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The Indonesian Journal of General Medicine
Published by International Medical Journal Corp. Ltd.
ISSN : -     EISSN : 3048104X     DOI : -
Core Subject : Health,
Dentistry Health Professions Medicine & Pharmacology Public Health Veterinary
ims: The Indonesian Journal of General Medicine aims to advance the field of medicine by disseminating high-quality research findings that are accessible to a broad audience of healthcare professionals, researchers, and policymakers. The journal is committed to supporting the development of medical knowledge and practice in Indonesia and globally, fostering innovative research and evidence-based clinical practices. Scope: The journal covers a wide range of topics within the general medical field, including but not limited to: Clinical studies in various medical disciplines Epidemiological research and public health issues Innovations in diagnostic techniques and treatments Reviews on current practices and emerging trends in medicine Case studies and clinical trials Health policy and medical education The Indonesian Journal of General Medicine welcomes submissions from all areas of medicine, particularly those that have significant implications for patient care, public health, and policy-making. The journal encourages submissions that offer new insights, propose novel approaches, or address challenges pertinent to the Indonesian and international medical communities.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 227 Documents
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Double Mycobacterial Infection in Septic Patient: A Rare Case of Pulmonary Tuberculosis and Leprosy Coinfection Kirana Paramitha Santosa; Anggar Jito
The Indonesian Journal of General Medicine Vol. 25 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/ktbbxd98

Abstract

Introduction: Co-infection of Tuberculosis (TB) and Leprosy is a rare occurrence, even in endemic areas.1 This co-infection has higher risks of drug resistance, complications, and mortality.2,3 Case Report: A 38-year-old male patient, who had been taking long-term steroids, presented in severe condition, showing signs of sepsis and ARDS. Multilobar infiltrates were found in both lungs, MTB/RIF was positive and sensitive to Rifampicin, BTA was found in slit skin smear test, liver enzyme levels were elevated, D-dimer level was increased (6 mg/L), low PaO2/FiO2 ratio (44.25 mmHg), along with an increased AaDO2 (508.4 mmHg). Despite receiving antimicrobial and anti-tuberculosis therapy, the patient's condition continued to deteriorate, resulting in septic shock and death. Discussion: The rarity of these cases in the modern literature is likely due to Bacillus Calmette-Guérin (BCG) vaccination in endemic areas, which provides at least partial protection against both diseases. Dual infection is associated with higher morbidity (5.5%) and mortality (37.2%).2 Appropriate diagnostic, screening, and therapeutic regimens are needed in clinical practice to prevent the risk of drug resistance and complications. This study aimed to present a complicated case of pulmonary TB and multibacillary leprosy co-infection in a septic patient.
Akurasi Diagnostik dan Korelasi Klinis Skor Alvarado terhadap Temuan Histopatologi serta Manifestasi Periappendicular Infiltrat: Analisis Retrospektif 75 Kasus di Indonesia Ario Achwanu Shafa; Bambang Arianto
The Indonesian Journal of General Medicine Vol. 25 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/vhf7fr58

