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All Journal Narra J The Journal of Society Medicine (JSOCMED)
Muknisa, Liza
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Double fatal consequences of distance metastasis in nasopharyngeal carcinoma after a completed chemoradiation in pregnancy: A case report Utami, Niken A.; Muknisa, Liza
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.221

Abstract

Distant metastasis in nasopharyngeal carcinoma (NPC) patients is one of the reasons for the decreased life expectancy with the most common metastasis spreads are to the bone, liver, and lung. Hepatoma is the most frequent liver malignancy and is one of the highest causes of cancer death worldwide and this can be as a result of NPC metastasis. The aim of this case report was to present a patient with hepatoma in pregnancy as a result of NPC metastasis. A 34-year-old pregnant female at 24–25 weeks of gestation presented with a chief complaint of heartburn and unbearable pain radiating to the back. Previous medical history reported that the patient had a liver enlargement. The patient was G4P2A1 with a single living intrauterine fetus and active fetal movements. The patient has a history of NPC and received a completed chemoradiation one month prior to hospital admission. Physical examination showed bilateral rales and palpable diffuse multiple nodule masses in the upper right abdominal quadrant. Laboratory examination revealed anemia, thrombocytopenia, negative hepatitis B surface antigen (HBsAg), and elevated liver markers. Abdominal ultrasonography results showed multiple diffuse nodules in the liver. The patient was diagnosed with a metastatic hepatoma based on the clinical and imaging findings. During hospitalization, the patient repeatedly experienced pleural effusion with suspicion metastases. A few days later, the fetal movements stopped and the ultrasonography indicated negative fetal heart rate. After experiencing respiratory distress for hours, the patient expired the day after. This case highlights that due to the potential adverse effects of chemotherapy and radiotherapy, the initiation of these therapies should be carefully decided to avoid adverse effects to mother and fetus.
Clinical Hirsutism Secondary to Ovarian Clear Cell Carcinoma: A Rare Case Report Muknisa, Liza; Nainggolan, Sarah Ika Nainggolan; Rusnaidi, Rusnaidi; Septivera, Yusra
Journal of Society Medicine Vol. 4 No. 10 (2025): October
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i10.240

Abstract

Introduction: Hirsutism affects 5–15% of premenopausal women, predominantly due to hyperandrogenemia (80–90% of cases), with the remainder classified as idiopathic or normoandrogenic. While virilizing ovarian tumors are known causes, the association between hirsutism and ovarian clear cell carcinoma (OCCC) has not been previously documented. Case Description: A 51-year-old multiparous woman presented with progressive abdominal distension over one year and new-onset hirsutism (Ferriman–Gallwey score 13) involving the face, axillae, pubic area, and lower limbs. She reported abdominal pain, nausea, vomiting, anorexia, 5-kg weight loss, vaginal discharge, regular menses, and poorly controlled type 2 diabetes. Examination revealed an underweight habitus and a firm, irregular, mobile, tender pelvic-abdominal mass extending above the umbilicus. Laboratory evaluation showed hypoalbuminemia (3.22 g/dL), elevated creatinine (1.64 mg/dL), markedly raised CA-125 (1,480 U/mL), and normal serum testosterone (7.5 ng/dL). Imaging confirmed a 9.5 × 8.3 × 5.5 cm solid-cystic right ovarian mass with ascites and suspected peritoneal metastases. Total abdominal hysterectomy with surgical staging was performed; histopathology confirmed OCCC. Conclusion: This is the first reported case of clinical hirsutism in OCCC with normal testosterone levels, supporting a diagnosis of idiopathic hirsutism. Potential mechanisms include increased peripheral 5α-reductase activity, androgen receptor hypersensitivity, or local androgen production, warranting further molecular investigation.
Co-Authors Nainggolan, Sarah Ika Nainggolan Rusnaidi Septivera, Yusra Utami, Niken A.