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Rapid Progressivity in a 62-Year-Old Circumcised Man with Penile Cancer: A Case Report Prabawati, Patricia; Setyono, Farid
Indonesian Health Journal Vol. 3 No. 1 (2024): Indonesian Health Journal
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/ihj.v3i1.375

Abstract

Penile cancer is a rare malignancy globally, including in Indonesia, with notable morbidity and mortality rates. This case report discusses a 62-year-old male with a penile mass, emphasizing the diagnostic challenges and the importance of early intervention in penile cancer cases. The patient presented with a progressively growing penile mass, dysuria, and penile pain. Clinical examination revealed a palpable, reddish mass on the penile shaft with unclear borders, a urethral fistula, and enlarged inguinal lymph nodes. Laboratory results showed white blood cell count, haemoglobin, platelet count, glucose, blood urea nitrogen, and creatinine abnormalities. An open biopsy suggested verrucous carcinoma, later revised to penile squamous cell carcinoma with inguinal lymph node metastases. Penile cancer, particularly squamous cell carcinoma, primarily affects older, uncircumcised men. Verrucous carcinoma, though rare, is associated with poor hygiene and lack of circumcision. Notably, misdiagnoses may occur due to the limited scope of open biopsies. Penile cancer is preventable, and its significant risk factors are modifiable. Penile carcinoma, although uncommon, poses severe consequences for affected individuals. Early diagnosis and intervention are crucial for improved outcomes. This case highlights the challenges in diagnosis, emphasizing the need for comprehensive assessments and awareness of the modifiable risk factors associated with penile cancer.
Multidisciplinary Treatment on a 69 years-old Male with Kidney Stone and Chronic Kidney Disease Prabawati, Patricia; Kusuma, Raditya
Journal of Medicine and Health Technology Vol. 1 No. 2 (2024)
Publisher : Direktorat Riset dan Pengabdian Kepada Masyarakat, Institut Teknologi Sepuluh Nopember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12962/j30466865.v1i2.2318

Abstract

Introduction Obstruction by kidney stones is one of the causes of chronic kidney disease (CKD). Out of all CKD cases, 10.3% are associated with obstruction due to kidney stones. Treatment of kidney stones can restore kidney function, but requires holistic and intense collaboration between urologists to treat the stones, nephrologist to monitor kidney function, and nutritionists to provide proper diet to prevent kidney stone reccurence Case Presentation A 69-year old male presented to the emergency departement with flank pain since 1 week ago. The patient complained of frequent flank pain since the last year. BOF radiological examination found staghorn stones in the right kidney, and ultrasonography revealed severe hydronephrosis of the right kidney. An impaired kidney function and decreased eGFR related to CKD were also found. The urologist performed bivalve nephrolithotomy on the right kidney. Afterwards, a histopathological examination was done to determine the stone material for further collaborative management with internist and nutritionist. After consultation with nutritionists regarding nutritional needs, monitoring from internist was done to monitor comorbidities and progression of CKD. Kidney function was evaluated after collaborative management and we found improvement on kidney function. Discussion In patients with CKD caused by obstruction due to kidney stones, it is necessary to treat the kidney stones first to relieve obstruction and restore kidney function. In this case the role of the internist is to control and recover kidney function after urologists have relieved the patient from urinary obstruction. Kidney stones that have been successfully removed are subjected to histopathological examination to determine its composition. After the composition were identified, consultation with a nutritionist is carried out to determine the right diet for the patient. With the right diet, prevention of stone reoccurrence is expected. Conclusion A history of kidney stones is associated with an increased risk of CKD. Multidisciplinary collaboration between urologists, nephrologist, and nutritionists helps lower the risk of stone recurrence and minimize the need for additional operative procedures through a focus on dietary and medical approaches and improved kidney function.