ABSTRACT
BACKGROUND: Acral melanoma involve the non-pigmented palmoplantar and subungual areas and are commonly seen among Asians. Patients commonly display advanced stage of disease at presentation. It may appear unnoticed and mimic benign lesions. METHODS: Data for this retrospective study was retrieved from Histopathology Unit, Sarawak General Hospital, Malaysia archive from 2003 to 2009. RESULT: 62.3% cases of malignant melanoma were acral melanoma. The mean age of diagnosis was 64.3 +/- 12.1. The involved sites were the heel (39.4%), middle and frontal plantar area (24.2%), toe (24.2%) and web spaces (9.1%). The clinical presentations were; an enlarging mass (60.6%), non-healing ulcer (24.2%) and abnormal pigmented lesion (15.2%). Most cases exhibited Breslow thickness >4.00 mm (87.9%) and Clark's levels V (50%). The majority showed moderate (non brisk) tumour infiltrating lymphocytes (57.6%). Ulceration (84.8%) and lymphovascular involvement were seen (24.2%). CONCLUSION: Acral melanoma is the commonest malignant melanoma in this Sarawakian cohort. Most of the cases presented with advanced stage disease.
Subject(s)
Melanoma/pathology , Skin Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Extremities , Female , Humans , Malaysia , Male , Middle Aged , Neoplasm Staging , Retrospective StudiesABSTRACT
Fungal osteomyelitis is a rare opportunistic infection. It exhibits some clinical and radiological similarities to several other bone pathologies. A diagnostic delay may result in significant increase in morbidity. We report a case of a 37-year-old man with underlying hypogammaglobulinaemia presented with isolated cryptococcal osteomyelitis of the femur.
Subject(s)
Cryptococcosis/diagnosis , Cryptococcosis/pathology , Cryptococcus/isolation & purification , Femur/pathology , Osteomyelitis/diagnosis , Osteomyelitis/pathology , Adult , Agammaglobulinemia/complications , Agammaglobulinemia/diagnosis , Biopsy , Cryptococcosis/microbiology , Femur/diagnostic imaging , Histocytochemistry , Humans , Male , Microscopy , Osteomyelitis/microbiology , RadiographyABSTRACT
Fungal osteomyelitis is a rare opportunistic infection. It exhibits some clinical and radiological similarities to several other bone pathologies. A diagnostic delay may result in significant increase in morbidity. We report a case of a 37-year-old man with underlying hypogammaglobulinaemia presented with isolated cryptococcal osteomyelitis of the femur.
ABSTRACT
Major congenital malformations occur in about 3% of newborn. Several studies have suggested that homozygosity for the C677T methylenetetrahydrofolate reductase (MTHFR) variant is a potential risk factor for neural tube defects (NTDs). It has been hypothesized that the maternal folic acid supplementation prevents NTDs by partially correcting reduced MTHFR activity associated with the variant form of the enzyme. This association has not been found in some ethnic groups. In this study, we attempted to assess the association between NTDs and MTHFR C677T in Malaysian Malay population. Results show that MTHFR 677TT genotype was absent in both patient and control groups.
Subject(s)
Gene Frequency , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Neural Tube Defects/genetics , Polymorphism, Genetic/genetics , Case-Control Studies , Child , Child, Preschool , Female , Genotype , Humans , Malaysia , Male , Mutation, MissenseABSTRACT
OBJECTIVE: We report a rare case of sinonasal hybrid tumour within an inverted papilloma. METHOD: The patient's case history and course of management are presented. The relevant medical literature are reviewed and discussed. RESULTS: A 60-year-old man presented with unilateral nasal obstruction associated with anosmia. An ENT examination revealed a unilateral, left nasal mass. A provisional diagnosis of inverted papilloma was made. The patient underwent a transnasal endoscopic excision of the tumour, which was unfortunately complicated by a cerebrospinal fluid leak. Further treatment of this patient is described. We highlight the features of associated malignancy in inverted papilloma, and the importance of thorough histopathological examination of tissue specimens. CONCLUSION: Treatment of inverted papilloma with limited involvement of the skull base can be successfully achieved by endoscopic excision. A high index of clinical suspicion, together with meticulous histopathological examination, will enable diagnosis of associated malignancy. This will ensure that appropriate adjuvant treatment is given, resulting in a good clinical outcome.
