INTRODUCTIONMetastatic orbital tumour from gastric cancer is rare. Patients with metastatic disease may present initially to the ophthalmologist with symptoms from metastases instead of from the primary cancer.

CLINICAL PICTUREWe report a case, with clinicopathological correlation, of metastatic gastric adenocarcinoma presenting first in the orbit with diplopia. Computed tomography and magnetic resonance imaging of the orbit showed a well-defined enhancing right intraconal tumour.

TREATMENT AND RESULTSExcisional biopsy was performed and histopathology confirmed a metastatic adenocarcinoma. Focused gastrointestinal screening revealed an otherwise asymptomatic Stage IV gastric adenocarcinoma. Chemotherapy was initiated with good tumour response.

CONCLUSIONEarly biopsy of unusual orbital tumours is critical as orbital metastases may be the initial manifestation of an asymptomatic primary. Histopathological diagnosis can aid localisation of the primary tumour and allow prompt treatment to be instituted.

Biopsy ; Diplopia ; pathology ; Hemangioma, Cavernous ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Orbital Neoplasms ; secondary ; surgery ; Stomach Neoplasms ; pathology ; Time Factors

COVID-19 is one of the worst global pandemics in the last 20 years caused by Severe Acute Respiratory Syndrome Coronavirus 2. To control the pandemic in Malaysia, on 18th March 2020 the government implemented the Movement Control Order (MCO), a non-pharmaceutical intervention (NPI) under Malaysia’s Prevention and Control of Infectious Diseases Act 1988. Despite a high rate of compliance to the MCO in East Malaysia, a month after its implementation, a new cluster of infections among hospital healthcare workers (HCW) had emerged. This paper reports the early findings of a multinational study involving Malaysia, Thailand, Italy, and the United Kingdom. Our early analysis seeks to understand two main situational factors in the states of Sabah and Sarawak in East Malaysia – testing rates and household composition between HCW and non-healthcare workers (non-HCW). Our results showed that there were higher testing rates and smaller-sized households among HCW when compared to non-HCW workers.

The COVID-19 outbreak continues to evolve with the number of cases increasing in Malaysia, placing a significant burden on general practitioners (GPs) to assess and manage suspected cases. GPs must be well equipped with knowledge to set up their clinics, use Personal Protective Equipment (PPE) appropriately, adopt standard protocols on triaging and referrals, as well as educate patients about PPE. The correct use of PPE will help GPs balance between personal safety and appropriate levels of public concern.

Lung cancer is the leading cause of cancer-related death around the world, being the top cause of cancer-related deaths among men and the second most common cause of cancer-related deaths among women in Singapore. Currently, no screening programme for lung cancer exists in Singapore. Since there is mounting evidence indicating a different epidemiology of lung cancer in Asian countries, including Singapore, compared to the rest of the world, a unique and adaptive approach must be taken for a screening programme to be successful at reducing mortality while maintaining cost-effectiveness and a favourable risk-benefit ratio. This review article promotes the use of low-dose computed tomography of the chest and explores the radiological challenges and future directions.