Abstract

Pendahuluan: Apendisitis akut merupakan salah satu kegawatdaruratan bedah abdomen yang paling sering ditemukan di Indonesia, yang memerlukan diagnosis cepat untuk mencegah komplikasi seperti perforasi dan peritonitis. Penggunaan sistem skoring seperti Skor Alvarado bertujuan untuk meningkatkan akurasi klinis dan menekan angka apendektomi negatif. Metode: Penelitian ini merupakan studi retrospektif analitik terhadap 75 pasien yang menjalani apendektomi di sebuah fasilitas kesehatan di Indonesia. Data dikumpulkan dari rekam medis yang mencakup usia, jenis kelamin, parameter Skor Alvarado, kadar leukosit, temuan operatif, dan hasil histopatologi. Analisis data dilakukan untuk menilai korelasi antara total skor dengan tingkat keparahan inflamasi. Penelitian: Mayoritas pasien adalah perempuan (62,7%) dengan rentang usia dominan dewasa muda. Skor Alvarado 5 merupakan yang paling banyak ditemukan (40,0%). Hasil histopatologi menunjukkan 33 kasus apendisitis subakut dan 11 kasus perforasi. Ditemukan korelasi signifikan antara skor tinggi (≥ 7) dengan temuan perforasi dan infiltrat periapendikular (p < 0,05). Terdapat kasus unik apendisitis granulomatosa tuberkulosa pada pasien dengan skor klinis tinggi. Diskusi: Skor Alvarado memiliki sensitivitas tinggi dalam mendeteksi komplikasi namun menunjukkan keterbatasan pada varian subakut dan pasien lanjut usia di mana respon inflamasi sistemik seringkali tidak selaras dengan kerusakan jaringan. Parameter leukositosis ekstrem (> 30.000/mm^{3}) berkorelasi kuat dengan pembentukan abses masif. Kesimpulan: Skor Alvarado tetap menjadi instrumen triase yang efektif di Indonesia. Penggunaan USG sebagai modalitas tambahan disarankan bagi pasien dengan skor menengah (5-6) untuk mengurangi risiko keterlambatan penanganan pada kondisi perforasi yang tersembunyi.
PERBANDINGAN EFEKTIVITAS TERAPI LATIHAN KONVENSIONAL DAN TERAPI REHABILITASI MEDIK PADA LANSIA DENGAN OSTEOARTHRITIS Astri Wahyuni; Imran Safei; Hendrian Chaniago
The Indonesian Journal of General Medicine Vol. 25 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/mr3pj670

Abstract

Latar Belakang: Osteoartritis (OA), khususnya osteoartritis lutut, merupakan penyakit degeneratif sendi yang paling sering dialami lansia dan menyebabkan nyeri, keterbatasan fungsi, penurunan kualitas hidup, serta peningkatan beban biaya kesehatan. Terapi latihan konvensional dikenal sebagai intervensi non-farmakologis utama, namun berkembang pula terapi rehabilitasi medik dengan pendekatan multimodal yang diklaim lebih komprehensif. Perbandingan efektivitas kedua pendekatan tersebut pada populasi lansia masih perlu dikaji secara mendalam. Metode: Penelitian ini merupakan literature review dengan desain narrative review. Penelusuran literatur dilakukan terhadap jurnal nasional dan internasional, ClinicalKey, sitasi Fakultas Kedokteran UMI, textbook, dan proceeding book yang terbit pada tahun 2015–2025. Seleksi artikel dilakukan berdasarkan kriteria inklusi dan eksklusi terkait populasi lansia dengan osteoartritis dan intervensi terapi latihan konvensional serta terapi rehabilitasi medik. Sebanyak 20 artikel yang memenuhi kriteria dianalisis secara deskriptif-analitis. Hasil: Hasil telaah menunjukkan bahwa terapi latihan konvensional efektif menurunkan nyeri dan meningkatkan fungsi sendi, terutama pada osteoartritis derajat ringan hingga sedang. Terapi rehabilitasi medik multimodal, yang mencakup latihan akuatik, kombinasi latihan dengan modalitas fisik, edukasi, dan self-management, memberikan manfaat yang lebih luas dan stabil dalam jangka panjang, terutama pada lansia dengan nyeri sedang hingga berat, keterbatasan fungsional, dan komorbiditas. Kesimpulan: Terapi latihan konvensional dan terapi rehabilitasi medik sama-sama efektif pada lansia dengan osteoartritis, namun pendekatan rehabilitasi medik yang terstruktur, multimodal, dan individual lebih unggul dalam menangani kompleksitas kondisi klinis dan meningkatkan kualitas hidup lansia secara berkelanjutan.
EFEK SUPLEMENTASI ZAT BESI DAN PROBIOTIK TERHADAP MIKROBIOTA USUS DAN KEJADIAN ANEMIA PADA IBU HAMIL Aryanti R. Bamahry; Ajardiana Idrus; Tendri Nasyrah Azzahra
The Indonesian Journal of General Medicine Vol. 26 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/kwweft53

