Mesenchymal chondrosarcoma is a rare disease with poor prognosis. Treatment including wide or radical excision is very important. Radiotherapy and chemotherapy are additional treatment options, but no conclusive results for their efficacy have been shown until date. Imaging modalities can give important clues for diagnosis and management planning. Angioembolization before surgery could be useful as prophylaxis to control intraoperative bleeding, increasing the likelihood of complete resection.
Chondrosarcoma, Mesenchymal ; Rare Diseases

Central venous catheter placement is indicated in patients requiring long-term therapy. With repeated venous catheterisations, conventional venous access sites can be exhausted. This case illustrates the expanding role of radiology in managing difficult venous access. We present a case of translumbar, transhepatic, and transcollateral placement of central catheter in a woman with a difficult venous access problem who required lifelong parenteral nutrition secondary to short bowel syndrome. This case highlights the technical aspects of interventional radiology in vascular access management.

Background: Superselective embolisation has been recognised as integral in the management of lower gastrointestinal haemorrhage. It has also reduced the need for emergency surgery. The objective of this case series was to describe the lower gastrointestinal haemorrhage cases seen in our centre, its diagnosis and the role of superselective embolisation in patient management. Methods: All patients who underwent superselective embolisation from January 2008 until April 2009 in our centre were analysed. Data were collected from the hospital electronic medical records. Results: Four patients (three males) with a mean age of 81 years were analysed. Multidetector computerised tomography and digital subtraction angiography were positive in all patients. Superselective embolisation with platinum microcoils was performed in all patients (n = 4). Technical success was achieved in all patients (100%). Conclusion: Superselective embolisation in the treatment of lower gastrointestinal haemorrhage is safe and effective with a very high technical success rate.

We report a rare case of Arteriovenous malformation (AVM) of the scalp in a 30 year-old Malay gentleman who presented with painless forehead swelling since birth. Magnetic Resonance Imaging (MRI) and cerebral angiogram performed and the findings are discussed

Brain ; pathology ; Demyelinating Diseases ; complications ; diagnosis ; pathology ; Encephalomyelitis ; complications ; diagnosis ; pathology ; Fatal Outcome ; Humans ; Leukoencephalitis, Acute Hemorrhagic ; complications ; diagnosis ; pathology ; Magnetic Resonance Imaging ; Male ; Young Adult

Introduction: The present study aimed to characterize the MRI features of intracranial primary central nervous system lymphoma (PCNSL) in the Malaysian population, and to compare the findings with other population-based studies. Methods: Twenty-four patients with histologically confirmed PCNSL from 2008 to 2014 were identified. Eighteen patients had MRI images at presentation available for review. The images were reviewed by two radiologists, noting the number, size, location, signal characteristics, perilesional oedema and characteristics of enhancement of the lesions. Results: Ten patients had solitary lesions, while 8 patients had multiple lesions with a total of 31 lesions. The lesions were mostly located in the frontal lobe and basal ganglia. Most lesions were hypointense on T1 sequences, hyperintense on T2 sequences, with moderate to marked perilesional oedema. All lesions showed contrast enhancement. Five lesions demonstrated the ‘notch sign’, 1 lesion showed ‘open-ring’ pattern of enhancement and 1 lesion had a non-enhancing core. Seventeen lesions demonstrated an uneven enhancement pattern, mainly in lesions that are abutting the ventricular margins. Conclusion: MRI findings of patients with PCNSL in our population concur with other population-based studies. Enhancement patterns like the ‘notch sign’, ‘open-ring’, and uneven enhancement are not uncommon in PCNSL.

Stroke care service in Malaysia is suboptimal despite the fact that it is one of the commonest cause of death. This is due to several limitations, including lack of resources and funding for the stroke care establishment and the management itself. Alternatively, other regions have come up with numerous ways to combat the difficulties in order to provide better stroke care services. We have identified the overwhelming benefits of creating stroke care units, thrombolysis services, and endovascular thrombectomy. For this reason, we designed a Regional Emergency Stroke Quick Response Network (RESQ) based on the needs of the current situation in Malaysia. With a standardised RESQ training, we hope to achieve close-knitted cooperation in between the emergency medical services, emergency department team and the RESQ, which subsequently will create an ideal improvised stroke care units.