Thursday, March 14, 2013

1321. Update on a rat's nose tumour

Dear Dr Sing,

Would it be possible to postpone his surgery to Monday afternoon? Approximately at 2pm.

I would like to have a second opinion sought out before proceeding the surgery as well as the X-ray that we spoke of during the previous appointment. Could I also request that only the specific lump and not the surrounding tissue be removed? Should it be that it is malicious, it will very likely reoccur and I would like to minimize the trauma that Moo might have to go through post surgery. Thus I'll like to have only the swelling drained if it is an abscess or only the specific tumor be removed to ease the pressure on his nasal passage without removal of the entire facial structure.

Do let me know if you are comfortable with the arrangement. You may also contact me at 98290503 should you have any further enquiries.

Thank you so much for everything you have done for XXX.



Pl feel free to get a second opinion, the X-rays (including contrast X-rays) and other investigations. A biopsy can be done to check whether the lump is malignant or not without excision of the lump after drainage (if it is an abscess, haematoma or cyst).

As to whether the specific lump can be removed without the surrounding tissues, it may or may not be possible if the lump is embedded inside the muscles or tissues. All surgeons will not want to remove unnecessary tissues disfiguring the patient.

My rationale for the complete excision of the nose lump is that it is growing. If it is an abscess, haematoma or cyst, then there is no need to excise the lump after drainage. If it is a slow growing soft tissue tumour, early excision is advised by me. A biopsy can be done first if the tumour is slow growing or is benign. If it is malignant, it should be excised soon.  

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