1.Onyx In Brain Arteriovenous Malformation Embolization
Hilwati Hashim ; A Sobri Muda ; Aida Abdul Aziz ; Zuhanis Abdul Hamid
Malaysian Journal of Medical Sciences 2016;23(4):59-64
Introduction: Embolisation has long been used as an adjunct to surgical resection
in the treatment of brain arteriovenous malformation (bAVM). The most commonly used
embolic material, n-butylcyanoacrylate glue, requires experience and skill to handle its quick
and unpredictable flow and polymerisation. A new liquid embolic agent, ethylene vinyl alcohol
copolymer (Onyx), is less adhesive and polymerises slowly, which provides better control for
radiologists performing embolisation.
Objective: To report our experience in embolisation using Onyx alone or in combination
with histoacryl for bAVM embolisation in our tertiary referral centre.
Methods: We retrospectively reviewed the anatomy, technical conditions, complications
and clinical outcome of all bAVM patients embolised at our centre using Onyx alone or in
combination with n-butylcyanoacrylate glue.
Results: Between 2010 and 2013, 13 patients [6 (46.2%) male; 7 (53.8%) female; aged, 14–
57 years] were included, and a total of 31 embolisations were performed. Clinical presentation
included hemorrhage [9 (69.2%)], seizures [2 (15.4%)], and headache [2 (15.4%)]. Most AVMs
were located in the brain hemispheres [12 (92.3%)] and measured <3 cm [7 (53.8%]. Complete
occlusion of the AVM was obtained in 2 (15.4%) patients; 11 (84.6%) patients had partial occlusion
[6 (54.5%) had <50% nidus occlusion]. Complications occurred in four procedures involving 3
patients (morbidity, 23.1%). This resulted in the death of 1 patient (mortality, 7.7%) and complete
recovery with no disability in 2 patients.
Conclusion: The total nidal occlusion achieved herein is comparable to other similar
studies. Our morbidity and mortality were higher compared to other studies which may be
attributed to the small number of patients. More data is being collected which may better reflect
on our experience.
2.Colon Cancer Recurrence Mimicking Renal Cell Carcinoma
Ahmad Ramzi Yusoff ; Yahya Mohd Aripin ; Zuhanis Abdul Hamid
The Medical Journal of Malaysia 2014;69(6):286-287
Colorectal cancer (CRC) is one of the most common
gastrointestinal cancers in the world. In Malaysia, it is the
third most common cancer for both men and women.
Curative surgical resection with en bloc removal of the
regional lymph nodes remains the mainstay of treatment
with 5-year survival rate of 70%-90% for local disease.
1
Nonetheless, about 1 in 3 curatively treated CRC patient will
suffer from local recurrence or metastasis .
2 Among the usual
sites of recurrence are liver, lungs, local and/or regional
intraabdominal and retroperitoneal lymph nodes.
3 We report
a rare case of colon cancer recurrence to the left kidney after
curative surgery and adjuvant therapy, which mimicked left
renal cell carcinoma.