MyMedR

An unexpected case of primary peritoneal carcinoma

Nur-Syahrina R, Siti-Aishah MA, Swaminathan M, Ng PH, Ismail S, Syazarina SO, et al.

Clin Ter, 2010;161(3):261-3.

PMID: 20589359

Primary peritoneal carcinoma (PPC) is a rare tumor that is histologically and immunohistochemically indistinguishable from epithelial ovarian carcinoma. The diagnosis is usually made after excluding gross ovarian involvement or the ovarian involvement is only confined to the surface. A 68-year-old lady presented with right iliac fossa pain and increasing CA125. The CT scan showed bilateral pelvic adnexal masses with peritoneal deposits within the right side of abdomen. She was initially diagnosed as carcinomatosis peritonei from the omental cake removed after exploratory surgery. She was managed as advanced ovarian tumor with peritoneal metastasis and was then administered six cycles of chemotherapy. Surgical intervention included debulking surgery consisting of total abdominal hysterectomy, bilateral salpingooophorectomy and omentectomy and also with right hemicolectomy. The histopathological findings were of primary peritoneal serous carcinoma with only minimal involvement of the serosal surface of the right ovarian capsule. No microscopic invasion into underlying ovarian cortex and stroma was observed. Multiple tumor deposits were also seen over the right paratubal and paraovarian tissue, both parametrium as well as serosal surface of the terminal ileum and periappendicular tissue. Immunohistochemically, the malignant cells were positive to CA125, focally positive to CK7 and negative to CD20 and Calretinin. PPC is one of important differential diagnosis which needs to be considered in cases of advanced ovarian tumor, although the former can only be ascertained after excluding the ovarian involvement microscopically.

Matched MeSH terms: Carcinoma/diagnosis*

Fulltext Thyroid papillary carcinoma in a 'hot' thyroid nodule

Kuan YC, Tan FH

QJM, 2014 Jun;107(6):475-6.

PMID: 24106316 DOI: 10.1093/qjmed/hct204

Matched MeSH terms: Carcinoma/diagnosis*

Fulltext Solid variant of papillary thyroid carcinoma in a 14-year-old girl

Abdul Rahman WF, Md Hashim MN, Win TT, Bakrin IH

BMJ Case Rep, 2013;2013.

PMID: 23749834 DOI: 10.1136/bcr-2013-010001

Solid variant of papillary thyroid carcinoma (PTC) is a rare, poorly characterised variant and predominantly reported in children with a history of radiation exposure. This variant has a high propensity for extra-thyroidal extension and cervical lymph node metastases. A 14-year-old Malay girl who had no history of radiation exposure, presented with multiple cervical lymphadenopathy and it was clinically suspicious for tuberculosis or lymphoma. An incisional biopsy revealed a metastatic PTC. The patient underwent total thyroidectomy with bilateral lateral neck dissection and histopathology report was solid variant of PTC. Whole-body I(131) scan was performed which revealed an intense tracer uptake in the neck. She was planned for radioactive iodine ablation and now on regular follow-up for monitoring of possible tumour metastasis.

Matched MeSH terms: Carcinoma/diagnosis*

Fulltext Primary clear cell carcinoma of minor salivary gland of the soft palate: a case report

Saleh KA, Nurishmah MI, Firouzeh GN, Goh BS

Med J Malaysia, 2012 Jun;67(3):335-6.

PMID: 23082431 MyJurnal

Clear cells can be found in numerous salivary and non-salivary tumors in the head and neck region, including metastatic lesions. They are rare low-grade tumors accounting for less than 1% of all salivary gland tumors and occur almost exclusively in the intra-oral minor salivary glands. Hyalinizing clear cell carcinoma (HCCC) is an extremely rare and recently described neoplasm predominantly affecting the oral cavity. Histologically, it is characterized by nests of glycogen-rich monomorphic clear cells within a hyaline stroma. HCCC often follows an indolent course with a limited metastatic potential. It is therefore important to differentiate this entity from other more aggressive clear cell tumors including metastatic tumors such as renal cell carcinoma. We hereby report a case of HCCC localized in minor salivary glands specifically in soft palate for its rarity, as well as to discuss the role of immunohistochemical stains, essential for its definitive diagnosis.