Abstract

Latar Belakang: Anemia merupakan salah satu masalah kesehatan yang umum terjadi pada ibu hamil. Suplementasi zat besi adalah zat besi tambahan yang diberikan sebagai tambahan nutrisi, probiotik adalah mikroorganisme hidup yang memberikaan manfaat kesehatan, terutama pada saluran cerna yang didapatkan melalui makanan yang mengandung probiotik maupun suplemen. Tujuan: Mengetahui efek dari suplementasi zat besi dan probiotik terhadap mikrobiota usus dan kejadian anemia pada ibu hamil. Metode: Systematic-narrative literature review mengikuti pedoman PRISMA 2020. Sumber data meliputi ScienceDirect, Pubmed, Cochrane serta prosiding dan disertasi dengan periode publikasi 2020–2025. Artikel dinilai berdasarkan kualitas metodologi, relevansinya dengan pemberian suplemen zat besi dan probiotik terhadap kadar zat besi dan mikrobiota usus, terutama pada ibu hamil. Analisis tematik dilakukan untuk menyintesis bukti terkini. Hasil: Beberapa studi menunjukkan bahwa suplementasi zat besi memberikan manfaat signifikan terhadap kadar zat besi pada ibu hamil, namun dapat menyebabkan efek samping gastrointestinal dan ketidakseimbangan mikrobiota usus. Suplementasi probiotik dapat meminimalisir efek tersebut dan mengoptimalkan penyerapan zat besi serta berperan dalam imunitas saluran cerna. Kesimpulan: Suplementasi zat besi dan probiotik memberikan efek positif terhadap peningkatan kadar zat besi dan kesehatan saluran cerna pada ibu hamil dengan anemia.
The Comprehensive Systematic Review of Association of Posterior Capsular Opacification (PCO) to IOL Material and Design Agnes Poppy Melina; Putu Ayu Wedayanti Daniputri; Ni Putu Ayu Rahmayanti
The Indonesian Journal of General Medicine Vol. 26 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/8m619q82

Abstract

Introduction: Posterior capsule opacification (PCO) remains the most common long-term complication of modern cataract surgery, leading to visual degradation and necessitating Nd:YAG laser capsulotomy. The risk of PCO is influenced by intraocular lens (IOL) characteristics, including material, optic edge design, and haptic configuration. However, the relative importance of these factors and potential interactions remain a subject of extensive research with sometimes conflicting findings. Methods: This comprehensive review synthesizes evidence from 80 studies, including randomized controlled trials, cohort studies, systematic reviews, and meta-analyses, that investigate the association between IOL characteristics and PCO development. Studies were screened based on predefined criteria including adult patients, uncomplicated cataract surgery, comparison of IOL materials/designs, quantitative PCO assessment, and a minimum follow-up of 6 months. Data were extracted on IOL specifications, PCO assessment methods, outcomes (scores, Nd:YAG rates), and study methodology. Results: The evidence robustly identifies a sharp posterior optic edge as the most critical design feature for PCO prevention, demonstrating significant benefits across all IOL materials (PMMA, silicone, acrylic) with up to a 35% absolute reduction in 9-year Nd:YAG rates (Haripriya et al., 2017). Regarding material, hydrophobic acrylic IOLs are consistently superior to hydrophilic acrylic, with meta-analyses showing a standardized mean difference of -1.80 in PCO severity and a relative risk of 6.96 for Nd:YAG capsulotomy favoring hydrophobic materials (Li et al., 2013; Wu et al., 2022). PMMA IOLs are associated with significantly higher PCO rates compared to modern foldable materials (Kobayashi et al., 2000; Sundelin et al., 2001). Comparisons between silicone and hydrophobic acrylic IOLs show time-dependent outcomes: acrylic may have an early advantage, but silicone may demonstrate better long-term (≥6 years) performance (Kwon et al., 2022). Haptic design (1-piece vs. 3-piece) shows no significant long-term impact on PCO when material and edge design are controlled (Leydolt et al., 2007; Haripriya et al., 2025). Surface modifications like heparin coating do not confer additional PCO protection (Krall et al., 2015). Discussion: The synthesis clarifies apparent conflicts in the literature by highlighting confounding variables, particularly the interaction between material and edge design, and the critical role of follow-up duration. The "barrier effect" of a sharp edge is the predominant mechanistic factor inhibiting lens epithelial cell migration. Significant performance variations exist even within the same material category, emphasizing that specific IOL platform characteristics are as important as broad material classification. Conclusion: For optimal PCO prevention, IOL selection should prioritize a sharp posterior optic edge design. Among acrylic materials, hydrophobic variants are preferred over hydrophilic. For patients with long life expectancy, silicone IOLs with a sharp edge may offer a long-term advantage, though this requires further validation. Haptic design is a secondary consideration. In resource-limited settings, adopting sharp-edged PMMA IOLs can substantially reduce the Nd:YAG capsulotomy burden.
Delayed Emergency Management of Testicular Torsion in a Rural Hospital Without Urologist: A Case Report Satrio Budi Wicaksono; Yustina
The Indonesian Journal of General Medicine Vol. 26 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/43w7as90

