Article Per Year (5 Year)
p-Index From 2021 - 2026
0.562
P-Index
This Author published in this journals
All Journal Open Access Indonesian Journal of Medical Reviews Archives of The Medicine and Case Reports
I Wayan Lolik Lesmana
Unknown Affiliation
Health Professions Medicine & Pharmacology Nursing Public Health

Published : 3 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 3 Documents
Search

 1 
Esophageal Squamous Cell Carcinoma Masquerading as Achalasia: A Case Report on Diagnostic Pitfalls and Therapeutic Strategies Renata Timoty Pasaribu; I Gde Ardika Nuaba; I Ketut Suanda; Ida Ayu Alit Widiantari; I Wayan Lolik Lesmana
Archives of The Medicine and Case Reports Vol. 6 No. 3 (2025): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v6i3.760

Abstract

Esophageal squamous cell carcinoma (SCC) is an aggressive malignancy often diagnosed at an advanced stage, leading to a poor prognosis. Its initial symptoms can be nonspecific, occasionally mimicking benign esophageal disorders such as achalasia, thereby posing significant diagnostic challenges. This report details such a case, emphasizing the diagnostic pitfalls and discussing therapeutic approaches. A 43-year-old male presented with a 5-month history of progressive dysphagia and odynophagia, initially suspected to be achalasia. Clinical findings, including significant weight loss and specific laboratory abnormalities, are detailed. Esophagogastroduodenoscopy revealed an obstructing tumor, confirmed as esophageal SCC by biopsy. Staging investigations, including Multi-Slice Computed Tomography (MSCT), characterized the disease as Stage IVA (T4N1M0). The patient underwent feeding gastrostomy for nutritional support and commenced systemic chemotherapy with docetaxel, carboplatin, and cetuximab. The treatment course and initial follow-up are described. In conclusion, this case underscores the critical importance of maintaining a high index of suspicion for malignancy in patients presenting with symptoms suggestive of achalasia, especially if accompanied by atypical features or risk factors. A meticulous and timely diagnostic evaluation, incorporating early endoscopy and biopsy, is paramount for accurate diagnosis and staging. Multidisciplinary management, including robust nutritional support and carefully selected systemic therapy, remains central to addressing advanced esophageal SCC.
Salvage Total Laryngectomy with Bilateral Deltopectoral Flap Reconstruction for Metastatic (Stage IVC) Laryngeal Carcinoma: A Case Report Steven Yohanis Latupeirissa; I Wayan Lolik Lesmana; Eka Putra Setiawan; I Gde Ardika Nuaba; Made Lely Rahayu; I Ketut Suanda
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 5 (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.v5i5.781

Abstract

The management of advanced laryngeal squamous cell carcinoma (SCC) that persists or recurs after definitive chemoradiotherapy presents a significant clinical challenge. This challenge is profoundly amplified in the setting of distant metastatic disease (Stage IVC), where the goals of treatment shift from curative intent to palliation and quality of life preservation. Surgical salvage in this context is controversial and reserved for highly selected cases with severe, unmanageable local symptoms. We present the case of a 58-year-old male, a long-term smoker, with Stage IVC (T3N2cM1) laryngeal SCC, complicated by bone metastases. He initially underwent definitive chemoradiotherapy. Ten months later, he presented with progressive local disease, including a fungating cervical mass and impending airway compromise. A palliative salvage total laryngectomy with bilateral Modified Radical Neck Dissection (MRND) was performed to control severe local symptoms. The extensive pharyngocutaneous defect was reconstructed using bilateral pedicled deltopectoral fasciocutaneous flaps. The final histopathology confirmed viable, moderately differentiated SCC with extensive cartilage invasion and, critically, a positive deep resection margin. The postoperative course was managed successfully, with the patient showing significant improvement in local symptoms and quality of life at short-term follow-up. This case highlights the complex decision-making required for palliative surgery in metastatic head and neck cancer. The discussion focuses on the justification for aggressive local intervention to palliate debilitating symptoms, the rationale for selecting the robust bilateral deltopectoral flap for reconstruction in a hostile, irradiated field, and the profound prognostic implications of a positive surgical margin in the salvage setting. In conclusion, palliative salvage total laryngectomy can be a viable strategy to improve quality of life in selected patients with Stage IVC laryngeal cancer and overwhelming local disease. However, achieving complete oncologic clearance is a formidable challenge, and management must be tailored within a multidisciplinary framework.
Solitary Sinonasal Neurofibroma in an Elderly Male: A Rare Presentation and Surgical Management Jessica Filbertine; I Gde Ardika Nuaba; I Ketut Suanda; Ida Ayu Alit Widiantari; I Wayan Lolik Lesmana
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 6 (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.v5i6.794

Abstract

Solitary sinonasal neurofibromas are rare peripheral nerve sheath tumors whose diagnosis is frequently confounded by non-specific symptoms and radiological features that mimic common inflammatory conditions. In the elderly, a unilateral sinonasal mass necessitates a high index of suspicion for neoplasia, yet diagnostic pitfalls remain a significant clinical challenge. A 65-year-old male with no stigmata of neurofibromatosis type 1 presented with a three-year history of progressively worsening unilateral nasal obstruction. Endoscopy revealed a large, pale, firm, non-friable mass. Computed tomography (CT) demonstrated an extensive, non-enhancing soft tissue mass originating in the left maxillary sinus, causing significant expansile bone remodeling and extending into multiple adjacent sinuses. The initial radiological impression was extensive sinonasal polyposis. However, an incisional biopsy followed by a comprehensive morphological analysis confirmed the diagnosis of a benign spindle cell tumor consistent with neurofibroma. The patient underwent complete tumor excision via a left lateral rhinotomy. The postoperative course was uneventful, with no recurrence at 12-month follow-up. In conclusion, this case underscores the critical importance of a thorough diagnostic workup for unilateral sinonasal masses in the elderly, where radiological findings can be misleading. Histopathological analysis is indispensable for the definitive diagnosis of spindle cell tumors in this location. For massive, maxillary-based neurofibromas with extensive lateral and anterior involvement, the lateral rhinotomy remains a vital and superior surgical approach, providing the necessary exposure to uphold the fundamental principle of complete oncologic resection and maximize the probability of a curative outcome.
Co-Authors Eka Putra Setiawan I Gde Ardika Nuaba I Ketut Suanda Ida Ayu Alit Widiantari Jessica Filbertine Made Lely Rahayu Renata Timoty Pasaribu Steven Yohanis Latupeirissa