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A rare case of massif Adenomatoid Odontogenic Tumor in the anterior region of mandible: Mimicking as dentigerous cyst Munandar, Aris; Syamsudin, Endang; Sylvyana, Melita; Rizki, Kiki Akhmad
Padjadjaran Journal of Dentistry Vol 27, No 3 (2015): November
Publisher : Faculty of Dentistry Universitas Padjadjaran, Indonesia

Background. Adenomatoid Odontogenic Tumor (AOT) is a rare tumor of epithelial origin. AOT appears in three clinico-topographic variants: follicular, extrafollicular and peripheral. The AOT was predominantly found in the upper jaw, and rarely found in mandible, especially at anterior mandible. AOT is a tumor of odontogenic epithelium having duct like structures, which may be partly cystic, and in some cases the solid lesion may be present only as masses in the wall of a large cyst. The surgical management of this lesion would be enucleation along with removal of associated impacted tooth. The prognosis for both of them is good and recurrences are very rare after complete removal of the lesion. Purpose. It is important to define final diagnose for AOT due to mimicking with DC in clinically and radiographically finding. Biopsy is still obviously necessary to the final diagnosis. Case. 15-year-old female patients reported with chief complain of swelling in anterior mandible. The swelling beginning 4 years ago, gradually progressed, with no history pain, discharge and patient is complaint about loss of sensation around anterior mandible. Aspiration revealed straw colored fluid thinking in the way of DC. The provisional diagnosis of DC was given due to clinical presentation and radiographic imaging. But the biopsy examination showed AOT due to duct-like epithelial cells was being found. Discussion.Â The case report illustrates characteristic clinical and radiographic features of follicular variant of AOT mimicking a DC at unusual site that is anterior mandible. AOT is thought to arise from odontogenic epithelium and associated with the impacted tooth. Rightfully AOT is a perfect imitator of DC radiographically as well as histopathologically. It usually clinically misdiagnosed as DC as both have a unilocular, well-defined radiolucency surrounding the crown of an impacted tooth. The mass was enucleated, involved teeth were extracted, and titanium plates are used to avoid pathologist fracture. The patient had uneventful postoperative recovery. Follow up of a year has not shown any evidence of recurrence. Conclusion.Â Follicular type of OAT could confuse us with DC if the support examination just only clinicaly finding and radiographic examination. This case could not be definitively diagnosed on clinical and radiographic features alone. Biopsy was obviously necessary to the final diagnosis.

Treatment of relapse Ameloblastoma after Hemimandibulectomy and Mandibular Reconstruction Putri, Dian Maifara; Hardianto, Andri; Syamsudin, Endang; Rizki, Kiki Akhmad
Padjadjaran Journal of Dentistry Vol 27, No 3 (2015): November
Publisher : Faculty of Dentistry Universitas Padjadjaran, Indonesia

Background. Ameloblastoma is a benign odontogenic tumor with an aggressive biological behaviour, and the surgical treatment frequently results in failure for the post operative recurrence. Purpose. The aim of this study was to evaluate the clinical result of the patient with aggressive recurrent ameloblastoma who underwent two times radical surgery to get recurrence free. Case. We report a patient who was diagnosed with ameloblastoma of the mandible 13 years ago and had undertaken operation hemimandibulectomy and mandibular reconstruction. However, recurrence occured and secondary surgical treatment (particularly radical) offers the best chance to the patient. The recurrence of an ameloblastoma mainly displays the ineffectiveness or perhaps lack of success of the main surgical treatment. Conclusion. The method has to be intense as well as radical in order to steer clear of reccurence. For ameloblastoma an ineffectiveness of initial surgical treatment indicates that more radical strategy led to minimum recurrence rate.

Histopathological Aspects as Predictor of Recurrency of Locally Advanced Breast Cancer Rizki, Kiki Akhmad; Djajakusumah, Teguh Marfen; Agustina, Hasrayati; Hidayat, Peri
Majalah Kedokteran Bandung Vol 56, No 2 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3193

The histopathological aspect of breast cancer has been established as one of the important prognostic factors of recurrence. This study aimed to determine whether histopathological examination can be used as a predictor of the incidence of recurrence in locally advanced breast cancer patients. This was a cohort retrospective observational study with a correlative analytical approach. Subjects of this study were breast cancer patients who have undergone mastectomy and/or received additional therapy at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, between January 2017 and September 2019. Data were collected through medical records and anatomical histopathology data. Subjects were divided based on their recurrency status. A total of 62 breast cancer patients were included in the study with 31 recurrent patients and 31 non-recurrent patients. A total of 29 patients in the recurrent group (93.5%) had lymphovascular invasion. Histopathology grading showed a difference in both groups, in which recurrent group patients were mostly (74.2%) in the high histopathological grade while 51.6% of samples in non-recurrent group were categorized as moderate histopathological grade. Complete histopathological margins were found in both recurrent and non-recurrent groups for 54.8% and 87.1% respectively. There is a correlation between histopathologic grading, lymphovascular invasion, and incision margin with the recurrence of a locally advanced stage breast cancer. It can be concluded that some histopathological aspects can be used as a predictor of recurrence in locally advanced breast cancer.

