Wafaa Alshakweer - Academia.edu (original) (raw)
Papers by Wafaa Alshakweer
Surgical Neurology International
Background: The third ventricle colloid cyst (CC) is a benign growth usually located in the third... more Background: The third ventricle colloid cyst (CC) is a benign growth usually located in the third ventricle and can cause various neurological symptoms, including sudden death. Modern surgical interventions may still result in a wide range of complications and cerebral venous thrombosis (CVT) is among them. Case Description: A 38-year-old female with an existing diagnosis of diabetes mellitus (DM) and hypothyroidism and a 6-month history of headaches, blurred vision, and vomiting presented to our clinic 3 days after the headaches became excessively severe. Neurological examination on admission revealed bilateral papilledema without any associated focal neurological deficits. Brain computed tomography and magnetic resonance imaging confirmed the presence of a third ventricle CC and associated non-communicating hydrocephalus involving the lateral ventricles. As a result, the patient underwent emergency bilateral external ventricular drainage (EVD) insertion followed by a third ventric...
Cureus
Plasmablastic lymphoma (PBL) is considered an aggressive rare variant of diffuse large B-cell lym... more Plasmablastic lymphoma (PBL) is considered an aggressive rare variant of diffuse large B-cell lymphoma that has a predilection to develop in immunocompromised patients, particularly HIV-positive individuals. This report highlights the development of such a rare and aggressive malignancy in a 55-year-old immunocompetent male. It outlines the atypical clinical presentation and pathological features of this disease entity. Overall prognosis and response to chemotherapy differ in the absence or presence of immunosuppression. This report includes a summary of the epidemiologic, clinical, and immunohistochemical characteristics of PBL based on a comprehensive review of the reported cases occurring in immunocompetent individuals.
Page 1. Brain Pathology 2: 97-1 09 (1 992) REVIEW Primary Central Nervous System Lymphoma John W.... more Page 1. Brain Pathology 2: 97-1 09 (1 992) REVIEW Primary Central Nervous System Lymphoma John W. Grant 1 and Peter G. lsaacson 2 1 Department of Histopathology, Addenbrooke's Hospital, Cambridge CB2 ZQQ, UK ...
Journal of Cancer Epidemiology, 2020
Objectives. This study is aimed at describing the epidemiological trends of primary CNS tumors in... more Objectives. This study is aimed at describing the epidemiological trends of primary CNS tumors in children and adults at the National Neurologic Institute in Saudi Arabia. Methods. A retrospective epidemiological approach was used where data was obtained from the department of pathology registry files and pathology reports. The records of all patients registered from January 2005 to December 2014 with a diagnosis of primary CNS tumor (brain and spinal cord) were selected. Data about sex, age, tumor location, and histologic type were collected. The classification was based on the International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3). Results. Nine hundred and ninety-two (992) cases of primary CNS tumors throughout the ten years (2005 to 2014) were reviewed. There were 714 (71.97%) adults and 278 (28.02%) in the pediatric age group. Nonmalignant tumors dominated the adult population (60.08%) while malignant tumors were more frequent in the pediatric population. ...
