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Uncommon Presentation of Perianal Condyloma Acuminata in a Young Male: A Case Report Christina, Natalia Maria; Prasetyo, Patricia Diana; Cendikiawan, Albert; Wijaya, Jeremiah Hilkiah
Medicinus Vol 13, No 3 (2024): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v13i3.8888

Background: Perianal warts, also known as anogenital warts or condyloma acuminata, represent a significant health concern in the young male population. Here, we present a unique case of a large perianal wart in a 26-year-old male patient.Case Description: The patient came to the surgical clinic with complaints of an anal lump for 7 months ago. The lump first appeared in February 2019 as big as a green bean, it increased in size, bled easily and painful to be touched. The patient had a history of anal intercourse 1 month before the lump appeared. The lump size was about 8 x 5 cm and resembled “cauliflower”. Diagnosis of suspected anal papilloma was made. In July 2019, an incisional biopsy was performed, and the result showed papilloma squamosa with condyloma acuminata as a differential diagnosis. In September 2019, perianal soft tissue tumor excision with advancement flap was performed and the result showed condyloma acuminata. Discussions: The case highlights the importance of careful evaluation and diagnosis in such clinical scenarios, as the initial diagnosis of anal papilloma was later refined to condyloma acuminata based on the biopsy and surgical findings. Early detection and appropriate management are crucial in cases like this to ensure the best possible patient outcomes.

WNT-Activated Medulloblastoma in A 6-Year-Old Boy Prasetyo, Patricia Diana; Wahjoepramono, Eka Julianta
Medicinus Vol 13, No 1 (2023): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i2.7530

Background: Medulloblastoma is the most common malignant brain tumor of childhood. Prognosis is mostly favorable, but may be affected by histological and molecular subtypes. Long-term therapy-related morbidity also remains a significant concern.Case Presentation: A 6-year-old boy with brainstem/midline cerebellum tumor. Histopathology found area of necrosis, sheets of malignant undifferentiated round cells with hyperchromatic nuclei and scanty cytoplasm, no nodule and no anaplasia. Immunohistochemistry found p53 wild-type staining pattern along with b-catenin diffuse cytoplasmic and focal nuclear staining. This indicated a diagnosis of WNT-activated medulloblastoma, World Health Organization (WHO) grade IV, with classic histological features.Discussion: WNT-activated medulloblastomas with classic histological features and no anaplasia were reported to have the most favorable prognosis. The current patient showed negative staining for GFAP, Olig2, EMA, H3K27M, EZHIP, and LIN28A, with retained staining for INI1 and BRG1, thus excluding several differential diagnosis such as atypical teratoid/rhabdoid tumor, embryonal tumor with multilayered rosettes, small cell glioblastoma, Ewing sarcoma, high-grade neuroepithelial tumor with BCOR alteration or diffuse midline glioma. Histopathology in combination with immunohistochemical and molecular subtyping of medulloblastoma can help to refine diagnosis, exclude differential diagnosis, and improve counseling in regards to overall prognosis.

Intracranial Solitary Fibrous Tumor in a 25-Year-Old Woman Prasetyo, Patricia Diana; Marisca, Stephanie; Wahjoepramono, Eka J.
Medicinus Vol 13, No 3 (2024): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v13i3.8890

Introduction: Intracranial solitary fibrous tumors (ISFTs) are extremely rare spindle cell tumors originating from dendritic mesenchymal cells expressing CD34 antigens that are usually benign, although malignant transformation had been reported. The knowledge of natural course and prognostic factors of ISFTs is still limited and the tumor is easily misdiagnosed.Case Presentation: An intra-cranial extra-axial tumor tissue resection from a 25-year-old woman was evaluated in the Surgical Pathology Laboratory. Histologic findings (cellular spindle cell tumor with ‘patternless’ pattern, staghorn blood vessels and <5 mitoses per 10 hpf) and immunophenotype (positive for CD34, weakly and focally positive for STAT6) suggested a diagnosis of intracranial solitary fibrous tumor WHO Grade II.Discussion: ISFTs have very low incidence in the CNS and are difficult to distinguish radiologically from meningiomas, thus post operative pathological examination and immunohistochemistry markers evaluations are the mainstay for diagnosis. ISFT is associated with NAB2-STAT6 gene fusion and may exhibits a wide spectrum of histological features. STAT6 immunohistochemistry is considered as one of the most sensitive diagnostic methods, while the evaluation of CD34 expression can be used as alternative diagnostic method despite having lower sensitivity.