Matched MeSH terms: Carcinoma/diagnosis

Fulltext Diffuse peritoneal lymphomatosis simulating peritoneal carcinomatosis

Sharifah MI, Zamzami NA, Rafeah TN

Med J Malaysia, 2011 Aug;66(3):270-2.

PMID: 22111459 MyJurnal

Burkitt's lymphoma is a form of Non-Hodgkin's B-cell lymphoma. We report a case of Burkitt's lymphoma mimicking peritoneal carcinomatosis. We will discuss the imaging and clinical findings that differentiate between peritoneal carcinomatosis and Burkitt's lymphoma. A 26-year-old man presented with nonspecific abdominal pain, vomiting and diarrhea associated with significant amount of loss of weight. Computed tomography images showed extensive peritoneal and mesenteric mass associated generalized lymphadenopathy. Core biopsy of the mass confirmed Burkitt's lymphoma. CT scan features are helpful indicator to differentiate Burkitt's lymphoma and peritoneal carcinomatosis. Focal or diffuse nodular thickening of the bowel wall with extensive lymphadenopathy are likely to be lymphomatosis over carcinomatosis. However, final and confirmatory diagnosis is histopathology examination.

Matched MeSH terms: Carcinoma/diagnosis*

Electro-navigational bronchoscopy for bilateral peripheral lung lesions: A case report

Faisal AH, Sopian AW, Tidi H

Med J Malaysia, 2017 08;72(4):241-243.

PMID: 28889136 MyJurnal

Electromagnetic navigational bronchoscopy (ENB), one of the methods of navigational bronchoscopy is an advanced diagnostic tool allowing tissue sampling at the lung peripheries which were previously accessible only by computed tomography (CT) guidance or video-assisted thoracoscopic surgery (VATS). We report a 53-year-old man who presented with a cough and dyspnea with constitutional symptoms for one month. CT thorax revealed multiple bilateral peripheral lung nodules and there were no endobronchial lesions on flexible bronchoscopy. ENB was performed using a loan machine from Veran navigational technology. Biopsy successfully revealed small cell carcinoma of the lung thus preventing him from undergoing a more invasive diagnostic procedure. This case highlights the utility of ENB in the evaluation of peripheral lung nodules that were inaccessible by conventional bronchoscopy. This is one of the first few successful applications of Veran ENB in Asia.

Matched MeSH terms: Small Cell Lung Carcinoma/diagnosis*

Fulltext The problem of uterine cervical carcinoma in Singapore and West Malaysia

Chan LKC

Singapore Med J, 1970 Sep;11(3):140-6.

PMID: 5472054

Matched MeSH terms: Carcinoma/diagnosis

Fulltext Nasopharyngeal carcinoma: recognizing it early in children with otitis media with effusion

Noorizan Y, Chew YK, Khir A, Brito-Mutunayagam S

Med J Malaysia, 2008 Aug;63(3):261-2.

PMID: 19248706 MyJurnal

Nasopharyngeal carcinoma (NPC) is a rare disease in children. Children with NPC almost always have the undifferentiated variant of the disease, which is associated with advanced locoregional and distant metastasis. We report two cases to illustrate that high index of suspicion is necessary to diagnose NPC in children especially those with atypical presentation of otitis media with effusion (OME).

Matched MeSH terms: Carcinoma/diagnosis*

Leiomyosarcoma of the breast: report of a case with fine needle aspiration cytologic, histologic and immunohistochemical features

Jayaram G, Jayalakshmi P, Yip CH

Acta Cytol., 2005 Nov-Dec;49(6):656-60.

PMID: 16450908

BACKGROUND: Leiomyosarcoma of the breast is a rare neoplasm. We present a case of primary leiomyosarcoma of the breast in a middle-aged female in whom fine needle aspiration cytologic features suggested sarcoma.