OncoTargets and Therapy
Background: Management of elderly patients with glioblastoma (GBM) is a controversial scenario an... more Background: Management of elderly patients with glioblastoma (GBM) is a controversial scenario and needs careful assessment and selection for aggressive radical treatment and chemotherapy protocols vs short-course radiotherapy without chemotherapy. Methods: We evaluated treatment patterns and outcome among elderly GBM patients treated in KFMC, Riyadh. The primary endpoint is overall survival (OS) and the secondary endpoint is progression-free survival (PFS); patients were reviewed regarding radiotherapy (Rth) fractionation modalities, surgery, and chemotherapy (CTR) given in correlation to PFS, OS. Results: Fifty-nine patients were recruited in our study with median age 66 (range: 60-81) years, and 47 (80%) were males. Thirtyseven patients (62.7%) had ECOG performance status (PS) ≥2, and 22 patients (37.3%) had PS <2. Gross total resection (GTR) and subtotal resection (STR) were done in 49 (82.9%) patients, and the median follow-up was 12 months. Thirty-eight (64%) patients received conventional Rth 60 Gray (Gy)/30 fractions or equal doses and 21 (36%) patients received hypofractionation Rth (40 Gy/15, 25 Gy/5 or 30 Gy/10 fractions). The median OS was 12 months (95%CI: 9.52-14.48). Receiving conventional Rth and completion of six months adjuvant CTR were significant factors for O.S (P=0.043 and 0.026), respectively. The median PFS was nine months (95%
IntroductionManagement of elderly patients with cancer is a controversial scenario and needs care... more IntroductionManagement of elderly patients with cancer is a controversial scenario and needs careful assessment and selection for aggressive radical treatment and chemotherapy protocols versus short-course radiotherapy without chemotherapy. Of note, definitions of the elderly vary in the glioblastoma (GBM) literature, with most of the randomized trials including patients aged 60, 65, or 70 years or older.Aim of the workTo evaluate treatment patterns and outcome among elderly GBM patients treated in KFMC, Riyadh. The primary endpoint is overall survival (OS) and the Secondary endpoint is progression-free survival (PFS) in relation to different treatment options and prognostic factors. MethodsThis is a retrospective study, included elderly GBM patients treated at KFMC, Riyadh, KSA between 1/2008 till 1/2018. 59 patients diagnosed with GBM ≥ 60 years were reviewed regarding radiotherapy (Rth) fractionation modalities, surgery, and chemotherapy (CTR) given in correlation to PFS, OS.Resu...
International Journal of Surgery Case Reports, 2017
INTRODUCTION: Inguinal lymph nodes are the frequent sites of metastasis for malignant lymphoma, s... more INTRODUCTION: Inguinal lymph nodes are the frequent sites of metastasis for malignant lymphoma, squamous cell carcinoma of anal canal, vulva and penis, malignant melanoma and squamous cell carcinoma of skin over lower extremities or trunk. Anatomically, endometrial carcinoma is less likely to spread to the superficial or deep inguinal lymph nodes, thus metastatic involvement of these lymph nodes can easily be overlooked. CASE PRESENTATION: Herein we report a case of a 65-year old Saudi morbid obese female, who presented with left inguinal lymphadenopathy as initial delayed site of metastasis almost 19 months after the initial treatment for FIGO IA endometrial carcinoma. Patient underwent left inguinal lymph node dissection. Histopathology confirmed metastatic endometrial adenocarcinoma, positive for cytokeratin (CK-7), estrogen receptor (ER) and progesterone receptors (PR), negative for CK-20 and CDX2. Following the post-surgery recovery, she was given extended field radiation therapy to para-aortic, pelvis and bilateral inguinal lymph nodes with concurrent cisplatin chemotherapy followed by high dose rate brachytherapy. CONCLUSION: Inguinal lymph nodes as delayed site of metastasis in early endometrial carcinoma is extremely rare entity. Incorporation of FDG-PET during the preoperative screening of inguinal nodes may be helpful. The impact of lymph node dissection and adjuvant radiation therapy on survival needs to be established.
Journal of Gastrointestinal & Digestive System, 2013
Introduction: Colon adenocarcinoma frequently metastasizes to the liver, regional lymph nodes, lu... more Introduction: Colon adenocarcinoma frequently metastasizes to the liver, regional lymph nodes, lungs and peritoneum. However, metastasis to the skeletal muscles is extremely rare manifestation of colon adenocarcinoma. To date, only few cases have been reported in the literature. Skeletal muscle metastasis from colon adenocarcinoma usually remains asymptomatic or manifest as swelling and are associated with dismal prognosis. Case presentation: A 28 years old Saudi man known case of adenocarcinoma of transverse colon treated with extended hemi-colectomy and chemotherapy one year back, presented with abdominal wall swelling and right buttock swelling since 8 months. Physical examination revealed right gluteal mass of size 3×2 cm and abdominal wall mass of size 2×2 cm. Rest of examination was unremarkable. Computed tomography-Positron emission tomography (CT-PET) showed 3×2 cm lobulated mass arising from gluteus maximus muscle and another mass in rectus abdominis muscle. Incisional biopsy confirmed the metastatic adenocarcinoma of colon. Patient subsequently underwent palliative radiotherapy followed by systemic chemotherapy. At time of publication, patient was alive with progressive disease. Conclusion: Skeletal muscles metastases are rare manifestation of adenocarcinoma of colon and searching for the primary focus in a patient with skeletal muscle metastasis, colon cancer should be considered as differential diagnosis.
