MyMedR

Fulltext Mucosal malignant melanoma of the maxillary sinus

Norhafizah M, Mustafa WM, Sabariah AR, Shiran MS, Pathmanathan R

Med J Malaysia, 2010 Sep;65(3):218-20.

PMID: 21939172

Mucosal malignant melanoma (MMM) is an aggressive tumour occurring in the upper respiratory tract. It is rare compared to malignant melanoma of the skin. We report a case of a 53-year-old man with left paranasal swelling. A biopsy showed high-grade spindle cell tumour. Subsequently a subtotal maxillectomy was performed. Histopathological examination revealed a hypercellular tumour composed of mixed spindle and epitheloid cells with very occasional intracytoplasmic melanin pigment. The malignant cells were immunopositive for vimentin, S-100 protein and HMB-45. It was diagnosed as mucosal malignant melanoma (MMM). This article illustrates a rare case of MMM where the diagnosis may be missed or delayed without proper histopathological examination that include meticulous search for melanin pigment and appropriate immunohistochemical stains to confirm the diagnosis. Malignant melanoma can mimic many other types of high-grade malignancy and should be considered as a differential diagnosis in many of these instances.

Matched MeSH terms: Maxillary Sinus Neoplasms/radiotherapy

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/radiotherapy

Mediastinal irradiation and its effect on the cardiovascular system

Tang D, Peng EW, Giri D, Chowdhary M, Sarkar P

Br J Hosp Med (Lond), 2009 Apr;70(4):222-4.

PMID: 19357601 DOI: 10.12968/hmed.2009.70.4.41626

Mediastinal irradiation for various malignancies can cause radiation injury to mediastinal structures, most importantly the cardiovascular system. This article reviews the effect of radiation on cardiovascular structures and the manifestations of various radiation-induced heart diseases.

Matched MeSH terms: Mediastinal Neoplasms/radiotherapy*

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.

PMID: 18989497

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/radiotherapy

Migration of a Hodge pessary into the abdominal cavity; a rare complications

Lim BK, Collaris RR

J Obstet Gynaecol Res, 2008 Jun;34(3):436-8.

PMID: 18588622 DOI: 10.1111/j.1447-0756.2008.00786.x

A 62-year old para 4 with a history of a radical hysterectomy followed by radiotherapy for endometrial carcinoma was seen shortly after insertion of a pessary for a total vault prolapse. On follow-up the pessary couldn't be retrieved. An abdominal X-ray revealed the pessary in the abdominal cavity and it had to be removed by means of a laparotomy. Fistula and defects have been reported both in longstanding pessary use and as long-term complication in radical surgery with radiotherapy. In view of potential - though rare - serious complications, adequate follow-up in pessary use is therefore mandatory. Adequate diagnostic investigations are essential in deciding on an appropriate approach for rare cases like these.

Matched MeSH terms: Endometrial Neoplasms/radiotherapy

Managing complications of radiation therapy in head and neck cancer patients: Part III. Provision of dentures

Rahman RA, Ngeow WC, Chai WL, Ramli R

Singapore Dent J, 2006 Dec;28(1):7-10.

PMID: 17378335

Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Pretreatment dental assessment should be provided for these patients before they undergo radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally and, as a result, they succumb to complicated oral adverse effects after radiation therapy. The management of radiation-induced caries, a sequelae of xerostomia has been reviewed in Part II of this series. In this article, the management of difficulty with dentures, another sequelae of xerostomia following radiation therapy is reviewed.

Matched MeSH terms: Head and Neck Neoplasms/radiotherapy*

Managing complications of radiation therapy in head and neck cancer patients: Part V. Management of mucositis

Ngeow WC, Chai WL, Rahman RA, Ramli R

Singapore Dent J, 2006 Dec;28(1):16-8.

PMID: 17378337

Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Where possible, pretreatment dental assessment shall be provided for these patients before they undergo radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally for radiation therapy. Because of this, they succumb to complicated oral adverse effects after radiation therapy. The second last part of this series reviews and discusses the management of complication that commonly occur to the oral mucosa, i.e. mucositis.

Matched MeSH terms: Head and Neck Neoplasms/radiotherapy*

Fulltext Acquired nasal posterior choanal atresia: postradiotherapy

Marina MB, Gendeh BS

Med J Malaysia, 2006 Mar;61(1):94-6.

