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All Journal Majalah Patologi Indonesia Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Indonesian Journal of Cancer
Azhar, Yohana
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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A Rare Parathyroid Carcinoma in Young Adult Man: Therapeutic Challenges in Tertiary Hospital with its Limitations Sitanggang, Rupita Sari Endangena; Azhar, Yohana; Agustina, Hasrayati
Indonesian Journal of Cancer Vol 18, No 1 (2024): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i1.1172

Abstract

Introduction: Parathyroid carcinoma is a rare malignant neoplasm. The symptoms that arise are related to hyperparathyroid conditions, which are clinically difficult to distinguish between benign and malignant disorders. These conditions make the diagnosis and treatment of parathyroid carcinoma challenging. Case Presentation: : In this case report, a 27-year-old male presented with weak limbs and a history of multiple recurrent fractures. Serum calcium ions and parathyroid hormone levels were increased. A comprehensive history taking, laboratory testing, and radiographic examination were used to confirm the diagnosis of parathyroid cancer. However, a histological study is still necessary to make a certain diagnosis. The patient underwent parathyroidectomy accompanied by intraoperative frozen section examination, then confirmed to have parathyroid carcinoma. Calcium serum evaluations were performed on the patient after surgery. Conclusions: Parathyroid carcinoma is a very rare case. Clinical manifestations and the results of investigations that are not typical and rarely found together in one patient’s condition make the diagnosis of this case very difficult. Although recommendations or standard protocols in the management of parathyroid carcinoma do not yet exist, the results of case reports are expected to increase the knowledge and management of parathyroid carcinoma patients.
Parathyroid Adenoma with Fibrous Dysplasia of Maxilla and Mandible in a Patient with End Stage Renal Disease (ESRD) on Routine Hemodialysis: A Case Report Lumban Tobing, Richard Sumihar Hasudungan; Azhar, Yohana
Indonesian Journal of Cancer Vol 18, No 4 (2024): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i4.1249

Abstract

Introduction: End Stage Renal Disease (ESRD) can cause secondary hyperparathyroidism, resulting in parathyroid hyperplasia. In parathyroid hyperplasia, monoclonal development can occur, resulting in nodular hyperplasia. This nodular hyperplasia was thought to develop into a carcinoma, but its development into a benign neoplasm is very rare. This case report presents a parathyroid adenoma that developed in a patient with endstage renal failure who required routine hemodialysis. Case Presentation: A 31yearold woman presented with complaints of facial bone swelling, shortened body, and a previous history of renal failure with hemodialysis therapy since 4 years ago. From the blood test, a hyperparathyroid condition was found, and a history of hypocalcemia. A sestamibi (MIBI) examination has also been done with the results of bilateral inferior parathyroid adenomas. The patient was diagnosed with bilateral inferior parathyroid adenoma with endstage renal disease (ESRD) on hemodialysis and bilateral inferior parathyroidectomy was performed on the patient. The patient’s progress was followed from diagnosis, surgery, and followup after surgery. At 4 months postoperatively, the suspicion of a mass in the residual parathyroid was confirmed by parathyroid hormone (PTH) and MIBI examination. The patient was suspected to have parathyroid hyperplasia in the remaining gland, with risk factors for hyperparathyroidism due to ESRD. Conclusions: ESRDinduced secondary hyperparathyroidism may lead to enlargement of all parathyroid glands which may develop into nodules. Therefore, careful monitoring and diagnostics supported by hospital policy is required and removal of all parathyroid glands is considered in such patients, even if not all parathyroid glands have masses.
Clinicopathological Characteristic of Radioactive Iodine-Refractory Differentiated Thyroid Carcinoma at Dr. Hasan Sadikin Hospital 2016-2021 Ayni, Tutik Nur; Agustina, Hasrayati; Hernowo, Bethy Suryawathy; Koesoemah, Raden Erwin Affandi Soeriadi; Azhar, Yohana
Majalah Patologi Indonesia Vol. 33 No. 1 (2024): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v33i1.606

Abstract

Background Initial therapy for differentiated thyroid carcinoma (DTC) is thyroidectomy with or without cervical lymph node dissection. Furthermore, radioactive iodine (RAI) is given to patients by considering risk stratification and other patient factors. Although most cases of DTC have a good prognosis after standard therapeutic approaches, the risks of local recurrence and distant metastases can be as high as 20% and 10%. Among these patients, two-thirds showed RAI-refractory. This is concerning because 10-year survival rate is less than 10%. This study aimed to analyze the clinicopathological characteristics of RAI-refractory DTC.   Methods This is a case-control study. Data was collected from the Department of Nuclear Medicine and Molecular Theranostics and Department of Anatomical Pathology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung period 1 January 2016-31 December 2021.   Results Clinicopathological factors associated with RAI-refractory DTC are age, sex, aggressive histologic subtype, LVI (lymphovascular invasion), m-ETE (microscopic extrathyroid extension), TNM (tumor, nodal, metastasis) stage, and ENE (extranodal extension), with p-value <0.05. Meanwhile, there was no significant difference in the histologic type between RAI-refractory and non-RAI-refractory groups.   Conclusion In the pathology report, it is necessary to include prognostically relevant tumor histopathological characteristics. In addition to histologic type, histologic subtype, and tumor size, other features such as presence and extent of capsular invasion, LVI, microscopic and macroscopic ETE, ENE, and number and size of metastatic lymph nodes, have been shown to provide additional prognostic information and are required in standard pathology reports for DTC.
Peran Mammografi Untuk Skrining Kanker Payudara: Sebuah Tinjauan Pustaka Soekersi, Hari; Azhar, Yohana; Akbari, Kiran Shadentyra
Majalah Kedokteran Indonesia Vol 72 No 3 (2022): Journal of the Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.72.3-2022-627

Abstract

Breast cancer is the most common cancer among women in Indonesia. The cure rate can be increased by early detection and appropriate therapy. The early detection modality recommended by WHO is screening mammography. The aim of this study was to determine the role and advantages and disadvantages of mammography compared to other modalities through narrative literature review with 30 literature that met the inclusion and exclusion criteria. The advantages of screening mammography are reducing mortality, increasing early treatment, and improving the quality of diagnostics as a follow-up to the results of screening. The disadvantages of this modality are overdiagnosis, false alarm, interval cancer, and radiation risk. Screening mammography can be combined with other modalities to increase accuracy such as MRI in high-risk women and ultrasound in women with denser breasts. The recommendation to initiate routine screening mammography at one year is 40 years. Barriers that often occur in lower middle-income countries are lack of knowledge and awareness, unavailable infrastructure and resources, accessibility, inadequate costs and the persistence of fear and shame. Therefore, the benefits of screening outweigh the risks and can be combined with other modalities to increase accuracy.
Co-Authors Akbari, Kiran Shadentyra Ayni, Tutik Nur Bethy Suryawathy Hernowo Hari Soekersi Hasrayati Agustina Koesoemah, Raden Erwin Affandi Soeriadi Lumban Tobing, Richard Sumihar Hasudungan Sitanggang, Rupita Sari Endangena