Background: The simultaneous presence of superior vena cava syndrome, tumor lysis syndrome, massive pleural effusion, and metabolic syndrome in a child with mediastinal neuroblastoma is exceedingly rare and sparsely described in the literature. The concurrent occurrence of superior vena cava syndrome (SVCS), tumor lysis syndrome (TLS), massive pleural effusion, and metabolic syndrome in a pediatric patient is exceedingly rare and poses significant diagnostic and therapeutic challenges. This case report highlights a rare and urgent clinical scenario involving these overlapping conditions. Case Presentation: An 8-year-old girl presented with shortness of breath, facial swelling, cough, and a neck lump. Imaging revealed a large mediastinal mass with massive right pleural effusion. Laboratory findings supported the diagnosis of TLS and metabolic syndrome in the context of obesity. Histopathology confirmed the differentiation of neuroblastoma. The patient was managed with steroids, chemotherapy, drainage, and supportive care, including metabolic syndrome assessment and nutritional interventions. Conclusions: This case emphasizes the importance of early recognition and multidisciplinary management of complex pediatric oncology emergencies. SVCS, TLS, and massive pleural effusion may co-occur in rare mediastinal neuroblastomas, especially in children with obesity and metabolic syndrome. Prompt recognition and integrated multidisciplinary care are essential to improve outcomes in complex pediatric oncology emergencies.
Background: Cancer-related fatigue is a significant concern for breast cancer patients undergoing chemotherapy, yet Indonesia lacks a culturally validated tool to assess. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Fatige-12 (EORTC QLQ-FA12), which measures physical, emotional, and cognitive fatigue, is available only in English. This study aims to evaluate the validity and reliability of the Indonesian version of the EORTC QLQ-FA12. Methods: A cross-sectional methodological study applied forward-backward translation following Beaton’s guidelines. Pretesting and validation involved 30 and 70 patients, respectively. Psychometric evaluation included content validity, internal consistency, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). Results: The scale showed strong content validity index (CVI = 0.917) and internal consistency (alpha = 0.905). Although EFA suggested statistical clustering of items, CFA supported the theoretical multidimensional structure of the original instrument. Model fit indices were acceptable (Goodness-of-Fit Index (GFI) = 0.952, Comparative Fit Index (CFI) = 0.930, Tucker Lewis Index (TLI) = 0.904, Standardized Root Mean Square Residual (SRMR) = 0.056), while Root Mean Square Error of Approximation (RMSEA) = 0.098 indicated moderate approximation error. Factor loading ranged from 0.23 to 0.91. Conclusions: The Indonesian EORTC QLQ-FA12 demonstrates satisfactory reliability and acceptable construct validity, preserving the multidimensional fatigue framework. The instrument is suitable for clinical and research assessment of cancer-related fatigue in Indonesian breast cancer patients
The remarkable progress of Anatomical Pathology over recent decades has fundamentally reshaped the landscape of oncologic diagnostics. From the early era when microscopic interpretation of routine hematoxylin-eosin (H&E) stained sections formed the diagnostic cornerstone, the discipline has evolved into a complex hub of integrated biological data. This journey began with mastery of histopathological and cytological morphology and expanded to the use of histochemical and immunohistochemical stains, enabling precise visualization of specific proteins. The transformation continued as molecular technologies became routinely implemented in major laboratories, extending diagnostic capacity far beyond the limits of the optical microscope.
Background: Myeloid sarcoma (MS) is a rare extramedullary tumor composed of myeloblasts or immature myeloid cells. It is often associated with acute promyelocytic leukemia (APL), which is a subtype of acute myeloid leukemia (AML), but rarely presents as the initial manifestation of the disease, particularly in children. Diagnosing MS is challenging due to its rarity and clinical resemblance to other malignancies. Early identification and proper diagnostic evaluation are crucial for accurate diagnosis and timely intervention. Case Presentation: We report a 2-year-old girl presenting with a history of a cranial mass and bilateral orbital involvement, initially suspected as neuroblastoma. Laboratory findings revealed anemia, leukocytosis with increased immature granulocytes. Bone marrow aspirate analysis demonstrated 40% promyelocytes, consistent with APL. Fine needle aspiration biopsy (FNAB) of the mandibular lesion showed malignant cells, and immunocytochemical staining was positive for myeloperoxidase (MPO), confirming the diagnosis of MS. The patient was treated with all trans retinoic acid (ATRA) and the chemotherapy agent methotrexate combined with daunorubicin, leading to a favorable response. Conclusions: This case highlights the importance of considering myeloid sarcoma in the differential diagnosis of orbital masses in children, especially when accompanied by hematologic abnormalities. Early recognition and appropriate diagnostic workup, including bone marrow analysis and immunocytochemistry, are essential to establish the diagnosis of APL with extramedullary involvement and to initiate prompt, targeted therapy.
