Case Study 6: Perth to Kuala Lumpur

Sir Charles Gairdner Hospital Perth to Kuala Lumpur Hospital Malaysia.

A 30-year-old male from Malaysia on holiday in Australia presented to a General Practitioner with a 1-month history of blurred vision and vomiting. He was referred to an ophthalmologist and underwent A CT-Brain scan on the January 27, 2013.

This scan showed crainocaudal heterogeneously enhanced mass in the pineal region measuring 3.2 x 2.9 x 3.1 cm with evidence of moderate to severe hydrocephalus and seeding into the forth ventricle was noted.

MRI on January 28, 2013 showed diffusion abnormal hyperintensity, involving the midbrain and thalami bilaterally and extending into the left cerebellar peduncle. There are 4 nodules of the fourth ependymal in the fourth ventricle with the largest measuring 6×5 mm and the remaining less than 2mm or less.

On the January 28 he underwent an endoscopy ventriculostomy and biopsy of pineal tumour and insertion of Extra Ventricular Drain. On the February 1, he underwent and Ventriculo-Peritoneal shunt.

The patient was neurologically stable, however, his prognosis was considered poor and required further surgical intervention to debulk the mass. On February 13, 2013 Medical Connect successfully repatriated him home to Malaysia for further treatment and family support.