PMID: 16708742

Reported cases of acquired posterior choanal atresia are very few in the English literature. A case of acquired posterior choanal atresia post radiotherapy is reported which was treated by endonasal endoscopic repair using microdebrider with untoward effect.

Matched MeSH terms: Nasopharyngeal Neoplasms/radiotherapy

Fulltext Delayed complication of radiotherapy: laryngeal fibrosis and bilateral vocal cord immobility

Prepageran N, Raman R

Med J Malaysia, 2005 Aug;60(3):377-8.

PMID: 16379198

Radiotherapy is the accepted treatment for early laryngeal carcinomas with the advantage of voice preservation. It is however, not without complications. We report a case of bilateral vocal cord immobility 15 years after radiotherapy. This appears to be due to ankylosis of cricoarytenoid joint and fibrosis of the larynx.

Matched MeSH terms: Laryngeal Neoplasms/radiotherapy*

Fulltext Bayesian inference of the Weibull model based on interval-censored survival data

Guure CB, Ibrahim NA, Adam MB

Comput Math Methods Med, 2013;2013:849520.

PMID: 23476718 DOI: 10.1155/2013/849520

Interval-censored data consist of adjacent inspection times that surround an unknown failure time. We have in this paper reviewed the classical approach which is maximum likelihood in estimating the Weibull parameters with interval-censored data. We have also considered the Bayesian approach in estimating the Weibull parameters with interval-censored data under three loss functions. This study became necessary because of the limited discussion in the literature, if at all, with regard to estimating the Weibull parameters with interval-censored data using Bayesian. A simulation study is carried out to compare the performances of the methods. A real data application is also illustrated. It has been observed from the study that the Bayesian estimator is preferred to the classical maximum likelihood estimator for both the scale and shape parameters.

Matched MeSH terms: Breast Neoplasms/radiotherapy

Fulltext Oropharyngeal flora changes in patients with head and neck malignancy post radiotherapy

Muthu K, Raman R, Gopalakrishnan G

Med J Malaysia, 2004 Dec;59(5):585-90.

PMID: 15889559

Radiotherapy has been recognized as a valuable modality of treatment in the management of head and neck cancers. It can have a direct bactericidal effect on the normal flora of the oropharynx. The objective of this study is to determine the changes in the oropharyngeal flora after external beam radiation. This prospective non randomized control study was performed to aid in identification of organisms involved in sepsis, as well as aid in choosing appropriate antibiotics for surgical procedures in irradiated patient. Forty patients with various head and neck malignancy and thirty control patients were selected. Oropharyngeal swabs were taken prior to radiotherapy, at the end and one month after radiotherapy. A single swab was taken from the control group. A full bacteriological analysis was performed. There was a statistically significant decrease in Alpha Hemolytic Streptococci and Neisseria species post radiotherapy. B Proteus and Candida Albicans showed a statistical significant increase in patients with head and neck cancer post radiotherapy. These changes remained even one month after radiotherapy.

Matched MeSH terms: Head and Neck Neoplasms/radiotherapy*

Outcome of Palliative and Radical Radiotherapy in Patients with Oral Squamous Cell Carcinoma - a Retrospective Study

Rai NP, Divakar DD, Al Kheraif AA, Ramakrishnaiah R, Mustafa SM, Durgesh BH, et al.

Asian Pac J Cancer Prev, 2015;16(16):6919-22.

PMID: 26514468

BACKGROUND: The treatment selection for the oral squamous cell carcinoma remains controversial. Radiation therapy or surgical excision of the lesion can be applied as the sole treatment or it can be used in combination with other treatment modalities. Radiotherapy is considered to be the safest of all the treatment modalities and can be used in several situations for oral and oropharyngeal cancers. The aim of this study was to evaluate the survival outcome differences in patients treated with radical and palliative radiotherapy as the primary treatment modality.

MATERIALS AND METHODS: The study included a total of 47 patients with oral cancer reporting to our hospital between years 2009 to 2010. The age group for the selected patients was more than 65 years, treated with radical and palliative radiotherapy with no prior surgical interventions. Patients were evaluated till Dec 2013 for overall survival time.