International Journal of Surgery Case Reports
Surgical Neurology International
Background: Spheno-orbital meningiomas (SOMs) are often benign. The association of meningioma and... more Background: Spheno-orbital meningiomas (SOMs) are often benign. The association of meningioma and systemic lupus erythematosus (SLE) is rarely discussed in the literature. Here, we report two patients with high-grade, SOMs with a prolonged history of SLE and review the literature. Case Description: The first case is a 52-year-old female patient with a 15-year history of SLE diagnosis who was referred to our center with a 1-year history of proptosis and excessive tearing of the left eye. This patient was operated for the left SOM with histopathological diagnosis of the World Health Organization (WHO) Grade III rhabdoid meningioma. The second case is a 36-year-old female patient with a 12-year history of SLE diagnosis who presented to our clinic with a 5-year-history of progressive right eye proptosis and occasional headaches. She was operated for the right SOM with histopathological diagnosis of the WHO Grade II chordoid meningioma. Conclusion: Rhabdoid and chordoid SOMs are uncommon...
Journal of Postgraduate Medicine, 2005
Granular cell tumour (GCT) is a rare soft tissue neoplasm commonly encountered in the head and ne... more Granular cell tumour (GCT) is a rare soft tissue neoplasm commonly encountered in the head and neck region, skin and subcutaneous tissue. GCT of the biliary system is most commonly reported in African-American females and usually presents as abdominal pain and obstructive jaundice. The neoplasm constitutes less than 10% of all benign tumours of the extra-hepatic biliary tree. No case of GCT involving the ampulla of Vater has been reported in the literature to date. We report a case of benign GCT involving the ampullary region in a 44-year-old Ethiopian male. Preoperative diagnosis was available on ERCP and deep biopsy. The patient was managed by debulking resection and biliary-enteric bypass and is symptom-free with no evidence of tumour progression after a follow-up of one year.
Case Reports in Neurological Medicine, 2015
Background. The cerebellum as initial site of distant metastasis from differentiated thyroid carc... more Background. The cerebellum as initial site of distant metastasis from differentiated thyroid carcinoma (DTC) including papillary (PTC) and follicular thyroid carcinoma (FTC) is rare manifestation.Case Presentations. Herein, we present three cases of cerebellar metastasis (CBM) of PTC. Mean age of patients was 67 years (range: 64–72), and mean duration between initial diagnosis and CBM was 49.6 months (range: 37–61). Frequent location was left cerebellar hemisphere and was associated with hydrocephalus. All patients underwent suboccipital craniectomy, and in two patients postoperative intensity modulated radiation therapy (IMRT) was given to deliver 5000 cGy in 25 fractions to residual lesions. Patient without postoperative IMRT had cerebellar recurrence along with lung and bone metastasis after 38 months. However, two patients were found alive and free of disease at the time of last follow-up.Conclusion. CBM from PTC is a rare clinical entity and is often associated with hydrocephal...
Journal of Cancer Therapy, 2015
BMJ case reports, 2013
Familial cerebral cavernous malformation is a rare entity. It has been described commonly among t... more Familial cerebral cavernous malformation is a rare entity. It has been described commonly among the Hispanic population and sparsely among the Italian, French, Swedish and Chinese populations. We discovered two families with this condition among the Saudi population for the first time. Both the index patients had a seizure as a prominent manifestation of their underlying structural lesion. One of them had recurrent attacks of bleeding in the cavernoma leading to a focal neurological deficit. The siblings and the parents of both the patients were screened using CT of the brain imaging. Two members within each family were found to have symptomatic cavernoma. A molecular genetics study revealed heterozygous KRIT1/CCM1 for a frameshift mutation in one of the patients. No detectable mutation was found in the other patient. These cases illustrate the existence of this condition beyond the commonly known geographical area of higher prevalence. Moreover, KRIT1/CCM1 might be the possible tar...
