1.Primary tuberculosis of palate
Malaysian Family Physician 2015;10(3):32-34
Primary tuberculosis (TB) of the hard palate is very rare. A 74-year-old man was presented with
6-month history of dysphagia along with an irregular mass in the hard and soft palate. Magnetic
resonance imaging (MRI) revealed thickened and increased signal intensity within hard and soft palate.
Tissue biopsy showed focal caseating granulomatous-like lesion and the histochemical staining using
Ziehl–Neelsen stain for acid-fast bacilli was positive. Positive histochemical studies provided evidences
that the hard palate mass was most likely due to TB. Thus, the patient was started on antituberculous
therapy
2.Temporal bone squamous cell carcinoma - Penang experience
Ng SY ; Pua KC ; Zahirrudin Z
The Medical Journal of Malaysia 2015;70(6):367-368
Temporal bone squamous cell carcinoma (TBSCC) is rare
and poses difficulties in diagnosing, staging and
management. We describe a case series with six patients
who were diagnosed TBSCC, from January 2009 to June
2014, with median age of 62 years old. All patients presented
with blood-stain discharge and external auditory canal
mass, showing that these findings should highly alert the
diagnosis of TBSCC. Three patients staged T3 and another
three with T4 disease. High-resolution CT (HRCT) temporal
findings were noted to be different from intraoperative
findings and therefore we conclude that MRI should be done
to look for middle ear involvement or other soft tissue
invasion for more accurate staging. Lateral temporal bone
resection (LTBR) and parotidectomy was done for four
patients with or without neck dissection. Patients with
positive margin, perineural invasion or parotid and glenoid
involvement carry poorer prognosis and postoperative
radiotherapy may improve the survival rate. One patient had
successful tumor resection via piecemeal removal approach
in contrast with the recommended en bloc resection shows
that with negative margin achieved, piecemeal removal
approach can be a good option for patients with T2-3
disease. In general, T4 tumor has dismal outcome
regardless of surgery or radiotherapy given.