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All Journal Majalah Kedokteran Bandung Indonesian Journal of Urology Indonesian Journal of Cancer JBN (Jurnal Bedah Nasional) Folia Medica Indonesiana
Sunaryo Hardjowijoto
Department Of Urology, Faculty Of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience Public Health

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Embryonal Rhabdomyosarcoma of Prostate in Adult: A Rare Case Report Andhika, Dimas Panca; Hardjowijoto, Sunaryo
Folia Medica Indonesiana Vol. 57, No. 2
Publisher : Folia Medica Indonesiana

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Abstract

Rhabdomyosarcoma is the fifth most common type of soft tissue solid tumor in children and the most common in the last two decades. Rhabdomyosarcoma of the urogenital organ is a rare mesenchymal tumor, covering 22% of all Rhabdomyosarcoma cases. The two most common histologic types are alveolar and embryonal, whereas botryoid and spindle cells are rarely found. We reported a case of embryonal Rhabdomyosarcoma of the prostate. In this study, we improved the understanding of Embryonal Rhabdomyosarcoma of the prostate on 23 years old male who had a history of swelling in the perineal area and a history of falling from a height in the groin area 5 months before. The patient complains of the difficulty of urinating and hematuria one month after falling. We underwent drainage of the swelling area, found pus 100cc and took a sample for pathological examination. The result was embryonal rhabdomyosarcoma. Prostate volume was 122cc, PSA 5,32 and PSAD 0,04. The CT scan result was solid mass size 15x8x18 cm at perineum enhance to the pelvic cavity, push the bladder to the superior, rectum to posterior, and urethra posterior to the left side. We diagnosed this patient as Embryonal Rhabdomyosarcoma prostate T2bG1N0M0 (stage 3) group 3 and intermediate-risk group. The patient underwent VAC chemotherapy based on D.9803 (IRS V) protocol and planned radiotherapy, but it stopped at halfway because of profuse bleeding. Embryonal Rhabdomyosarcoma is an aggressive tumor, especially in adults. However, there was limited evidence and guideline to diagnose and manage the disease.
Skeletal-Related Events (SRE) in Prostate Cancer: A Report of Two Cases Diatmika, Anak Agung Ngurah Oka; Hardjowijoto, Sunaryo
Folia Medica Indonesiana Vol. 57, No. 3
Publisher : Folia Medica Indonesiana

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A skeletal-related event (SRE) is an event occurring due to bone metastasis in prostate cancer. SREs are usually marked by pain, pathological fractures, spinal cord compression, hypercalcemia, or bone metastasis requiring radiotherapy or operation. Case I: A 64-year-old male was diagnosed with a pathological fracture of the left femur. Thoracal CT scan showed osteoblastic lesions in the thoracal vertebrae, sternum, clavicle, and humeral head. Spinal MRI showed destruction of the cervical to sacral vertebral bodies. The histopathological result with Adenocarcinoma Gleason scores 8 (4+4) and an initial prostate-specific antigen (PSA) level of 689,7 ng/dL. Afterward, subcapsular orchiectomy was performed. However, his PSA level was still high (>100 ng/dL) even after serum testosterone had reached a castration level. The patient died during the first chemotherapy using docetaxel. Case II: A 61-year-old male was diagnosed with inferior paraplegia and neurogenic bladder, paraparesis, urinary retention, and pain in the flank area. Spinal MRI showed a pathological compression fracture of the 8th thoracic vertebrae. Thoracal CT scan showed costal and 8th thoracal vertebrae destruction as well as multiple nodules in the lungs. Histological results with Adenocarcinoma Gleason score 9 (4+5) and an initial PSA level of 750 ng/dL. Afterward, subcapsular orchiectomy was performed. Serum testosterone reached castration level with the lowest PSA concentration of 21.6 g/dL. The patient declined chemotherapy and agreed to palliative treatment. He died one year after diagnosis. A high PSA level (>500 ng/dL) could potentially be used as a predictor for severe SRE.
Co-Authors A.A. Ketut Agung Cahyawan W Agung Dwi Wahyu Widodo Anak Agung Ngurah Oka Diatmika Aryati Aryati Aulia, Rifky Basuki B Purnomo, Basuki B Budiono Diatmika, Anak Agung Ngurah Oka Dimas Panca Andhika Doddy M Soebadi Doddy M. Soebadi Eddy Sunarno, Eddy Edwin Ongkorahardjo, Edwin Endang Joewarini Endi Prilansa Mahadi Fadhli Hasan Fauriski Febrian Prapiska, Fauriski Febrian Gondo Mastutik heri budiono I Wayan Yudiana I'tishom, Reny Ida Bagus Putra Pramana Johan Renaldo Juniastuti Juniastuti Kusuma, Raditya Lukman Hakim Lukman Hakim M. Andriady S. Nasution M. Asro Abdih Marta Hendry, Marta Meles, Dewa Ketut Moh. Ayodhia Soebadi Mohamad Ayodhia Soebadi Mohammad Ayodhia Soebadi Muhammad Ridha Mukti, Ade Indra Nurhadi, Pradana Purwati Purwati Purwati putri, Karinda triharyu caesari RIFKYA ULIA, RIFKYA Rizaldi, Fikri Sabilal Alif Satrya Husada, Satrya septa surya wahyudi, septa surya Septina Rahayu, Septina Soetojo Soetojo Suhartono Taat Putra Tarmono Djojodimedjo Taufik Indrawan Triyono Karmawan Sukmana Pria wahjoe djatisoesanto Wardhana, Sonny Andikha Wayan Suarsana Widjoseno Gardjito, Widjoseno Widodo J P Widodo J Pudjirahardjo Widodo J Pujiraharjo Willy Sandhika Yuanda, Rameshdo Zamroni Zamroni