1.Alveolar Rhabdomyosarcoma of the Neck in a Two-Months-Old Baby: Diagnostic Challenges
Medicine and Health 2019;14(1):228-233
Rhabdomyosarcoma (RMS) is the most common soft tissue malignancy in children
and adolescents. The rarity of its occurrence in infant poses a great difficulty
in terms of diagnosis and management. Here, we report an aggressive case of
alveolar rhabdomyosarcoma in an infant who presented with neck swelling and
neurological complications. The Magnetic Resonance Imaging (MRI) revealed
a soft tissue swelling of the neck with intraspinal extension and spinal cord
compression, raising the possibility of a neurogenic or malignant nerve sheath
tumour. Histopathological examination revealed a primitive, small round cell
tumour with no rhabdoid differentiation. The clinical presentation, neurological
symptoms, tumor location and the histopathologic features were highly suggestive
of neuroblastoma. However, the tumour cells were positive for desmin with focal
and weak nuclear positivity for myogenin and MyoD1; immunoexpressions
which were in favour of rhabdomyosarcoma. Fluorescent in situ hybridization
(FISH) confirmed the presence of a translocation t(2;13)(q35;q14), supporting
the diagnosis of alveolar rhabdomyosarcoma. Despite chemotherapy, patient
succumbed to death after two months due to septic shock. Rhabdomyosarcoma
is highly aggressive mesenchymal neoplasm which may present with diagnostic
difficulty. This case highlights the importance of molecular studies in making an
accurate diagnosis so that appropriate chemotherapy may be instituted.
3.Non-bacteremia liver abscess caused by Burkholderia pseudomallei from a tertiary teaching hospital in Malaysia: a case report and literature review
Wahab, A.A. ; Nurazizah, S.M.A. ; Ding, C.H. ; Muttaqillah, N.A.S. ; Nordashima, A.S. ; Kori, N. ; Periyasamy, P.
Tropical Biomedicine 2023;40(No.3):290-294
Melioidosis is endemic in Southeast Asia, including Malaysia. Liver abscess is not uncommon in
melioidosis, but it is usually associated with bacteremia. We presented a case of a 55-year-old gentleman
with underlying end-stage renal failure who presented with non-specific abdominal pain for three
months. Initial blood investigations showed leukocytosis and increased C-reactive protein. Computed
tomography (CT) of the abdomen revealed multiple hypodense lesions in the liver and spleen. The culture
of the liver specimen obtained through the ultrasound-guided isolated Burkholderia pseudomallei. He
was given an adjusted dose of intravenous ceftazidime due to underlying renal failure. Melioidosis
serology also returned positive for IgM with titer >1:1280. His blood cultures were reported negative
three times. Despite on antibiotics for five weeks, there was no significant improvement of the liver
abscesses was observed. He was unfortunately infected with the SARS-CoV-2 virus during his admission
and passed away due to severe COVID-19 pneumonia.