1.Isolated sphenoid sinusitis: A big headache.
Noor Liza Ishak ; Sethu Thakachy Subha ; Saraiza Abu Bakar
Malaysian Family Physician 2019;14(1):29-30
Isolated sphenoid sinusitis is a rare clinical entity with potentially devastating
complications such as cranial neuropathies, cavernous sinus thrombosis, meningitis and
intracranial abscess. It accounts for only 2.7- 3.0% of all paranasal sinus diseases.1A patient may present with myriad symptoms, ranging from occipital or vertex headache, retro-orbital pain, otalgia, drowsiness to meningitis-like symptoms. With these non-specific and varied symptoms, patients are usually not referred to an otorhinolaryngologist, which contributes to further delay in diagnosis and proper management. Prompt and accurate diagnosis is necessary in order to avoid catastrophic complications due to the proximity of the sphenoid sinus to vital neurovascular structures.
2.Solitary Fibrous Tumour of the Submandibular Region: A Rare Entity
Noor Liza Ishak ; Primuharsa Putra Sabir Athar Husin ; Suria Hayati Md Pauzi ; Isa Mohd Rose ; Mohd Razif Mohamad Yunus
Malaysian Journal of Medicine and Health Sciences 2016;12(2):60-63
Solitary fibrous tumours of the head and neck region are
extremely rare. The clinical diagnosis is often difficult to
establish, and this lesion may be indistinguishable from other
soft tissue neoplasms. An 18-year old Chinese gentleman
presented with a painless right submandibular swelling which
was increasing in size for eight months. A computed
tomography scan showed a well-defined solid mass measuring
about 2.0 x 2.96 cm in the submandibular region. The tumour
was resected and was confined within its capsule.
Immunohistochemical staining was strongly positive for CD34,
CD 99, and vimentin and negative for desmin, smooth muscle
actin (SMA), cytokeratin, S100 and CD68. The microscopic and
immunohistochemical profile were compatible with solitary
fibrous tumour. Distinguishing solitary fibrous tumours from
various spindle neoplasms can be difficult. In view of the
resemblance, immunohistochemical staining can help
differentiate solitary fibrous tumour from spindle neoplasm.
Neoplasms, Tumors, Cancer
3.Mantle Cell Lymphona Masquerading as Obstructive Sleep Apnoea
Noor Liza Ishak ; Tan Sui Teng ; Mahfida Mahat
Malaysian Journal of Medicine and Health Sciences 2023;19(No.3):390-392
Tonsillar malignancy typically presents with asymmetrical tonsillar enlargement, lesion on the tonsils, sore throat or
a neck mass. We report a case of unsuspected tonsillar malignancy in a 56-year-old gentleman who presented with
symptoms of obstructive sleep apnoea. His tonsils were grade III bilaterally with normal mucosa. Tonsillectomy was
performed to improve patient’s compliance with Continuous Positive Airway Pressure (CPAP) therapy. These tonsillar specimens were reported to be Mantle Cell Lymphoma (MCL) based on the histology and ancillary studies. This
case highlights that benign-looking symmetrical tonsillar enlargement can harbour occult malignancy. It is important
to note that OSA symptoms may be the presentation for haematological malignancies. Tonsillar specimens should
be sent for histopathological examination regardless of the indication to avoid misdiagnosis and delay in treatment.