Journal of postgraduate medicine
Granular cell tumour (GCT) is a rare soft tissue neoplasm commonly encountered in the head and ne... more Granular cell tumour (GCT) is a rare soft tissue neoplasm commonly encountered in the head and neck region, skin and subcutaneous tissue. GCT of the biliary system is most commonly reported in African-American females and usually presents as abdominal pain and obstructive jaundice. The neoplasm constitutes less than 10% of all benign tumours of the extra-hepatic biliary tree. No case of GCT involving the ampulla of Vater has been reported in the literature to date. We report a case of benign GCT involving the ampullary region in a 44-year-old Ethiopian male. Preoperative diagnosis was available on ERCP and deep biopsy. The patient was managed by debulking resection and biliary-enteric bypass and is symptom-free with no evidence of tumour progression after a follow-up of one year.
Saudi medical journal, 2005
A 48-year-old Saudi male was admitted with features of obstructive jaundice. Endoscopic retrograd... more A 48-year-old Saudi male was admitted with features of obstructive jaundice. Endoscopic retrograde cholangiopancreatography showed stricture in distal common bile duct CBD. Computed tomography scan revealed lymphadenopathy along CBD and in porta hepatis. Cholangiocarcinoma, lymphoma or metastatic deposits were suspected but no definite preoperative diagnosis could be established. Laparotomy disclosed lymph node enlargement in porta hepatis and along the CBD and lesser curvature of the stomach. Triple bypass procedure was performed to relieve the obstruction. Pathological examination of the lymph nodes showed Castleman disease of hyaline vascular type.
Middle East journal of anaesthesiology, 2009
We report a challenging case of a newborn with a massive anterior mediastinal teratoma (MT), occu... more We report a challenging case of a newborn with a massive anterior mediastinal teratoma (MT), occupying nearly the right hemithorax, presenting at birth with life threatening respiratory distress (RD). Optimal approach and outcome was achieved with a coordinated, multidisciplinary approach.
Surgical Neurology International
Background: The third ventricle colloid cyst (CC) is a benign growth usually located in the third... more Background: The third ventricle colloid cyst (CC) is a benign growth usually located in the third ventricle and can cause various neurological symptoms, including sudden death. Modern surgical interventions may still result in a wide range of complications and cerebral venous thrombosis (CVT) is among them. Case Description: A 38-year-old female with an existing diagnosis of diabetes mellitus (DM) and hypothyroidism and a 6-month history of headaches, blurred vision, and vomiting presented to our clinic 3 days after the headaches became excessively severe. Neurological examination on admission revealed bilateral papilledema without any associated focal neurological deficits. Brain computed tomography and magnetic resonance imaging confirmed the presence of a third ventricle CC and associated non-communicating hydrocephalus involving the lateral ventricles. As a result, the patient underwent emergency bilateral external ventricular drainage (EVD) insertion followed by a third ventric...
Cureus
Plasmablastic lymphoma (PBL) is considered an aggressive rare variant of diffuse large B-cell lym... more Plasmablastic lymphoma (PBL) is considered an aggressive rare variant of diffuse large B-cell lymphoma that has a predilection to develop in immunocompromised patients, particularly HIV-positive individuals. This report highlights the development of such a rare and aggressive malignancy in a 55-year-old immunocompetent male. It outlines the atypical clinical presentation and pathological features of this disease entity. Overall prognosis and response to chemotherapy differ in the absence or presence of immunosuppression. This report includes a summary of the epidemiologic, clinical, and immunohistochemical characteristics of PBL based on a comprehensive review of the reported cases occurring in immunocompetent individuals.
Page 1. Brain Pathology 2: 97-1 09 (1 992) REVIEW Primary Central Nervous System Lymphoma John W.... more Page 1. Brain Pathology 2: 97-1 09 (1 992) REVIEW Primary Central Nervous System Lymphoma John W. Grant 1 and Peter G. lsaacson 2 1 Department of Histopathology, Addenbrooke&#x27;s Hospital, Cambridge CB2 ZQQ, UK ...