Abstract

Background Testicular torsion is a time-sensitive urological emergency requiring prompt diagnosis and surgical intervention to prevent irreversible ischemia and testicular loss. International guidelines emphasize immediate surgical exploration in patients with high clinical suspicion rather than delaying intervention for confirmatory imaging. Delays are more common in rural hospitals due to limited resources and lack of urologists. Case Presentation A 13-year-old boy presented with sudden severe left scrotal pain. Physical examination revealed a hard, horizontally lying left testis with absent cremasteric reflex. The TWIST score was 6, indicating high risk of torsion. Color Doppler ultrasonography showed reduced perfusion. Surgical exploration was performed approximately 7 hours after admission, revealing intravaginal torsion exceeding 360° with non-viable testis. Left orchiectomy and right orchidopexy were performed. Postoperative recovery was uneventful. Discussion This case highlights the importance of early clinical diagnosis, utilization of the TWIST score, and prompt surgical management. Delayed intervention related to emergency department workload, operating room availability, and absence of on-site urologists contributed to testicular loss. Conclusion In rural hospitals without urologists, standardized triage using TWIST, early surgical referral, and consideration of manual detorsion are essential to reduce preventable orchiectomy.
CHARACTERISTICS AND CLINICAL MANIFESTATIONS OFE-CIGARETTE OR VAPING USE–ASSOCIATED LUNG INJURY (EVALI) A.Muh. Nasywan Akbar; Edward Pandu Wiriansyah; Bulkis Natsir
The Indonesian Journal of General Medicine Vol. 27 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/ddfggw32

Abstract

Electronic cigarettes (e-cigarettes) have been the most commonly used tobacco products among young people since 2014. E-cigarettes are battery-operated devices that heat a liquid to produce an aerosol containing various active chemical substances. This study aimed to describe the characteristics and clinical manifestations of E-cigarette, or Vaping, Product Use–Associated Lung Injury (EVALI). The study was conducted by collecting secondary data from multiple research journals published between 2020 and 2025. The results indicate that EVALI is a lung disease associated with the use of e-cigarettes or vaping products. The clinical manifestations of EVALI are heterogeneous but commonly include respiratory symptoms, constitutional symptoms (such as fever and fatigue), and gastrointestinal symptoms. EVALI is caused by exposure to chemical substances contained in vaping products, including tetrahydrocannabinol (THC), nicotine, and other additives. During the epidemic period, EVALI management has not yet had standardized guidelines regarding dosing and treatment stratification. The management of EVALI is divided into non-pharmacological and pharmacological approaches. The complexity of diagnostic procedures required for EVALI results in most diagnosed patients being hospitalized, with oxygen saturation levels below 95% at the time of hospital admission.
Hubungan antara Gerakan Repetitif pada Pekerja Pabrik Rokok di Indonesia terhadap Risiko Terjadinya Sindrom Terowongan Karpal Melany; Ruben Timothy Abednego
The Indonesian Journal of General Medicine Vol. 27 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/6qgja976