RESULTS: Twenty nine patients were treated with radical radiotherapy as main stay of treatment, out of which 21 died during the follow up time with median survival of 352 ± 281.7 days with 8 patients alive. All the 16 patients were dead who received palliative radiotherapy with a median survival time of 112 ± 144.0 days.

CONCLUSIONS: This retrospective study showed improved overall survival time, loco regional control rates and reduced morbidity in patients treated with radical radiotherapy when compared to patients treated with palliative radiotherapy.

Matched MeSH terms: Mouth Neoplasms/radiotherapy*

Combined endoscopic transnasal and transoral approach for extensive upper cervical osteoradionecrosis

Tan SH, Ganesan D, Rusydi WZ, Chandran H, Prepageran N, Waran V

Eur Spine J, 2015 Dec;24(12):2776-80.

PMID: 26210311 DOI: 10.1007/s00586-015-4153-1

PURPOSE: Osteoradionecrosis (ORN) is a rare yet well-recognized complication following radiotherapy to the head and neck. We illustrate the only case of a spontaneous extrusion of the sequestered C1 arch through the oral cavity and discuss our experience with a combined endoscopic transnasal and transoral approach for cervical ORN.

METHODS: A 56-year-old female presented with a 3-month history of blood-stained nasal discharge. She had been treated with radiotherapy for nasopharyngeal carcinoma 25 years earlier. Flexible nasal endoscopy demonstrated an exposed bone with an edematous posterior nasopharyngeal mass. Computed tomography showed a pre-vertebral mass with destruction of C1 and C2. She underwent occipito-cervical fusion followed by a combined transnasal and transoral endoscopic debridement of non-viable bone in the same perioperative setting. Healing of the raw mucosa was by secondary intention and reconstruction was not performed.

RESULTS: Histopathological examination reported ulcerated inflamed granulation tissue with no evidence of malignancy. During follow-up, she remained neurologically intact with no recurrence.

CONCLUSION: Using both nasal and oral spaces allows placement of the endoscope in the nasal cavity and surgical instruments in the oral cavity without splitting the palate. Hence, the endoscopic transnasal and transoral approach has vast potential to be effective in carefully selected cases of cervical ORN.

Matched MeSH terms: Nasopharyngeal Neoplasms/radiotherapy

Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

Yahya N, Ebert MA, Bulsara M, Haworth A, Kennedy A, Joseph DJ, et al.

Radiother Oncol, 2015 Jul;116(1):112-8.

PMID: 26163088 DOI: 10.1016/j.radonc.2015.06.011

To identify dosimetry, clinical factors and medication intake impacting urinary symptoms after prostate radiotherapy.

Matched MeSH terms: Prostatic Neoplasms/radiotherapy*

Anesthetic management of a parturient with superior vena cava obstruction for cesarean section

Chan YK, Ng KP, Chiu CL, Rajan G, Tan KC, Lim YC

Anesthesiology, 2001 Jan;94(1):167-9.

PMID: 11135739

Matched MeSH terms: Mediastinal Neoplasms/radiotherapy*

Fulltext A successful pregnancy outcome in treated vulval rhabdomyosarcoma

Ariza M, Rafaee T, Adeeb N, Muhaizan WM, Isa MR

Med J Malaysia, 1999 Sep;54(3):371-3.

PMID: 11045067

A 14 year old girl presented in 1986 with a huge perineal swelling which was progressively increasing in size and associated with loss of weight and loss of appetite. Biopsy from the mass revealed rhabdomyosarcoma of the vulva. She was treated with chemotherapy and radium implant. She responded well to the regime. Fibrosis of the vulva and vagina caused difficulty in consummation. Once it was corrected, she conceived easily and proceeded to a normal pregnancy and delivery.

Matched MeSH terms: Vulvar Neoplasms/radiotherapy*

Fulltext Papillary adenocarcinoma of the nasopharynx--case report and review of the literature

Nojeg MM, Jalaludin MA, Jayalakshmi P

Med J Malaysia, 1998 Mar;53(1):104-6.

PMID: 10968147

We report a rare tumour of the nasopharynx- papillary adenocarcinoma. This is usually of low grade and certainly in out patient it behaved so. It is even rarer to have this tumour in a patient with Turner's syndrome in whom there is a high incidence of gynaecological malignancy. It has not previously been documented and the occurrence in this patient is probably coincidental.

