NAVIGATING POST-TONSILLECTOMY WATERS IN AUTISM: A TALE OF COMPLICATIONS AND TRIUMPH Adenotonsillectomy (AT) is a common surgery performed in the field of otolaryngology. The most prevalent problems following AT are haemorrhage and breathing obstruction, although many individuals do not experience any subsequent difficulties. We would like to present a case of a child with autism spectrum disorder (ASD) who developed dysphagia and subsequent detrimental complications, including dehydration, after undergoing AT. This condition requires a multidisciplinary strategy to address the problem and provide special care and treatment for ASD children. By employing an all-encompassing strategy, the child demonstrated notable progress in her symptoms and was released after recuperation, with laboratory results returning to normal.

Introduction: Cancer patients’ perception on the treatment they received is vital to determine their adherence to cancer treatment, but important data on how this variable affects posttraumatic growth (PTG) experience by cancer patients is lacking. This cross-sectional study aimed to evaluate the degree of PTG among a cohort of head and neck cancer (HNC) survivors who were within first year of diagnosis and determined the association between perception of cancer treatment received (expectation and satisfaction with cancer treatment received and the feeling about the adverse effects) and PTG controlling for socio-demographic and clinical characteristics. Methods: HNC survivors were recruited from two oncology referral centres, and they were administered socio-demographic and clinical characteristics questionnaire, the Malay version of the Cancer Therapy Satisfaction Questionnaire (CTSQ) (to assess the satisfaction, expectation and feeling about the adverse effects of cancer treatment received) and the Malay version of the Posttraumatic Growth Inventory-Short Form (PTGi-SF) (to measure the degree of PTG). Results: A total of 200 HNC survivors participated in the study. The mean total PTGI-SF score was 39.5 (standard deviation [SD] = 9.3). Greater degree of positive expectation of cancer treatment and satisfaction with cancer treatment received significantly contributed to higher level of PTG, whereas feeling about side effects of treatment was not associated with PTG, after controlling for socio-demographic and clinical characteristics. Conclusion: Incorporating psychosocial interventions (such as education on cancer treatment and counselling) into the treatment regimen may facilitate development of PTG and hence, safeguard the mental well-being of HNC patients.

Oral squamous cell carcinoma (OSCC) is the commonest malignant tumour affecting the oral cavity with a poor 5-year disease free survival. We present an octogenarian with a recurrent oral cavity squamous cell carcinoma, treated with salvage mandibulectomy without bony reconstruction. No immediate or intermediate perioperative complications were documented. Subsequent monthly surveillance clinical examination, endoscopy and computed tomography at six months post-operative showed no evidence of residual tumour. Geriatric syndrome, perioperative risk and oncologic stratification are three main cornerstones in evaluating feasibility of oncologic surgery in an elderly patient. A multidisciplinary approach allowed surgical extirpation of OSCC with a good outcome

Paraneoplastic neurological disorder (PND) is a condition due to immune cross-reactivity between the tumour cells and the normal tissue, whereby the “onconeural” antibodies attack the normal host nervous system. It can present within weeks to months before or after the diagnosis of malignancies. Nasopharyngeal carcinoma is associated with paraneoplastic syndrome, for example, dermatomyositis, and rarely with a neurological disorder. We report on a case of nasopharyngeal carcinoma with probable PND. Otolaryngologists, oncologists and neurologists need to be aware of this condition in order to make an accurate diagnosis and to provide prompt treatment.

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

Isolated laryngeal histoplasmosis is a very rare entity. It has variable clinical presentations that might mimic both benign and malignant lesions, and is usually associated with pulmonary and other disseminated forms of histoplasmosis. Herein, we report a case of primary laryngeal histoplasmosis without the involvement of other systems in a 70-year-old Chinese man, who previously worked as a miner. He presented with a history of hoarseness for two months, with no other associated symptoms. Direct laryngoscopy revealed irregularity of the posterior one-third of both vocal folds. Histopathological examination revealed the presence of Histoplasma capsulatumon periodic acidSchiff and Grocott's methenamine silver staining. The lesion resolved after one month of oral itraconazole treatment. However, the patient had to complete six months of antifungal treatment to prevent recurrence.
Aged ; Amphotericin B ; therapeutic use ; Antifungal Agents ; therapeutic use ; Histoplasma ; isolation & purification ; Histoplasmosis ; diagnosis ; drug therapy ; microbiology ; Humans ; Laryngitis ; diagnosis ; drug therapy ; microbiology ; Laryngoscopy ; Larynx ; microbiology ; pathology ; Male ; Occupational Diseases ; diagnosis ; drug therapy ; microbiology ; Occupational Exposure ; adverse effects

Carcinoma of the tongue accounts for 35% of squamous cell carcinomas of the oral cavity. Metastases to regional lymph nodes are common and subclinical nodal metastases may be found in up to 30% of T1 and T2 oral tongue carcinoma. For distant metastases, it normally metastasises to the lung, bones and liver. We report a case of a 34-year-old lady who initially presented with a T2N1MO carcinoma of the tongue that was treated by surgery and chemotherapy. After 1.5 years, she developed multiple meta- static skin lesions.

Sinonasal tract malignancies are usually slow growing tumours with non-specific unilateral symptoms (occasionally bilateral) normal to the site of origin. They comprise a wide spectrum of pathological features. We report the case of a low grade non-intestinal sinonasal adenocarcinoma (SNAC) in a 38-year-old man who presented with a-six month history of right sided nasal blockage that was associated with occasional purulent rhinorrhoea and a month history of epistaxis.

Mucoepidermoid carcinoma is a malignant epithelial tumour of glandular tissue, usually of the major salivary glands. However it can present in the minor salivary glands, especially in the soft palate. We report the case of a 72-year-old Malay female after presentation with sore throat, fever and odynophagia, was diagnosed with mucoepidermoid carcinoma of the soft palate.
Mucoepidermoid Tumor ; Salivary Gland Neoplasms ; Salivary Glands, Minor

OBJECTIVE/strong: To describe a case of juvenile angiofibroma with unusual protrusion out of the nasal cavity, and its management with surgery and radiotherapy.br /br /strongMETHODS:/strong br /strongDesign/strong: Case Report br /strongSetting/strong: Tertiary Public Referral Centre br /strongPatient/strong: Onebr /br /strongRESULTS/strong: A 17-year-old gentleman presented with a huge tumor protruding from his left nostril, diagnosed with juvenile angiofibroma stage IlIA by MRI and angiography. Following successful pre-operative embolization, the protruding mass was ligated and truncated, followed by surgical resection via external approach. Post-operative residual tumor was treated with adjuvant radiotherapy. There was no evidence of recurrence after nine months.br /br /strongCONCLUSION/strong: A high index of suspicion is of paramount importance in the diagnosis of JA and avoids the possibility of an unwarranted biopsy which could spell disaster. The most useful tools for diagnosis are MRI and arterial angiography. Treatment is primarily surgical. Irradiation therapy has been reported to achieve satisfactory outcomes, especially for unresectable residual disease and/or intracranial extension, where total surgical resection is unlikely to be attained without unacceptable morbidity./p
Human ; Male ; Adolescent ; Angiofibroma-diagnosis, radiotherapy, surgery ; Nasopharyngeal Neoplasms ; neoplasms ; Magnetic Resonance Imaging ; Nasal Cavity ; nose