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All Journal Open Access Indonesian Journal of Medical Reviews
Gargarin Nabalah
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Health Professions Medicine & Pharmacology

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Unraveling a Thyroid Collision Tumor: A Rare Case of Concurrent Papillary and Follicular Carcinoma Gargarin Nabalah; Henky Agung Nugroho; Esti Yuniar Anggrimulya
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 3 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i3.713

Abstract

Papillary thyroid carcinoma (PTC) represents the most common thyroid malignancy, accounting for 70-80% of cases, while follicular thyroid carcinoma (FTC) constitutes the second most prevalent differentiated thyroid cancer, comprising 10-15% of thyroid malignancies. The concurrent occurrence of PTC and FTC within the same thyroid gland, known as a collision tumor, is a rare phenomenon, posing diagnostic and therapeutic challenges. This case report aims to describe a unique presentation of this rare entity and discuss its clinicopathological features. We present the case of a 61-year-old female with a history of left thyroidectomy 25 years prior, who presented to our surgical oncology department with a palpable right breast mass. The initial workup revealed metastatic papillary thyroid carcinoma in the breast. Subsequent evaluation of the thyroid bed, including neck ultrasound and fine needle aspiration biopsy (FNAB) of a right thyroid nodule, led to the suspicion of a thyroid malignancy. The patient underwent completion thyroidectomy and central neck dissection. Final histopathological examination of the surgical specimen confirmed the rare diagnosis of a collision tumor, revealing the simultaneous presence of both PTC and FTC within the right thyroid lobe remnant. Immunohistochemical staining further characterized the distinct tumor components. The patient received postoperative radioactive iodine (RAI) ablation and thyroid hormone suppressive therapy. In conclusion, this case underscores the importance of considering the possibility of thyroid collision tumors in patients with thyroid nodules, especially in those with a history of thyroid disease or presentations of metastatic disease from an unknown primary. A comprehensive diagnostic approach, integrating clinical findings, radiological imaging, cytological examination, and detailed histopathological analysis with immunohistochemistry, is crucial for accurate diagnosis.
Unusual Presentation of Malignant Melanoma: A Case of Giant Amelanotic Involvement of the Hand Gargarin Nabalah; Henky Agung Nugroho
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 3 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i3.716

Abstract

Malignant melanoma, a cancer originating from melanocytes, typically presents as a pigmented lesion. Amelanotic melanoma, a subtype lacking pigmentation, poses diagnostic challenges due to its varied clinical appearance. Acral amelanotic melanoma (AAM), occurring on the palms, soles, and subungual areas, is particularly rare. This case report describes an unusual presentation of a giant amelanotic malignant melanoma on the left hand, highlighting the diagnostic and management complexities. A 45-year-old male presented to the surgical oncology clinic with a three-year history of a progressively enlarging lump on his left hand. Initially small, the lesion rapidly grew in the past year, accompanied by ulceration and bleeding. Physical examination revealed an 8 cm x 6 cm x 4 cm rough-shaped, skin-colored mass with crusting and easily bleeding sores on the left palm. No axillary lymphadenopathy was noted. Histopathological examination of a biopsy sample indicated amelanotic malignant melanoma, which was confirmed by positive HMB-45 staining on immunohistochemistry. Magnetic Resonance Imaging (MRI) revealed a large soft tissue mass infiltrating the muscles of the left hand and causing bone marrow replacement in the 4th and 5th metacarpal bones. The patient subsequently underwent wrist disarticulation. Postoperative follow-up at one and six months showed good recovery without recurrence. In conclusion, this case underscores the importance of considering amelanotic melanoma in the differential diagnosis of unusual hand lesions, even in the absence of typical pigmentation. Proper histopathology and immunohistochemistry are crucial for accurate diagnosis and to rule out other malignancies. This report contributes to the limited literature on giant AAM of the hand and highlights the surgical management of this rare entity.
Co-Authors Esti Yuniar Anggrimulya Henky Agung Nugroho