Matched MeSH terms: Nasopharyngeal Neoplasms/radiotherapy*

Fulltext Radiotherapy in locally advanced cancer of the cervix

Biswal BM, Rath GK, Joshi RC, Mohanti BK, Ganesh T, Singh R

Med J Malaysia, 1998 Mar;53(1):30-6.

PMID: 10968134

Radical radiotherapy is considered as the treatment of choice in locally advanced cancer cervix. In late stages radiotherapy produce optimum palliation and to some extent cure. Three hundred cases of cancer cervix (stage I-IV) comprising stage-I (7), stage-II (144), stage-III (145) and stage IV (4) were evaluated and treated with radiotherapy between April 1990 to July 1994. FIGO stage IB, IIA and IIB (early), were treated with predominant intracavitary radiotherapy (34 Gy X 2 fractions; within one week) followed by external pelvic radiotherapy to a dose of 36 Gy in 18 fractions; treating 200 cGy per fraction, 5 days a week. The late stage (stage-IIB, IIIA and IIIB, IVA) of disease were managed with initial external radiotherapy to a dose of 50 Gy, followed by a single intracavitary dose of 30 Gy to point-A. The median follow up was 33 months (range 12-72 months). The tumor volume less than 100 cc were associated with better survival than volume more than 100 cc (p < 0.05). The five year actuarial survival was 83%, 68% and 58% respectively in FIGO stage I-III disease. There were 0.33% and 2.6% late grade-III bladder and rectal complications. Our experience shows effectiveness of radiotherapy in the management of locally advanced cancer of the cervix.

Matched MeSH terms: Uterine Cervical Neoplasms/radiotherapy*

A simplified approach for exit dose in vivo measurements in radiotherapy and its clinical application

Banjade DP, Shrestha SL, Shukri A, Tajuddin AA, Bhat M

Australas Phys Eng Sci Med, 2002 Sep;25(3):110-8.

PMID: 12416587

This is a study using LiF:Mg;Ti thermoluminescent dosimeter (TLD) rods in phantoms to investigate the effect of lack of backscatter on exit dose. Comparing the measured dose with anticipated dose calculated using tissue maximum ratio (TMR) or percentage depth dose (PDD) gives rise to a correction factor. This correction factor may be applied to in-vivo dosimetry results to derive true dose to a point within the patient. Measurements in a specially designed humanoid breast phantom as well as patients undergoing radiotherapy treatment were also been done. TLDs with reproducibility of within +/- 3% (1 SD) are irradiated in a series of measurements for 6 and 10 MV photon beams from a medical linear accelerator. The measured exit doses for the different phantom thickness for 6 MV beams are found to be lowered by 10.9 to 14.0% compared to the dose derived from theoretical estimation (normalized dose at dmax). The same measurements for 10 MV beams are lowered by 9.0 to 13.5%. The variations of measured exit dose for different field sizes are found to be within 2.5%. The exit doses with added backscatter material from 2 mm up to 15 cm, shows gradual increase and the saturated values agreed within 1.5% with the expected results for both beams. The measured exit doses in humanoid breast phantom as well as in the clinical trial on patients undergoing radiotherapy also agreed with the predicted results based on phantom measurements. The authors' viewpoint is that this technique provides sufficient information to design exit surface bolus to restore build down effect in cases where part of the exit surface is being considered as a target volume. It indicates that the technique could be translated for in vivo dose measurements, which may be a conspicuous step of quality assurance in clinical practice.

Matched MeSH terms: Neoplasms/radiotherapy*

Delayed post-irradiation bulbar palsy in nasopharyngeal carcinoma

Chew NK, Sim BF, Tan CT, Goh KJ, Ramli N, Umapathi P

Neurology, 2001 Aug 14;57(3):529-31.

PMID: 11502928

In a hospital series of 70 patients on follow-up after radiotherapy for nasopharyngeal carcinoma, 14 patients (20%) developed delayed post-irradiation bulbar palsy 1 to 18 years after radiotherapy (mean 5.5 years). Functional disability was moderate to severe. Three patients had aspiration pneumonia with one mortality. Post-irradiation bulbar palsy was a common complication and probably resulted from direct neuronal damage.

Matched MeSH terms: Nasopharyngeal Neoplasms/radiotherapy*

Displaying publications 41 - 60 of 149 in total