Uncommon Presentation of Perianal Condyloma Acuminata in a Young Male: A Case Report Christina, Natalia Maria; Prasetyo, Patricia Diana; Cendikiawan, Albert; Wijaya, Jeremiah Hilkiah
Medicinus Vol. 13 No. 3 (2024): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v13i3.8888

Background: Perianal warts, also known as anogenital warts or condyloma acuminata, represent a significant health concern in the young male population. Here, we present a unique case of a large perianal wart in a 26-year-old male patient.Case Description: The patient came to the surgical clinic with complaints of an anal lump for 7 months ago. The lump first appeared in February 2019 as big as a green bean, it increased in size, bled easily and painful to be touched. The patient had a history of anal intercourse 1 month before the lump appeared. The lump size was about 8 x 5 cm and resembled “cauliflower”. Diagnosis of suspected anal papilloma was made. In July 2019, an incisional biopsy was performed, and the result showed papilloma squamosa with condyloma acuminata as a differential diagnosis. In September 2019, perianal soft tissue tumor excision with advancement flap was performed and the result showed condyloma acuminata. Discussions: The case highlights the importance of careful evaluation and diagnosis in such clinical scenarios, as the initial diagnosis of anal papilloma was later refined to condyloma acuminata based on the biopsy and surgical findings. Early detection and appropriate management are crucial in cases like this to ensure the best possible patient outcomes.

Intracranial Solitary Fibrous Tumor in a 25-Year-Old Woman Prasetyo, Patricia Diana; Marisca, Stephanie; Wahjoepramono, Eka J.
Medicinus Vol. 13 No. 3 (2024): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v13i3.8890

Introduction: Intracranial solitary fibrous tumors (ISFTs) are extremely rare spindle cell tumors originating from dendritic mesenchymal cells expressing CD34 antigens that are usually benign, although malignant transformation had been reported. The knowledge of natural course and prognostic factors of ISFTs is still limited and the tumor is easily misdiagnosed.Case Presentation: An intra-cranial extra-axial tumor tissue resection from a 25-year-old woman was evaluated in the Surgical Pathology Laboratory. Histologic findings (cellular spindle cell tumor with ”˜patternless’ pattern, staghorn blood vessels and <5 mitoses per 10 hpf) and immunophenotype (positive for CD34, weakly and focally positive for STAT6) suggested a diagnosis of intracranial solitary fibrous tumor WHO Grade II.Discussion: ISFTs have very low incidence in the CNS and are difficult to distinguish radiologically from meningiomas, thus post operative pathological examination and immunohistochemistry markers evaluations are the mainstay for diagnosis. ISFT is associated with NAB2-STAT6 gene fusion and may exhibits a wide spectrum of histological features. STAT6 immunohistochemistry is considered as one of the most sensitive diagnostic methods, while the evaluation of CD34 expression can be used as alternative diagnostic method despite having lower sensitivity.

WNT-Activated Medulloblastoma in A 6-Year-Old Boy Prasetyo, Patricia Diana; Wahjoepramono, Eka Julianta
Medicinus Vol. 13 No. 1 (2023): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i2.7530

Background: Medulloblastoma is the most common malignant brain tumor of childhood. Prognosis is mostly favorable, but may be affected by histological and molecular subtypes. Long-term therapy-related morbidity also remains a significant concern.Case Presentation: A 6-year-old boy with brainstem/midline cerebellum tumor. Histopathology found area of necrosis, sheets of malignant undifferentiated round cells with hyperchromatic nuclei and scanty cytoplasm, no nodule and no anaplasia. Immunohistochemistry found p53 wild-type staining pattern along with b-catenin diffuse cytoplasmic and focal nuclear staining. This indicated a diagnosis of WNT-activated medulloblastoma, World Health Organization (WHO) grade IV, with classic histological features.Discussion: WNT-activated medulloblastomas with classic histological features and no anaplasia were reported to have the most favorable prognosis. The current patient showed negative staining for GFAP, Olig2, EMA, H3K27M, EZHIP, and LIN28A, with retained staining for INI1 and BRG1, thus excluding several differential diagnosis such as atypical teratoid/rhabdoid tumor, embryonal tumor with multilayered rosettes, small cell glioblastoma, Ewing sarcoma, high-grade neuroepithelial tumor with BCOR alteration or diffuse midline glioma. Histopathology in combination with immunohistochemical and molecular subtyping of medulloblastoma can help to refine diagnosis, exclude differential diagnosis, and improve counseling in regards to overall prognosis.

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