Journal of Cancer Epidemiology, 2020
Objectives. This study is aimed at describing the epidemiological trends of primary CNS tumors in... more Objectives. This study is aimed at describing the epidemiological trends of primary CNS tumors in children and adults at the National Neurologic Institute in Saudi Arabia. Methods. A retrospective epidemiological approach was used where data was obtained from the department of pathology registry files and pathology reports. The records of all patients registered from January 2005 to December 2014 with a diagnosis of primary CNS tumor (brain and spinal cord) were selected. Data about sex, age, tumor location, and histologic type were collected. The classification was based on the International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3). Results. Nine hundred and ninety-two (992) cases of primary CNS tumors throughout the ten years (2005 to 2014) were reviewed. There were 714 (71.97%) adults and 278 (28.02%) in the pediatric age group. Nonmalignant tumors dominated the adult population (60.08%) while malignant tumors were more frequent in the pediatric population. ...
OncoTargets and Therapy
Background: Management of elderly patients with glioblastoma (GBM) is a controversial scenario an... more Background: Management of elderly patients with glioblastoma (GBM) is a controversial scenario and needs careful assessment and selection for aggressive radical treatment and chemotherapy protocols vs short-course radiotherapy without chemotherapy. Methods: We evaluated treatment patterns and outcome among elderly GBM patients treated in KFMC, Riyadh. The primary endpoint is overall survival (OS) and the secondary endpoint is progression-free survival (PFS); patients were reviewed regarding radiotherapy (Rth) fractionation modalities, surgery, and chemotherapy (CTR) given in correlation to PFS, OS. Results: Fifty-nine patients were recruited in our study with median age 66 (range: 60-81) years, and 47 (80%) were males. Thirtyseven patients (62.7%) had ECOG performance status (PS) ≥2, and 22 patients (37.3%) had PS <2. Gross total resection (GTR) and subtotal resection (STR) were done in 49 (82.9%) patients, and the median follow-up was 12 months. Thirty-eight (64%) patients received conventional Rth 60 Gray (Gy)/30 fractions or equal doses and 21 (36%) patients received hypofractionation Rth (40 Gy/15, 25 Gy/5 or 30 Gy/10 fractions). The median OS was 12 months (95%CI: 9.52-14.48). Receiving conventional Rth and completion of six months adjuvant CTR were significant factors for O.S (P=0.043 and 0.026), respectively. The median PFS was nine months (95%
IntroductionManagement of elderly patients with cancer is a controversial scenario and needs care... more IntroductionManagement of elderly patients with cancer is a controversial scenario and needs careful assessment and selection for aggressive radical treatment and chemotherapy protocols versus short-course radiotherapy without chemotherapy. Of note, definitions of the elderly vary in the glioblastoma (GBM) literature, with most of the randomized trials including patients aged 60, 65, or 70 years or older.Aim of the workTo evaluate treatment patterns and outcome among elderly GBM patients treated in KFMC, Riyadh. The primary endpoint is overall survival (OS) and the Secondary endpoint is progression-free survival (PFS) in relation to different treatment options and prognostic factors. MethodsThis is a retrospective study, included elderly GBM patients treated at KFMC, Riyadh, KSA between 1/2008 till 1/2018. 59 patients diagnosed with GBM ≥ 60 years were reviewed regarding radiotherapy (Rth) fractionation modalities, surgery, and chemotherapy (CTR) given in correlation to PFS, OS.Resu...
