidemiology; Paranasal Sinus Neoplasms/pathology; Paranasal Sinus Neoplasms/virology*

Retroperitoneal malignant fibrous histiocytoma causing profuse bleeding per rectum

Sim PH, Pathmanathan R, Jalleh RP

Aust N Z J Surg, 1995 Jan;65(1):68-70.

PMID: 7818432

A case is reported of retroperitoneal malignant fibrous histiocytoma (MFH) invading into the colon, causing fresh bleeding per rectum. It illustrates the difficulty encountered in the pre-operative diagnosis of this condition, especially in a patient with an atypical presentation of profuse lower gastrointestinal bleeding.

Matched MeSH terms: Colonic Neoplasms/pathology; Retroperitoneal Neoplasms/complications*; Retroperitoneal Neoplasms/pathology

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