Abstract

Latar Belakang: Gerakan repetitif tangan dan pergelangan tangan merupakan salah satu faktor risiko okupasi utama untuk terjadinya Sindrom Terowongan Karpal (Carpal Tunnel Syndrome/CTS). Pekerja pabrik rokok di Indonesia, khususnya pada proses penggulungan (rolling) dan pengemasan (packaging), terpapar secara intensif terhadap gerakan repetitif, postur statis canggung, dan durasi kerja yang panjang, sehingga diduga berisiko tinggi mengalami CTS. Namun, bukti langsung yang menghubungkan paparan spesifik pada pekerja pabrik rokok di Indonesia dengan insidensi CTS masih terbatas. Metode: Tinjauan sistematis ini dilakukan dengan menyaring 37 sumber literatur berdasarkan kriteria yang telah ditetapkan. Kriteria penyaringan meliputi populasi pekerja pabrik rokok di Indonesia, pengukuran CTS sebagai outcome, pemeriksaan gerakan repetitif sebagai paparan okupasi, serta desain studi observasional atau tinjauan sistematis dengan data kuantitatif. Ekstraksi data dilakukan terhadap karakteristik populasi, deskripsi aktivitas kerja repetitif, metode asesmen CTS, hubungan statistik antara gerakan repetitif dan CTS, faktor risiko lain, serta kualitas studi. Hasil: Dari 37 sumber, hanya tiga studi yang secara langsung meneliti pekerja pabrik rokok di Indonesia. Bukti tidak langsung dari meta-analisis internasional dan tinjauan literatur menunjukkan hubungan yang kuat dan konsisten antara gerakan repetitif dan peningkatan risiko CTS, dengan Odds Ratio (OR) 2.26 (95% CI: 1.73–2.94) (Barcenilla et al., 2012). Faktor risiko okupasi lain yang signifikan meliputi getaran (OR=5.40), penggunaan kekuatan tangan (OR=4.23), serta kombinasi gerakan repetitif dan stres psikososial (OR=4.94). Pada pekerja pabrik rokok, aktivitas seperti menggulung rokok dengan postur membungkuk hingga 88° dikategorikan berisiko sedang hingga tinggi secara ergonomis. Studi intervensi di industri rokok "X" di Kediri menunjukkan bahwa modifikasi ergonomis tempat kerja dapat menurunkan keluhan muskuloskeletal dan biaya pengobatan hingga 56,97%, serta meningkatkan produktivitas hingga 41,47% (Sajiyo et al., 2009). Program latihan tangan dan peregangan di tempat kerja juga terbukti efektif mengurangi gejala CTS pada populasi pekerja sejenis. Diskusi: Temuan mendukung adanya asosiasi positif antara gerakan repetitif pada pekerja pabrik rokok dan peningkatan risiko CTS. Profil paparan pekerja pabrik rokok yang unik—menggabungkan gerakan repetitif halus, postur canggung statis, dan jam kerja panjang—menciptakan lingkungan berisiko tinggi. Namun, bukti langsung masih sangat terbatas, didominasi oleh desain studi cross-sectional dengan sampel kecil dan variasi metode asesmen CTS yang menghambat komparabilitas. Kekosongan penelitian (research gap) utama adalah kurangnya studi kohort longitudinal dan penelitian intervensi dengan ukuran sampel yang memadai serta diagnosis CTS berbasis konduksi saraf (NCS) pada populasi spesifik ini. Kesimpulan: Gerakan repetitif pada pekerja pabrik rokok di Indonesia berhubungan dengan peningkatan risiko CTS, didukung oleh bukti tidak langsung yang kuat dan bukti langsung yang terbatas namun mengarah pada kesimpulan serupa. Intervensi ergonomis dan program latihan merupakan strategi pencegahan yang menjanjikan dan telah menunjukkan efektivitas dalam konteks Indonesia. Diperlukan penelitian lebih lanjut dengan desain longitudinal dan metode diagnosis yang lebih ketat untuk memperkuat bukti kausal dan menginformasikan kebijakan kesehatan kerja yang lebih tepat sasaran.
A Comprehensive Systematic Review of The Relationship between Poverty Status and Access to Tuberculosis Treatment in Developing Countries Harlina Hi M Konoras; Muhammad Irsan; Brian Enrique Fritzgerald
The Indonesian Journal of General Medicine Vol. 27 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/cd0wy377

