CASE PRESENTATION: We present a case report of a parapharyngeal space mass that was found to be pleomorphic adenoma of minor salivary gland, their clinical presentation, radiological imaging and literature review of the transoral surgical approaches for parapharyngeal tumour.
DISCUSSION AND CONCLUSION: The transoral approach remains one of the classical and effective methods for the resection of the benign prestyloid parapharyngeal tumour. The surgeons need to have a good knowledge of diagnostic imaging and surgical techniques to determine which surgical procedure is the best for the patients in order to eradicate the diseases and minimize the complications ultimately.
CASE REPORT: We experienced a patient presented with painless right neck swelling and hard tonsillar hypertrophy for past six month. Computer tomography showed the tumour extended to the parapharyngeal space and metastasized to the thoracolumbar vertebras. The intraoral biopsy of the tonsil confirmed primary small cell neuroendocrine carcinoma of the tonsil. The clinical presentation, radiological imaging, histopathological investigations, and methods of treatment are discussed.
CONCLUSIONS: Due to the rarity of this disease, there is no definitive treatment yet for this disease. The physicians must thoroughly understand the nature and characteristic of the disease to find the best treatment. The latest discoveries in chemotherapy drugs and radiotherapy may improve the treatment modalities in the future.
METHODS: A total of 22 consented participants with facial palsy was assessed with photos and videography recordings where they performed 10 standard facial expressions. The severity of facial paralysis was evaluated with the House-Brackmann, Sydney, and Sunnybrook grading scales subjectively and with the facial nerve conduction study objectively. The assessments were repeated after 3 months.
RESULTS: A Wilcoxon signed-rank test showed that there were statistically significant change in all three gradings after 3-month of assessment. The responsiveness of the nerve conduction study was significant for the nasalis and orbicularis oris muscles. It was not significant for the orbicularis oculi muscle. The nasalis and orbicularis oculi showed statistically significant correlation with the three classification systems except for the orbicularis oculi muscle.
CONCLUSIONS: All three grading systems, House-Brackmann, Sydney, and Sunnybrook, showed statistically significant responsiveness after 3 months of evaluation. The nasalis and orbicularis oculi muscle can be used to predict facial palsy recovery because they showed strong positive and negative correlations with the extent of facial nerve degeneration from the nerve conduction study.
AIM: This work investigated the occurrence of chromosome aberrations in Rusa timorensis, Rusa unicolor and Axis axis raised in a nucleus deer farm in Malaysia with a history of declining fertility of unknown origin.
MATERIALS & METHODS: Blood samples were collected from 60 animals through venipuncture, cultured for 72 h and arrested at metaphase. SmartType® and Ideokar® software were used to karyotype the chromosomes.
RESULTS: We found 15 out of the 60 animals screened from both sexes harbor some form of chromosome aberration. Chromosomal aberrations exist at the rate of 25% and may not be unconnected with the observed reduced fertility on the farm. Further investigations should be carried out, especially on the offspring of the studied animals to transmission of these aberrations. The animals that are confirmed to transmit the chromosomal aberrations should be culled to arrest the propagation of their abnormalities.
METHODS: This cross-sectional study included all SGT cases undergoing surgical resection at Hospital Universiti Sains Malaysia (HUSM) and Hospital Raja Perempuan Zainab II (HRPZ) in Malaysia from April 2022 to April 2023. IHC staining was performed on paraffin-embedded tissues at the Pathology Laboratory, HUSM, to evaluate the expression of p16, HPV16-L1, and HPV18-E6 oncoproteins. The clinicopathological data were correlated with the staining results.
RESULTS: 49 SGT cases were identified, mainly in middle-aged Malay women, with most tumours originating from the parotid gland. Malignant tumours included mucoepidermoid carcinoma (22.4%), adenoid cystic carcinoma (4.1%), acinic cell carcinoma (4.1%), and adenocarcinoma (2%). Benign tumours primarily consisted of pleomorphic adenoma (49%) and Warthin tumours (16.3%). Positive p16 expression was detected in 67% of cases, while HPV16 and HPV18 were detected in 65% and 90% of tumours, respectively. HPV16-L1 exhibited 75.8% sensitivity and 56.3% specificity, while HPV18-E6 showed 100% sensitivity and 31.2% specificity compared to p16.
CONCLUSION: The study findings suggest a correlation between the presence of high-risk HPV types 16 and 18 and the development of SGT, as evidenced by the overexpression of p16, HPV16-L1, and HPV18-E6 oncoproteins. Both HPV16-L1 and HPV18-E6 tests are acceptable, reliable, and sensitive for detecting high-risk HPV in SGT.
METHODS: A cross-sectional multicentre study with tissue analysis of Malaysian patients diagnosed with primary OPSCC within a five-year period, from 2015 to 2019 between 01/01/2015 to 31/12/2019 was undertaken. Determination of HPV status was carried out using p16INK4a immunohistochemistry on tissue microarrays constructed from archived formalin-fixed paraffin-embedded tissue.
RESULTS: From the cases identified, 184 cases had sufficient tissue material for analysis. Overall, median age at diagnosis was 63.0 years (IQR = 15) and 76.1% of patients were males. In our cohort, 35.3% of patients were Indian, 34.2% were Chinese, 21.2% were Malay and 9.2% were from other ethnicities. The estimated prevalence of HPV-associated OPSCC in our cohort was 31.0% (CI 24.4-38.2%). The median age for the HPV-associated OPSCC sub-group of patients was not significantly lower than the median age of patients with HPV-independent OPSCC. More than half of HPV-associated OPSCC was seen in patients of Chinese ethnicity (54.4%). Patients with HPV-associated OPSCC had a much better overall survival than patients with HPV-independent OPSCC (Log rank test; p