International Journal of Surgery Case Reports, 2017
INTRODUCTION: Inguinal lymph nodes are the frequent sites of metastasis for malignant lymphoma, s... more INTRODUCTION: Inguinal lymph nodes are the frequent sites of metastasis for malignant lymphoma, squamous cell carcinoma of anal canal, vulva and penis, malignant melanoma and squamous cell carcinoma of skin over lower extremities or trunk. Anatomically, endometrial carcinoma is less likely to spread to the superficial or deep inguinal lymph nodes, thus metastatic involvement of these lymph nodes can easily be overlooked. CASE PRESENTATION: Herein we report a case of a 65-year old Saudi morbid obese female, who presented with left inguinal lymphadenopathy as initial delayed site of metastasis almost 19 months after the initial treatment for FIGO IA endometrial carcinoma. Patient underwent left inguinal lymph node dissection. Histopathology confirmed metastatic endometrial adenocarcinoma, positive for cytokeratin (CK-7), estrogen receptor (ER) and progesterone receptors (PR), negative for CK-20 and CDX2. Following the post-surgery recovery, she was given extended field radiation therapy to para-aortic, pelvis and bilateral inguinal lymph nodes with concurrent cisplatin chemotherapy followed by high dose rate brachytherapy. CONCLUSION: Inguinal lymph nodes as delayed site of metastasis in early endometrial carcinoma is extremely rare entity. Incorporation of FDG-PET during the preoperative screening of inguinal nodes may be helpful. The impact of lymph node dissection and adjuvant radiation therapy on survival needs to be established.
Journal of Gastrointestinal & Digestive System, 2013
Introduction: Colon adenocarcinoma frequently metastasizes to the liver, regional lymph nodes, lu... more Introduction: Colon adenocarcinoma frequently metastasizes to the liver, regional lymph nodes, lungs and peritoneum. However, metastasis to the skeletal muscles is extremely rare manifestation of colon adenocarcinoma. To date, only few cases have been reported in the literature. Skeletal muscle metastasis from colon adenocarcinoma usually remains asymptomatic or manifest as swelling and are associated with dismal prognosis. Case presentation: A 28 years old Saudi man known case of adenocarcinoma of transverse colon treated with extended hemi-colectomy and chemotherapy one year back, presented with abdominal wall swelling and right buttock swelling since 8 months. Physical examination revealed right gluteal mass of size 3×2 cm and abdominal wall mass of size 2×2 cm. Rest of examination was unremarkable. Computed tomography-Positron emission tomography (CT-PET) showed 3×2 cm lobulated mass arising from gluteus maximus muscle and another mass in rectus abdominis muscle. Incisional biopsy confirmed the metastatic adenocarcinoma of colon. Patient subsequently underwent palliative radiotherapy followed by systemic chemotherapy. At time of publication, patient was alive with progressive disease. Conclusion: Skeletal muscles metastases are rare manifestation of adenocarcinoma of colon and searching for the primary focus in a patient with skeletal muscle metastasis, colon cancer should be considered as differential diagnosis.
International Journal of Surgery Case Reports
Surgical Neurology International
Background: Spheno-orbital meningiomas (SOMs) are often benign. The association of meningioma and... more Background: Spheno-orbital meningiomas (SOMs) are often benign. The association of meningioma and systemic lupus erythematosus (SLE) is rarely discussed in the literature. Here, we report two patients with high-grade, SOMs with a prolonged history of SLE and review the literature. Case Description: The first case is a 52-year-old female patient with a 15-year history of SLE diagnosis who was referred to our center with a 1-year history of proptosis and excessive tearing of the left eye. This patient was operated for the left SOM with histopathological diagnosis of the World Health Organization (WHO) Grade III rhabdoid meningioma. The second case is a 36-year-old female patient with a 12-year history of SLE diagnosis who presented to our clinic with a 5-year-history of progressive right eye proptosis and occasional headaches. She was operated for the right SOM with histopathological diagnosis of the WHO Grade II chordoid meningioma. Conclusion: Rhabdoid and chordoid SOMs are uncommon...
Journal of Postgraduate Medicine, 2005
Granular cell tumour (GCT) is a rare soft tissue neoplasm commonly encountered in the head and ne... more Granular cell tumour (GCT) is a rare soft tissue neoplasm commonly encountered in the head and neck region, skin and subcutaneous tissue. GCT of the biliary system is most commonly reported in African-American females and usually presents as abdominal pain and obstructive jaundice. The neoplasm constitutes less than 10% of all benign tumours of the extra-hepatic biliary tree. No case of GCT involving the ampulla of Vater has been reported in the literature to date. We report a case of benign GCT involving the ampullary region in a 44-year-old Ethiopian male. Preoperative diagnosis was available on ERCP and deep biopsy. The patient was managed by debulking resection and biliary-enteric bypass and is symptom-free with no evidence of tumour progression after a follow-up of one year.
