Dear Drs

Oncology Department

Sarawak General Hospital

Date: 18th April 2023

RE: MUHAMMAD BIN ABDULLAH @ CHONG SWEE FONG

DIAGNOSIS:RIGHT LUNG ADENOCARCINOMA

I would like to refer this 62 years old, gentleman who have underlying of hypertension,
Ischemic Heart Disease (IHD) and Iron Deficiency Anemia. This patient is an active
smoker who smoker 1 pack per day since more than 20 years ago. Currently working as
a lorry driver.
Initially, presented to us with chronic cough for the past 2 months and complain loss of
weight for the past 4 months with around 4-5 kg losses. He went to KK Miri to seek
treatment and done chest x-ray and noted have large consolidation at right middle zone
of the thorax, sputum AFB x1,x2 and x3 done and all showed negatives. Then, patient is
sent to Miri General Hospital for further investigation and done CT-guided biopsy and
HPE result showed morphological squamous cell and adenocarcinoma pattern both
present ; non-small cell carcinoma.
Further history, patient denied any loss of appetite, no hemoptysis, no PTB contact and
denied any history malignancy in the family.
Patient had done CT-TAP on 13th January 2023 and result as follows:
-right lung mass with focal lymphangitis changes and pre-and subcarinal
lymphadenopathy with staging T4N2Mx, size of mass is 9.1x6.9x9.8cm
-multiple liver lesion with fluid attenuation, suggestive of cysts

Blood investigations as follows:

twc

Hb

hct
PLT

creat

urea

na

cl

ca

mg

Po4

ast

ldh

ck

T.bil

Dir.bil

ast

alt

alp

alb

pt

inr

aptt
This case was referred to Dr Kong Ming Mingtze, (MO Oncology Oncall).
Input: after discuss with Dr Eng ( Oncologist Oncall) :
-TCA RTU clinic new case earlist date available
-spoken to En.Badri (Pegawai Pembantu Tadbir), TCA given on 3 rd May 2023 at
2pm
-For PET/CT scan if patient affordable
-given date for PET scan at BMC Kuching on 2nd May 2023 at 9.30 am
-For ECHO and to take Hep B/C and HIV screening