A Young Kayan Woman with a Massive Eye Tumour.

While going through my collections of more than 2000 clinical pictures, I came across this newspaper cutting from last year about a younKayan woman our team operated on.

The case shows how fortunate are people who lived in big towns and cities in Sarawak where they can gain easy access to health care. The natives in Sarawak often live in sparsely inland areas who have to relie on Charity Organizations for medical health. This patient lived in a remote part of Sarawak near the border with Kalimantan (the Borneo part of Indonesia) and developed a slowly progressive swelling below the left eye for the past 9 years. She was seen once in Miri about 4 or 5 years ago but the surgeon who saw her attempted to aspirate the mass by sticking a needle. However, nothing was apirated and the patient returned to her village and didnot return for follow-up due to financial constrains. Unfortunately, the mass continued to grow with time resulting in severe disfigurement with her left globe pushed out of position. She avoided seeing people and always covered her left face with her long hair. It was not until March 2009 was she re-referred to Miri General Hospital where she was seen by Dr. Chieng, Consultant Ophthalmologist. A scan done in Miri showed a solid tumour extending to the back of the orbit. Dr. Chieng referred her to our Eye Department in Sarawak General Hospital, Kuching for further management. While in Kuching, she was also found to have ventricular septal defect which was medically managed by Prof Dr Sim of the Cardiology Department.

A massive white gelatinous mass was removed from the orbit and the tumour measured 9cm in length. Histology showed this to be a myxoma, an unusual tumour but not malignant ie. cancerous. She made a good recovery and we recommended further surgery at a later date to reconstruct her eyelids to make the two sides symmetrical. However, she did not return from follow-up after one year. The tumour rarely recurred and hopefully she is now leading a normal life in her village.