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

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Giant Malignant Phyllodes Tumor in a 36-year-old Female: A Rare Case Report Betty, Betty; Hasibuan, Arie Widiansyah; Siregar, Denny Rifsal
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1315

Abstract

Introduction: Phyllodes tumor (PT) is infrequent among breast neoplasms, representing less than 1% of all breast neoplasms, with 10% to 30% of them being malignant. The occurrence rate of malignant phyllodes tumor (MPT) is about 2.1 cases per million people.Case Presentation: We report the case of a 36-year-old female who had a significant mass in her right breast. Macroscopically, the cut surface was grayish-white with cystic areas containing a hemorrhagic mass; the tumor occupied nearly the entire breast with indistinct borders. The tumor measured 26 x 16 x 11 cm. Microscopically, the tumor exhibited a solid structure with ductal proliferation and hypercellular stroma forming a leaf-like appearance. Proliferation of fibrous connective tissue with dysplastic cell morphology and atypical mitoses was found in 10/10 high-power fields (HPFs). Malignant heterologous components included bone matrix with osteoclast-like giant cells and chondroid components. Immunohistochemical Ki-67 staining was positive in more than 20% of the cell nuclei.Conclusion: The tumor is large with unclear infiltration boundaries and contains malignant heterologous components. Immunohistochemical Ki-67 staining was positive in more than 20% of the cell nuclei, confirming this as a case of malignant phyllodes tumor. This case is notable due to its rarity, frequent recurrence, and the challenges in establishing a diagnosis and treatment regimen.
Generalized Pustular Psoriasis yang Menunjukkan Perbaikan dengan Terapi Kortikosteroid: Laporan Kasus Alferraly, T. Ibnu; Hasibuan, Arie Widiansyah; Yuzar, Devi Nafilah
Majalah Kedokteran Indonesia Vol 75 No 6 (2025): 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.75.6-2025-1937

Abstract

Introduction: Generalized pustular psoriasis (GPP) is a rare, acute inflammatory and potentially life-threatening variant of psoriasis, characterized by widespread sterile pustular eruptions on an erythematous base, often accompanied by systemic symptoms such as fever, malaise, and leukocytosis. GPP differs from chronic plaque psoriasis due to dysregulation of the IL-36 pathway and IL36RN mutations, classifying it as an autoinflammatory keratinization disease, which poses significant therapeutic challenges, especially in settings with limited healthcare resources and restricted access to biologic agents.Case Report: A 43-year-old man presented with high fever, severe skin pain, and widespread pustules coalescing into “lakes of pus.” Histopathological examination revealed orthokeratosis, parakeratosis, regular acanthosis, thinning of the suprapapillary plate, Munro microabscesses, and Kogoj’s spongiform pustules. Case Discussion: A diagnosis of Von Zumbusch-type GPP was established based on clinical and histopathological findings. Although biologic agents are the first- line treatment according to current guidelines, short-term systemic corticosteroids remain an important option in resource-limited settings. The patient responded well to intravenous methylprednisolone and topical corticosteroids, with significant reduction in the Psoriasis Area and Severity Index (PASI) and no relapse during eight weeks of follow-up.Conclusion: This case underscores the feasibility of achieving remission in generalized pustular psoriasis using conventional systemic corticosteroids under close monitoring, particularly in resource-limited settings where access to biologic agents may be restricted.
Co-Authors Alferraly, T. Ibnu betty betty Siregar, Denny Rifsal Yuzar, Devi Nafilah