Abstract

Introduction: Tuberculosis (TB) remains a major global health challenge, disproportionately affecting populations in low- and middle-income countries (LMICs). Poverty is a fundamental social determinant that intersects with and exacerbates barriers to TB care, from diagnosis through treatment completion. Understanding the multifaceted relationship between poverty status and access to TB treatment is critical for designing equitable and effective interventions to end the TB epidemic (Teo et al., 2020; Tanimura et al., 2014). Methods: This comprehensive systematic review synthesized evidence from 80 studies examining the relationship between poverty and TB treatment access in developing countries. A rigorous screening process was employed, focusing on studies with TB patients in LMICs that quantitatively assessed economic factors as exposures and treatment access as an outcome. Data extraction followed a structured protocol covering study context, poverty definitions, treatment access measures, financial and non-financial barriers, treatment outcomes, and tested interventions. Results: The evidence consistently demonstrates a strong negative association between poverty and TB treatment access. A significant proportion of TB patients face catastrophic health expenditures, with rates reaching 43% overall, 80% for drug-resistant TB, and 81% for HIV-coinfected patients (Ghazy et al., 2022; Ghazy et al., 2021). Indirect costs, primarily income loss, constitute approximately 60% of the total financial burden. Non-financial barriers, including geographic distance, stigma, and structural healthcare system limitations, further impede access. Poverty is associated with longer diagnosis and treatment delays, with patient delays averaging 28 days in low-income countries compared to 10 days in upper-middle-income countries (Teo et al., 2021). Effective interventions include cash transfers (OR 1.77 for positive clinical outcomes), food support, decentralized diagnostics, and community-based care models (Richterman et al., 2018; Filho, 2009; Assebe et al., 2025). Discussion: The relationship between poverty and TB treatment access is complex and mediated through multiple pathways. The heterogeneity in findings can be explained by contextual factors such as national economic development, drug resistance status, and case-finding strategies. The dominance of indirect costs highlights the insufficiency of policies focusing solely on eliminating direct medical fees. Multi-component, pro-poor interventions that address financial, geographic, and social barriers simultaneously show the greatest promise for improving equity in TB care. Conclusion: Poverty is a powerful driver of inequitable access to TB treatment in developing countries, leading to catastrophic costs, treatment delays, and poorer outcomes. To achieve global TB targets, programs must move beyond medical-focused models and integrate comprehensive social protection, poverty-sensitive service delivery innovations, and active case-finding strategies tailored to the needs of the most vulnerable populations. Future research should employ standardized poverty measurements and robust designs to evaluate the cost-effectiveness of integrated, pro-poor TB interventions.
Radiotherapy in Malignant Melanoma of the Nasal Cavity: A Rare Case Re-Irradiation Using Volumetric-Modulated Arc Therapy (VMAT) and Brachytherapy Maren Irgiwi Fadlilah; Nova Agusta Isdiarto; Arundito Widikusumo
The Indonesian Journal of General Medicine Vol. 28 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/djykgh08

Abstract

Background: Malignant mucosal melanoma of the nasal cavity is a rare tumor with agressive characteristic and poor prognosis. Modern radiotherapy modalities such as Intensity-Modulated Radiotherapy (IMRT), VMAT, and brachytherapy offer the potential of the improvement of local control in tumor that historically known as radioresistant. The aim of this case report is to discuss malignant melanoma of the nasal cavity and the impact of radiotherapy, with a focus on re-irradiation using VMAT and brachytherapy in this diasase. Case description and Discussion: A man, 61 years old was diagnosed with malignant melanoma of the nasal cavity based on imaging and histopathology result. The patient underwent four cycles of chemotherapy, followed by external beam radiotherapy using IMRT technique with total dose 70 Gy/35 fractions. Post-treatment evaluation revealed residual mass, leading to re-irradiation using VMAT at 50 Gy/25 fractions, followed by Ir-192 brachytherapy at 16 Gy/4 fractions using a nasopharyngeal applicator. The cumulative total BED administered exceeded >160 Gy. Side effects on organs at risk were minimal, and post-treatment nasal bleeding and nasal congestion symptoms did not recur. Conclusion: A Multimodal approach combining IMRT, re-irradiation of VMAT, and brachytherapy demonstrates promising clinical outcomes in cases of malignant melanoma of the nasal cavity. The administration of a high cumulative Biological Effective Dose (BED) enables optimal tumor control without increasing toxicity to surrounding organs. This strategy is worth considering in the management of inoperable or locally recurrent head and neck mucosal melanoma.

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