Correlation Between CA 15-3 And Miller Payne Histopathological Response In Locally Advanced Breast Cancer Undergoing FAC Regiment Neoadjuvant Chemotherapy Rizki, Kiki Akhmad; Azhar, Raden Yohana; Dewayani, Birgitta; Fahman, Aulia Novariza
Majalah Kedokteran Bandung Vol 56, No 2 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3145

Response to chemotherapy for breast cancer can be assessed using the CA 15-3 tumor marker, or through histopathological means such as Miller Payne assessment. This study aimed to explore the correlation between CA 15-3 level and histopathological response in locally advanced breast cancer. This is a cross-sectional study measuring CA 15-3 before and after neoadjuvant chemotherapy using the FAC regiment. This study took place in Dr. Hasan Sadikin Hospital Bandung, Indonesia, from January to August 2022. Data on histopathological responses before chemotherapy and after surgery were also collected. Thirty-nine patients were admitted as subjects. Most patients had invasive carcinoma of no special type (79.5%) and luminal B HER 2 molecular subtype (38.5%). A significant decrease in CA 15-3 level after chemotherapy (from 23.54±18.38 ng/ml to 16.30±6.51 ng/mL) was observed. No significant correlation between CA 15-3 level and Miller Payne histopathological responses were found in the subjects.

Treatment of relapse Ameloblastoma after Hemimandibulectomy and Mandibular Reconstruction Putri, Dian Maifara; Hardianto, Andri; Syamsudin, Endang; Rizki, Kiki Akhmad
Padjadjaran Journal of Dentistry Vol 27, No 3 (2015): November 2015
Publisher : Universitas Padjadjaran

Background. Ameloblastoma is a benign odontogenic tumor with an aggressive biological behaviour, and the surgical treatment frequently results in failure for the post operative recurrence. Purpose. The aim of this study was to evaluate the clinical result of the patient with aggressive recurrent ameloblastoma who underwent two times radical surgery to get recurrence free. Case. We report a patient who was diagnosed with ameloblastoma of the mandible 13 years ago and had undertaken operation hemimandibulectomy and mandibular reconstruction. However, recurrence occured and secondary surgical treatment (particularly radical) offers the best chance to the patient. The recurrence of an ameloblastoma mainly displays the ineffectiveness or perhaps lack of success of the main surgical treatment. Conclusion. The method has to be intense as well as radical in order to steer clear of reccurence. For ameloblastoma an ineffectiveness of initial surgical treatment indicates that more radical strategy led to minimum recurrence rate.

A rare case of massif Adenomatoid Odontogenic Tumor in the anterior region of mandible: Mimicking as dentigerous cyst Munandar, Aris; Syamsudin, Endang; Sylvyana, Melita; Rizki, Kiki Akhmad
Padjadjaran Journal of Dentistry Vol 27, No 3 (2015): November 2015
Publisher : Universitas Padjadjaran

Background. Adenomatoid Odontogenic Tumor (AOT) is a rare tumor of epithelial origin. AOT appears in three clinico-topographic variants: follicular, extrafollicular and peripheral. The AOT was predominantly found in the upper jaw, and rarely found in mandible, especially at anterior mandible. AOT is a tumor of odontogenic epithelium having duct like structures, which may be partly cystic, and in some cases the solid lesion may be present only as masses in the wall of a large cyst. The surgical management of this lesion would be enucleation along with removal of associated impacted tooth. The prognosis for both of them is good and recurrences are very rare after complete removal of the lesion. Purpose. It is important to define final diagnose for AOT due to mimicking with DC in clinically and radiographically finding. Biopsy is still obviously necessary to the final diagnosis. Case. 15-year-old female patients reported with chief complain of swelling in anterior mandible. The swelling beginning 4 years ago, gradually progressed, with no history pain, discharge and patient is complaint about loss of sensation around anterior mandible. Aspiration revealed straw colored fluid thinking in the way of DC. The provisional diagnosis of DC was given due to clinical presentation and radiographic imaging. But the biopsy examination showed AOT due to duct-like epithelial cells was being found. Discussion. The case report illustrates characteristic clinical and radiographic features of follicular variant of AOT mimicking a DC at unusual site that is anterior mandible. AOT is thought to arise from odontogenic epithelium and associated with the impacted tooth. Rightfully AOT is a perfect imitator of DC radiographically as well as histopathologically. It usually clinically misdiagnosed as DC as both have a unilocular, well-defined radiolucency surrounding the crown of an impacted tooth. The mass was enucleated, involved teeth were extracted, and titanium plates are used to avoid pathologist fracture. The patient had uneventful postoperative recovery. Follow up of a year has not shown any evidence of recurrence. Conclusion. Follicular type of OAT could confuse us with DC if the support examination just only clinicaly finding and radiographic examination. This case could not be definitively diagnosed on clinical and radiographic features alone. Biopsy was obviously necessary to the final diagnosis.