CASE: A 55-year-old female presented with a rapidly growing breast lump of 1 month's duration. On examination, an ulcerating, 12 x 10 cm tumor was seen involving the lower medial and lateral quadrants of the right breast. Fine needle aspiration cytology showed variably sized, dissociated and loosely clustered polygonal, plump and spindle cells with pale blue cytoplasm and vesicular nuclei that were round, oval or irregular. Occasional giant forms and nucleolated and mitotic cells were present. A single cluster of benign ductal cells was seen. The tumor cells did not express immunocytologic reactivity to estrogen receptor protein. A cytologic diagnosis of sarcoma was given with differential diagnoses of metaplastic carcinoma and malignant phyllodes tumor. Histologic study established the diagnosis of leiomyosarcoma. Leiomyosarcoma of the breast shows fine needle aspiration cytologic features of sarcoma, but specific tumor typing may not be possible, especially when the cytologic material is inadequate for ancillary staining required to distinguish leiomyosarcoma from metaplastic carcinoma and malignant phyllodes tumor.

Matched MeSH terms: Carcinoma/diagnosis

Comparative study of cytologic and colposcopic findings in preclinical cervical cancer

Maziah AM, Sharifah NA, Yahya A

Malays J Pathol, 1991 Dec;13(2):105-8.

PMID: 1823091

Seventy-seven patients who had PAP smear cytology and colposcopic examination in a 2-year period between 1988 and 1989 were reviewed. Those with findings indicative or suspicious of malignancy were subjected to biopsy. All 50 patients thus biopsied were confirmed to have preclinical cancer on histological examination. Compared against histology, PAP smear cytology gave an accuracy rate of 90% (5 false negatives) and colposcopy gave an accuracy rate of 94% (3 false negatives). These results demonstrate that the two techniques are useful as screening tests for preclinical cervical cancer. The results are improved if they are used complementarily. However, there was poor specificity in the categorisation of cervical cancer by both methods. This was probably due to the subjectiveness of the two procedures. The study also raised the possibility of a higher incidence of preclinical cervical cancer in the Chinese ethnic group.

Matched MeSH terms: Carcinoma/diagnosis*

Fulltext Ultrasound of the cold thyroid nodule

Alif AK, Meah F

Med J Malaysia, 1984 Jun;39(2):123-6.

PMID: 6392839

Matched MeSH terms: Adenocarcinoma/diagnosis; Carcinoma/diagnosis

Fulltext New directions in gynaecologic oncology

Sivanesratnam V

Med J Malaysia, 1991 Sep;46(3):205-11.

PMID: 1839913

Matched MeSH terms: Carcinoma/diagnosis

Fulltext Clinical presentation of patients with nasopharyngeal carcinoma

Suzina SAH, Hamzah M

Med J Malaysia, 2003 Oct;58(4):539-45.

PMID: 15190630

The poor prognosis for patients with nasopharyngeal carcinoma is principally due to its advanced stage at the time of diagnosis. The symptoms and clinical findings at presentation of 56 patients with confirmed nasopharyngeal carcinoma is described and analysed. Recognising the common modes of presentation is essential to diagnose the disease at an early stage.

Matched MeSH terms: Carcinoma/diagnosis

Fulltext Exome Sequencing Identifies Potentially Druggable Mutations in Nasopharyngeal Carcinoma

Chow YP, Tan LP, Chai SJ, Abdul Aziz N, Choo SW, Lim PV, et al.

Sci Rep, 2017 03 03;7:42980.