Case Reports in Neurological Medicine, 2015
Background. The cerebellum as initial site of distant metastasis from differentiated thyroid carc... more Background. The cerebellum as initial site of distant metastasis from differentiated thyroid carcinoma (DTC) including papillary (PTC) and follicular thyroid carcinoma (FTC) is rare manifestation.Case Presentations. Herein, we present three cases of cerebellar metastasis (CBM) of PTC. Mean age of patients was 67 years (range: 64–72), and mean duration between initial diagnosis and CBM was 49.6 months (range: 37–61). Frequent location was left cerebellar hemisphere and was associated with hydrocephalus. All patients underwent suboccipital craniectomy, and in two patients postoperative intensity modulated radiation therapy (IMRT) was given to deliver 5000 cGy in 25 fractions to residual lesions. Patient without postoperative IMRT had cerebellar recurrence along with lung and bone metastasis after 38 months. However, two patients were found alive and free of disease at the time of last follow-up.Conclusion. CBM from PTC is a rare clinical entity and is often associated with hydrocephal...
Journal of Cancer Therapy, 2015
BMJ case reports, 2013
Familial cerebral cavernous malformation is a rare entity. It has been described commonly among t... more Familial cerebral cavernous malformation is a rare entity. It has been described commonly among the Hispanic population and sparsely among the Italian, French, Swedish and Chinese populations. We discovered two families with this condition among the Saudi population for the first time. Both the index patients had a seizure as a prominent manifestation of their underlying structural lesion. One of them had recurrent attacks of bleeding in the cavernoma leading to a focal neurological deficit. The siblings and the parents of both the patients were screened using CT of the brain imaging. Two members within each family were found to have symptomatic cavernoma. A molecular genetics study revealed heterozygous KRIT1/CCM1 for a frameshift mutation in one of the patients. No detectable mutation was found in the other patient. These cases illustrate the existence of this condition beyond the commonly known geographical area of higher prevalence. Moreover, KRIT1/CCM1 might be the possible tar...
Journal of postgraduate medicine
Granular cell tumour (GCT) is a rare soft tissue neoplasm commonly encountered in the head and ne... more Granular cell tumour (GCT) is a rare soft tissue neoplasm commonly encountered in the head and neck region, skin and subcutaneous tissue. GCT of the biliary system is most commonly reported in African-American females and usually presents as abdominal pain and obstructive jaundice. The neoplasm constitutes less than 10% of all benign tumours of the extra-hepatic biliary tree. No case of GCT involving the ampulla of Vater has been reported in the literature to date. We report a case of benign GCT involving the ampullary region in a 44-year-old Ethiopian male. Preoperative diagnosis was available on ERCP and deep biopsy. The patient was managed by debulking resection and biliary-enteric bypass and is symptom-free with no evidence of tumour progression after a follow-up of one year.
Saudi medical journal, 2005
A 48-year-old Saudi male was admitted with features of obstructive jaundice. Endoscopic retrograd... more A 48-year-old Saudi male was admitted with features of obstructive jaundice. Endoscopic retrograde cholangiopancreatography showed stricture in distal common bile duct CBD. Computed tomography scan revealed lymphadenopathy along CBD and in porta hepatis. Cholangiocarcinoma, lymphoma or metastatic deposits were suspected but no definite preoperative diagnosis could be established. Laparotomy disclosed lymph node enlargement in porta hepatis and along the CBD and lesser curvature of the stomach. Triple bypass procedure was performed to relieve the obstruction. Pathological examination of the lymph nodes showed Castleman disease of hyaline vascular type.
Middle East journal of anaesthesiology, 2009
We report a challenging case of a newborn with a massive anterior mediastinal teratoma (MT), occu... more We report a challenging case of a newborn with a massive anterior mediastinal teratoma (MT), occupying nearly the right hemithorax, presenting at birth with life threatening respiratory distress (RD). Optimal approach and outcome was achieved with a coordinated, multidisciplinary approach.