PENGALAMAN SARKOMA SINOVIAL DI RUMAH SAKIT HASAN SADIKIN, TERUTAMA PADA SARKOMA SINOVIAL BAHU KANAN Isburhan, Mohamad Rizal; Rizki, Kiki Akhmad
Jurnal Cahaya Mandalika ISSN 2721-4796 (online) Vol. 4 No. 3 (2023)
Publisher : Institut Penelitian Dan Pengambangan Mandalika Indonesia (IP2MI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36312/jcm.v4i3.1595

This research was conducted at Hasan Sadikin Hospital by taking histopathological examination data from 2015 to 2018. There were 24 patients with distribution, 11 male patients and 13 female patients. Synovial sarcoma in the upper extremities was 9 patients and 15 patients in the lower extremities. Synovial sarcoma type is biphasic in 10 patients and monophasic in 14 patients. Reported male, 25 years with synovial sarcoma on the right shoulder. Physical examination of the patient revealed a lump with scar tissue with a soft tissue mass palpable with a size of 10x8x8cm, flat surface, springy consistency without pain. The patient underwent radiotherapy with a total of 60 gray radiation. The patient underwent wide excision under general anesthesia with the result of a tumor mass-free margin from postoperative histopathological examination. Patients are routinely controlled every 3 to 6 months to see any recurrences and metastases. Cases of synovial sarcoma are quite rare cases, a common primary soft tissue malignancy, often occurring in adolescents and young adults with the majority aged 15-40 years.

Korelasi Rasio Neutrofil Limfosit Dengan Tingkat Kejadian Metastasis KGB Pada Pasien Karsinoma Payudara Stadium Awal Ryanda, Hanno; Rizki, Kiki Akhmad; Septrina, Rani
Action Research Literate Vol. 8 No. 2 (2024): Action Research Literate
Publisher : Ridwan Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/arl.v8i2.260

Kanker payudara merupakan salah satu keganasan yang paling sering terjadi pada wanita dan merupakan kanker nomor dua paling banyak di dunia. Walaupun sudah ada beberapa parameter yang dapat digunakan untuk memprediksi metastasis KGB dari kanker payudara, dibutuhkan parameter yang akurat, ekonomis dan mudah diakses dari fasilitas kesehatan terpencil. Rasio neutrofil limfosit dianggap dapat memenuhi kriteria tersebut dengan peran neutrofil yang dapat mencerminkan keadaan peradangan inang dan efek anti tumor yang dimediasi oleh sitotoksik limfosit T. Penelitian ini dirancang sebagai penelitian observasional analitik retrospektif dengan rancangan cross-sectional dengan uji korelasi, uji diagnostik dan uji regresi dengan mengambil data sekunder dari pasien yang didiagnosis karsinoma payudara di Divisi Bedah Onkologi RSUP Hasan Sadikin Bandung pada tahun 2018-2023. Teknik pengambilan sampel pada penelitian ini menggunakan consecutive sampling. Pasien dipilih berdasarkan kriteria inklusi dan eksklusi. Pencatatan tersebut terdiri dari data rekam medis berupa biodata pasien, hasil pemeriksaan histopatologi, dan hasil pemeriksaan laboratorium. Dengan 52 sampel, didapatkan korelasi Rasio Neutrofil Limfosit dengan tingkat kejadian metastasis KGB, dimana hasil perhitungan pada kurva AUC menunjukkan nilai cut off untuk rasio NLR adalah sebesar 3,2 dan nilai koefisien AUC (area under curve) sebesar 0,771 dimana nilai ini berada pada kategori baik (>0,7 – 0,8). Penelitian ini juga mencari data antara kejadian metastasis KGB dengan grading histopatologis, invasi limfovaskular, dan subtipe. Penelitian ini menunjukan hubungan yang signifikan antara rasio neutrofil limfosit dengan metastasis KGB pada pasien dengan kanker payudara, dengan cut-off point di angka 3,2

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