PMID: 28256603 DOI: 10.1038/srep42980

In this study, we first performed whole exome sequencing of DNA from 10 untreated and clinically annotated fresh frozen nasopharyngeal carcinoma (NPC) biopsies and matched bloods to identify somatically mutated genes that may be amenable to targeted therapeutic strategies. We identified a total of 323 mutations which were either non-synonymous (n = 238) or synonymous (n = 85). Furthermore, our analysis revealed genes in key cancer pathways (DNA repair, cell cycle regulation, apoptosis, immune response, lipid signaling) were mutated, of which those in the lipid-signaling pathway were the most enriched. We next extended our analysis on a prioritized sub-set of 37 mutated genes plus top 5 mutated cancer genes listed in COSMIC using a custom designed HaloPlex target enrichment panel with an additional 88 NPC samples. Our analysis identified 160 additional non-synonymous mutations in 37/42 genes in 66/88 samples. Of these, 99/160 mutations within potentially druggable pathways were further selected for validation. Sanger sequencing revealed that 77/99 variants were true positives, giving an accuracy of 78%. Taken together, our study indicated that ~72% (n = 71/98) of NPC samples harbored mutations in one of the four cancer pathways (EGFR-PI3K-Akt-mTOR, NOTCH, NF-κB, DNA repair) which may be potentially useful as predictive biomarkers of response to matched targeted therapies.

Matched MeSH terms: Carcinoma/diagnosis*

Primary carcinoma of liver

Islam N, Hasan M, Ali SM

Med J Malaysia, 1977 Jun;31(4):322-5.

PMID: 927240

Matched MeSH terms: Carcinoma/diagnosis*

Cytohistology of morule in cribriform-morular variant of papillary thyroid carcinoma

Sakurai K, Onouchi T, Yamada S, Baba Y, Murata T, Tsukamoto T, et al.

Malays J Pathol, 2019 Dec;41(3):339-343.

PMID: 31901919

INTRODUCTION: Cribriform-morular variant (CMV) is a rare variant of papillary thyroid carcinoma. It frequently occurs in association with familial adenomatous polyposis (FAP), although some cases are sporadic. Herein, we report a case of CMV and analyse morule cytohistology.

CASE REPORT: The patient was a 47-year-old woman with no familial history of FAP. A 3.0-cm unifocal mass was identified in the left thyroidal lobe. Fine-needle aspiration cytology revealed papillary clusters of atypical cells with nuclear grooves, which was suspected to be conventional papillary thyroid carcinoma. Histologically, the tumour comprised a papillary and cribriform growth of atypical cells with cytoplasmic accumulation and nuclear translocation of b-catenin. In addition, frequent morule formation was identified.

DISCUSSION: In this case, we performed morule analysis through correlative light and electron microscopy (CLEM), and revealed its ultrastructure. Although CMV is a rare form of thyroid carcinoma, it should be considered along with its distinct clinicopathological characteristics.

Matched MeSH terms: Carcinoma/diagnosis

Diet and physical activity in relation to weight change among breast cancer patients

Yaw YH, Shariff ZM, Kandiah M, Weay YH, Saibul N, Sariman S, et al.

Asian Pac J Cancer Prev, 2014;15(1):39-44.

PMID: 24528062

BACKGROUND: This study aimed to provide an overview of lifestyle changes after breast cancer diagnosis and to examine the relationship between dietary and physical activity changes with weight changes in breast cancer patients. Women with breast carcinomas (n=368) were recruited from eight hospitals and four breast cancer support groups in peninsular Malaysia. Dietary and physical activity changes were measured from a year preceding breast cancer diagnosis to study entry. Mean duration since diagnosis was 4.86±3.46 years. Dietary changes showed that majority of the respondents had decreased their intake of high fat foods (18.8-65.5%), added fat foods (28.3-48.9%), low fat foods (46.8-80.7%), red meat (39.7%), pork and poultry (20.1-39.7%) and high sugar foods (42.1-60.9%) but increased their intake of fish (42.7%), fruits and vegetables (62.8%) and whole grains (28.5%). Intake of other food groups remained unchanged. Only a small percentage of the women (22.6%) had increased their physical activity since diagnosis where most of them (16.0%) had increased recreational activities. Age at diagnosis (β= -0.20, p= 0.001), and change in whole grain (β= -0.15, p= 0.003) and fish intakes (β= 0.13, p= 0.013) were associated with weight changes after breast cancer diagnosis. In summary, the majority of the women with breast cancer had changed their diets to a healthier one. However, many did not increase their physical activity levels which could improve their health and lower risk of breast cancer recurrence.

