Introduction: Thyroid enlargement is one of the common surgical presentations in the Department of Surgery, Hospital Universiti Sains Malaysia (HUSM). Among them, benign non-toxic multinodular goiter constitutes one third (30%) of patients who underwent thyroidectomy. Common complications of thyroidectomy include recurrent laryngeal nerve (RLN) injury, hypocalcaemia, and recurrence of the thyroid lesion. Objective & Methods: This is a retrospective study of patients diagnosed with multinodular goiter treated in HUSM between January 1996 and December 2005. A total of 111 patients were studied and 52 of them underwent subtotal thyroidectomy while 59 underwent total thyroidectomy. The outcome in terms of RLN injury, hypocalcaemia and mass recurrence were analyzed. Results: Post operative complications were studied in both groups. Permanent recurrent laryngeal nerve injury occurs in 2.4% (1 case) in subtotal thyroidectomy group compared to total thyroidectomy group (3.6%, 2 cases). Five cases from total thyroidectomy group suffered from permanent hypocalcaemia but none in the other group. 70.7% (29 cases) from subtotal thyroidectomy group have functional remnant of thyroid tissue. Recurrence rate post subtotal thyroidectomy after 5 years is only 4.9% (2 cases). Conclusion: The post operative outcome in patients who underwent subtotal thyroidectomy in HUSM from January 1996 to December 2005 was better than total thyroidectomy with significant functional thyroid remnant.

Hypopygiopsis violacea, a species of fly of forensic importance, was recovered from a corpse and described for the first time. The morphological structures of the second and third instar larvae of four specimens were examined using light microscope. Observations were focused on three main morphological characters: cephalopharyngeal skeleton, anterior and posterior spiracles. Cephalopharyngeal skeleton of second instar larva is darkly pigmented and without accessory sclerite below the mouth hook. The anterior spiracles of second and third instar larvae have 8-9 papillae each, arranged in a single row. The posterior spiracle of second instar larva has two spiracular slits with no thickening of peritreme. This differentiates it from the third instar, whereby the latter has three slits for each posterior spiracle. Cephalopharyngeal skeleton of third instar larva is heavily pigmented. An accessory sclerite is found below the hook part of third instar larva but is absent in second instar. Peritreme of the posterior spiracle of third instar larva is thick almost complete encircling a button. The intersegmental spines of the cuticular surface are dome-shaped and unicuspid. Third instar larva of this species is large with size approximately 15 mm long. These findings provide important identification features of immature stages of Hy. violacea which could be useful in forensic entomology.

Primary retroperitoneal cavernous hemangioma is a very rare benign neoplasm. A retroperitoneal hemangioma may be detected accidentally or be symptomatic due to local compression on adjacent structures. We reported on the diagnosis and treatment of a patient with PRCH with a subtle clinical presentation and atypical findings on computed tomography imaging. The patient presented with right hypochondriac discomfort for one month duration. Computed tomography of the abdomen revealed a huge mass arising from right lobe of liver which was compressing the surrounding structures. Intraoperatively there was a huge cystic like mass arising from the retroperitoneum which had clear margin with the adjacent structures. The tumour was successfully excised with an intact capsule and histopathological examination revealed a cavernous hemangioma.
cystic ; hemangioma ; neoplasm ; retroperitoneal