Tomy Lesmana
Department Of Surgery, Faculty Of Medicine, Universitas Airlangga, Dr Soetomo Hospital, Surabaya

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Abdominal skin metastasis in endometrial cancer Eccita Rahestyningtyas; Pungky Mulawardhana; Tomy Lesmana
Majalah Obstetri dan Ginekologi Vol. 27 No. 2 (2019): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (542.307 KB) | DOI: 10.20473/mog.V27I22019.84-89

Abstract

Objectives: Surgical wound metastases in stage 1 endometrial cancer are possible, with a variety of different pathophysiological possibilities. Comprehensive management is needed to keep the patient on the possibility of a good prognosis.Cases Report: During January 2015 – January 2018 at dr. Soetomo Hospital, there were 2 cases of metastatic endometrial cancer in the laparotomy wounds by which the condition is very rare. Case 1, The patient was diagnosed with endometrial carcinoma following the results of curettage. Anatomical pathology examination was done and obtained grade 2 endometrioid adenocarcinoma. In Case 2, the patient underwent Total Abdominal Hysterectomy and Bilateral Salpingo-Oophorectomy in 2013 at Mojokerto General Hospital, indicating Uterine Fibroids and Ovarian Cysts. The results of anatomical pathology examination were unknown. On April 2017, the patient complained abdominal swelling since 3 months ago.Conclusion: In January 2015 - January 2018, 2 cases of metastatic endometrial cancer was found in a former laparotomy operation where this condition is very rare in endometrial cancer cases with low grade ,so that follow-up, monitoring and more vigilance are required in patients with low-grade endometrial Ca who have finished undergoing a surgery and chemotherapy. Rapture or mass resection, followed by external radiation, may be performed in patients with recurrence in the laparotomy wound area or in patients with high risk factors for endometrial cancer such as a history of estrogen use, tamoxifen, nullipara, obesity, diabetes mellitus, and family history of endometrial cancer. Currently, there is no fixed procedure (guideline) in RS. Dr. Soetomo to overcome recurrences especially in the scars of cancer surgery.
Diagnostic Accuracy of Clinical Features, Laboratory Features, and Ultrasound Imaging Compared to Intraoperative Findings in Patients with Obstructive Jaundice Yudith Meityana Hernandita; Tomy Lesmana; Alphania Rahniayu
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 14 No. 1 (2023): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V14I12023.21-25

Abstract

Highlights:1. Patients with obstructive jaundice have either benign or malignant underlying etiologies.2. Ultrasound imaging had the highest accuracy in diagnosing the etiology of obstructive jaundice among other examinations, such as clinical signs and laboratory tests. AbstractIntroduction: Jaundice due to biliary obstruction can be caused by a diverse group of diseases, including both benign and malignant etiologies. This study aimed to evaluate the accuracy of clinical features, laboratory features, and ultrasound imaging in diagnosing the etiology of obstructive jaundice with intraoperative findings as the gold standard.Methods: This was an observational cross-sectional analytic study conducted on 49 subjects by obtaining patients’ data from medical records in the Medical Record Center Dr. Soetomo General Academic Hospital, Surabaya. Collected data were statistically analyzed using a diagnostic test.Results: In this study, sensitivity (Sn), specificity (Sp), and accuracy of each feature in differentiating masses and stones as the etiology of obstructive jaundice were obtained. Progressive jaundice had Sn 88.2%, Sp 37%, and accuracy 56.8%. Complaints of fever had Sn 73.9%, Sp 90.9%, and accuracy 79.4%. Courvoisier’s law had Sn 61.5%, Sp 61.5%, and accuracy 61.5%. Serum CA 19-9 had Sn 75%, Sp 58.3%, and accuracy 67.9%. Ultrasound imaging had Sn 81.8%, Sp 100%, and accuracy 93.3%.Conclusion: Ultrasound imaging had the highest accuracy in diagnosing the etiology of obstructive jaundice, followed by complaints of fever, serum CA 19-9, Courvoisier’s law, and progressive jaundice, respectively.