1.The disappearing act: Mom, have you seen my earring?
Irfan MOHAMAD ; Mohd Najeb SOLEH ; Arul A/L ARUMUGAM
Brunei International Medical Journal 2011;7(3):167-167
A 13-year-old girl complained of a painful right ear lobe of three days duration. She tried to remove
the ear ring and had to abandon the attempt when it started to bleed. Examination showed
the right ear lobe was swollen and tender on palpation (Panel). The swelling was firm, with an
area of hardness palpable in the centre. There was no pus or discharge from the swelling. On the
posterior aspect of right ear lobule, there was a pointed golden needle pin noted (Panel).
What is the diagnosis?
Answer: refer to page 189
2.The disappearing act: Mom, have you seen my earring? - Answers.
Irfan MOHAMAD ; Mohd Najeb SOLEH ; Arul A/L ARUMUGAM
Brunei International Medical Journal 2011;7(3):189-189
Answer: Embedded ear ring
The patient was started on oral antibiotics
and an analgesic. Her condition improved
with treatment, with reduction of oedema and
pain. The hard mass inside the earlobe, which
was the gold ear ring, was palpable. The ear
ring was removed under local anaesthesia
and the wound healed well upon follow-up in
the clinic.
3.Ultrasonic Scissors-Assisted ‘Open-Book’ Thyroidectomy in Massive Goiter Compressing Airway and Causing Unilateral Vocal Cord Paralysis
Irfan Mohamad ; Ali Ango Yaroko ; Mohd Najeb Soleh ; Centilnathan Periasamy
The Medical Journal of Malaysia 2013;68(2):183-185
A massive goiter may constrict the trachea resulting in
shortness of breath. Recurrent laryngeal nerve compression
may cause vocal cord paralysis. We highlight a case of a 62-year-old female with a 30 year history of an anterior neck swelling gradually increasing in size. She presented with acute symptoms of upper airway obstruction and voice
changes. Emergency thyroidectomy was performed by
dividing the middle part of the gland using ultrasonic
scissors. The recovery was uneventful and the patient
regained normal vocal cord function post operatively.
4.Intramuscular Sternohyoid Hemangioma: An Unusual Neck Mass
Irfan Mohamad ; Mohd Najeb Soleh ; Khairul Shakir Abdul Rahman ; Sharifah Emilia Tuan Sharif
The Medical Journal of Malaysia 2013;68(2):166-167
A neck mass with soft consistency suggests the diagnosis
of a cyst which is usually congenital in origin. Needle
aspiration yielding blood should alert the physician the
possibility of hemangioma although it is very rare.
Ultrasonography and computed tomography will delineate
the extent and nature of the lesion and provide the roadmap
for surgical excision. We report a case of a girl who
presented with a painless neck mass which was later found
to be a hemangioma originating from the sternohyoid
muscle. The morphology and immunohistochemical stain
were consistent with hemangioma.