ie eS 1A International Assistance Sdn Bhd S27 International DEFERMENT LETTER We Bar Sign Way 7300 Assistance Sdn. Bhd. eb eeeed eecal eae nono 2se068-1/0F/1 Attention : MR WONG TWEE JUAT Patient Name | LINDA SOETANTO Company | ALLIANZ LIFE-HS CARE PREMIER XTRA Employee Name | LINDA SOETANTO Plan Code | HSx4-ESSENTIAL IC/Card No _| x530406/8000210117364438 | Diagnosis | Recurrent fibromatosis left scapular region DOB / SEX 1987-02-12/F Admission | 2021-12-03 ‘Thank you for providing medical treatment for our member as above. 1. Kindly inform the symptom start date and when diagnosis established before this recurrent condition. The operhon wane clone on 29/4] 20/9 Faceted PE fr your ensitluabor 2. Kindly provide available investigation report that confirms the condition of fibromatosis. Eaclored a ory 9 ME reyeted on 27/4 fr01F 3, Please clarify any previous history of treatment as an inpatient or outpatient related to the current diagnosis. i, At your facility: Ar above— li, Besides your facility: Zz 4, Please inform the possible causes of this recurrent conditionLab No NA Passport ; XS30408 ReferNo/RIN : 19860/19 Patients Name Reported : 05/2019 09:39:34 Doctor's Name Age/Sex : a2/Female Clinic Name Received : 20/04/2019 14:30:52 Specimen HP 3303/0419 GROSS A) LUMP AT BACK “The specimen consists of a piece of fibrofatty tissue measuring 60x40x30mm. The tissue is covered by an ellipse of skin measuring 40x1Omm. The cut surface shows a solid greyish white tumour measuring 20x15mm. Representative samples are submitted in seven (7) blocks. B) FURTHER SKIN MARGIN ‘The specimen consists of an ellipse of skin with subcutaneous fat measuring 100x40x30mm. Representative samples are ‘submitted in four (4) blocks. MICROSCOPY |!) FROZEN SECTIONS A) Lump at back. = Benign neural tumour and compatible with Schwannoma. Excision margins are clear of tumour. B) Further skin margin. - Excisions are clear of the tumour. Il) PARAFFIN SECTIONS. 4) Sections from the lump at back show a poorly circumscribed lesion in the subcutaneous fat invading the underlying striated muscle fibres. The lesion is composed of long sweeping fascicles of uniform and slender fibroblasts. The nuclei of the fibroblasts are uniform in morphology. No significant nuclear atypia and mitoses are seen. The fibroblasts are Surrounded and separated from one another by abundant collagen. There are also regularly distributed thin-walled blood vessels with perivascular oedema throughout the lesion. Lymphoid aggregates are seen at the edge of the lesion, The excision margins are not clear of the lesion focally. The overlying skin ellipse is unremarkable. an i a HH ISLAND HOSPITAL on zane an ian Spe hn Se eee “Stocco 2240 22 | 4804 2267 909 |Lab No” : Hesgogogia@ = IC No: N/A Passport : XS30406 ReferNo/RUN : 19680/19 Patients Name. LINDA SOETANTO. Reported : oaOs201a oa39.04 Doctors Name: WONG TWEE JUAT Age! Sex : 32/ Female ClinicName —_: IS ISLAND HOSPITAL Received : 2904/2019 14:20:52 Specimen + Eiozen Section 2) Sections from the further skin margin show small foci of residual tumour in the subcutaneous fat. The new excision margins are clear of tumour. FINAL DIAGNOSIS 1) Lump at back. - Extraabdominal fibromatosis (extraabdominal desmoid). 2) Further skin margin. = The new excision margins are clear of tumour. @ ae me Hi ISLAND HOSPITAL (OR, ZANOLBW HARUN, "MOC DCP. MAC. AM 208 Macafter Read, 10450 Penang Maan ‘Corsoare Panos! "Yadou 2240222 | Fs +404 226790 | We wlandhowpalcom