Matched MeSH terms: Carcinoma/diagnosis

Cytologic features and differential diagnosis in chondroma of the breast: a case report

Sivakumar S, Kaur G

Acta Cytol., 2009 May-Jun;53(3):303-5.

PMID: 19534271 DOI: 10.1159/000325312

BACKGROUND: Extraskeletal (soft tissue) chondromas are rare neoplasms. They are seen most frequently in the soft tissues of hands and feet. A chondroma occurring in the breast is exceedingly uncommon. We present a case of pure chondroma of the breast in a young woman in whom fine needle aspiration (FNA) cytologic features suggested a cartilaginous neoplasm.

CASE: A 28-year-old woman presented with a mobile lump in the left breast. Mammography showed a high-density nodule without microcalcifications. A clinical diagnosis of fibroadenoma was made. A differential diagnosis was obtained on FNA. Excisional biopsy of the lump showed the histopathologic features of chondroma. There was no recurrence or appearance of new lesion during 13 months of follow-up.

CONCLUSION: Chondroma of the breast shows FNA cytologic features of cartilaginous tumor, but specific tumor typing may not be possible. This case highlights the difficulties that may arise in FNA diagnosis of cartilaginous tumor especially when it occurs at an unusual site. Awareness of the cytologic features combined with clinical and radiologic findings should guide the cytopathologist to make correct diagnosis of this neoplasm.

Matched MeSH terms: Carcinoma/diagnosis

Fulltext Arthritis as an initial presentation of malignancy: two case reports

Sachdev Manjit Singh B, Wan SA, Cheong YK, Chuah SL, Teh CL, Jobli AT

J Med Case Rep, 2021 Feb 23;15(1):94.

PMID: 33618728 DOI: 10.1186/s13256-020-02642-z

BACKGROUND: Arthritis is rarely reported as a paraneoplastic manifestation of occult malignancy. We report herein two cases of paraneoplastic arthritis due to occult malignancy. CASE 1: The patient was a 65-year-old woman of asian descent who was a former smoker with a history of spine surgery performed for L4/L5 degenerative disc disease. She presented with a 1-month history of oligoarthritis affecting both ankle joints and early morning stiffness of about 3 hours. Laboratory tests were positive for antinuclear antibody at a titer of 1:320 (speckled) but negative for rheumatoid factor. She was treated for seronegative spondyloarthritis and started on prednisolone without much improvement. A routine chest radiograph incidentally revealed a right lung mass which was found to be adenocarcinoma of the lung. She was treated with gefitinib and her arthritis resolved. CASE 2: The patient was a 64-year-old woman of asian descent, nonsmoker, who presented with a chief complaint of asymmetrical polyarthritis involving her right wrist, second and third metacarpophalangeal joints, and first to fifth proximal interphalangeal joints. She was treated for seronegative rheumatoid arthritis (RA) and started on sulfasalazine, with poor clinical response. Six months later, she developed abdominal pain which was diagnosed as ovarian carcinoma by laparotomy. Her arthritis resolved following treatment of her malignancy with chemotherapy.

CONCLUSION: In summary, paraneoplastic arthritis usually presents in an atypical manner and responds poorly to disease-modifying antirheumatic drugs. Accordingly, we recommend screening for occult malignancy in patients presenting with atypical arthritis.

Matched MeSH terms: Carcinoma/diagnosis

Nasopharyngeal carcinoma: clinical trends

Indudharan R, Valuyeetham KA, Kannan T, Sidek DS

J Laryngol Otol, 1997 Aug;111(8):724-9.

PMID: 9327009 DOI: 10.1017/s0022215100138460

Nasopharyngeal carcinoma (NPC) is one of the most difficult diseases to diagnose at an early stage. The clinical presentation of 122 patients with confirmed NPC is described and the findings analysed. The common modes of presentation and cases where detailed nasopharyngeal examination need to be performed are highlighted. We emphasize the importance of health education and training for primary care physicians for early detection of these cases.

Matched MeSH terms: Carcinoma/diagnosis*

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