Background: Pazopanib is approved as a first-line targeted therapy for metastatic renal cell carcinoma (mRCC), typically initiated at 800 mg once daily. However, maintaining this standard dose is often challenging due to patients’ poor general condition and treatment-related adverse effects. Few studies have explored whether a reduced dose could provide comparable clinical benefits with improved tolerability. This study aims to investigate the clinical survival outcomes of an initial low dose (400 mg) of Pazopanib in mRCC patients. Methods: This retrospective pilot study evaluated mRCC patients between 2019 and 2024 who were treated with an initial 400 mg Pazopanib and followed by escalation to 800 mg (if possible) at a national cancer referral hospital. If patients could not tolerate escalation dose, they received the low dose throughout treatment. Demographic data, adverse effects, and survival outcomes were collected. Radiographic progression-free survival (rPFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Results: Forty-three patients (aged 21—77 years) were included, with 67.9% being male. Most patients (48.8%) had a single site of metastasis, with the liver being the most common. After a mean follow-up of 15.1 (± 7.1) months, 18 patients (41.9%) had died. The median rPFS was 14.6 months (11.6—17.6), and the median OS was 23.5 months (19.3—27.7). Only 3 patients (6.97%) discontinued treatment due to adverse effects. While 27.9% experienced no adverse events, the most common symptoms were nausea and vomiting (25.6%). Conclusions: Initiating treatment with 400 mg Pazopanib in mRCC patients may offer acceptable survival outcomes with good tolerability and compliance. In the future, this low-dose strategy could serve as a feasible alternative for patients at risk of poor tolerance to standard dosing.
Background: Liquid-based cervical cytology is a monolayer slide preparation technique that enhances the accuracy of conventional Pap smears. Blood contamination (erythrocytes) is one of the most common causes of inadequate liquid-based cervical cytology samples. Therefore, alternative methods and materials are necessary to improve the adequacy of blood contaminated liquid-based cervical cytology samples. This study aims to evaluate the effectiveness of a 95% alcohol and glacial acetic acid combination in enhancing the adequacy of blood-contaminated liquid-based cervical cytology samples. Methods: A total of 30 samples were included in this study, with patients aged between 21 and 59 years. The samples were divided into two groups based on the ratio of 95% alcohol to glacial acetic acid, specifically 4:1 and 3:2. The study utilized an experimental design, wherein sample lysis was carried out using these two reagent combinations. The adequacy of the samples was evaluated microscopically both prior to and following the lysis process. Statistical analysis was performed using the Wilcoxon Signed-Rank Test and the Mann-Whitney U Test. Results: The results demonstrated that the 95% alcohol and glacial acetic acid combination effectively improved sample adequacy, with the 3:2 ratio yielding a more significant improvement (80%) compared to the 4:1 ratio (60%). The p-values from the Wilcoxon Signed Rank Test were 0.003 for the 4:1 ratio and < 0.001 for the 3:2 ratio, indicating a significant difference between pre-lysis and post-lysis adequacy. However, the Mann-Whitney U test showed no significant difference between the two concentration ratios (p = 0.240). Conclusions: The combination of 95% alcohol and glacial acetic acid is an effective alternative for enhancing the adequacy of blood-contaminated liquid-based cervical cytology samples, with the 3:2 ratio providing optimal results.
Hepatocellular carcinoma (HCC) is the third leading cause of cancer death and the sixth most diagnosed cancer. Curcumin (C) has anticancer effects toward HCC and may enhance the antitumor effects of certain traditional chemotherapeutic and molecular target drugs. Co administration with piperine (P) improves curcumin’s bioavailability, while taurine (T) also exhibits antitumor properties. This study aimed to assess the potential effects of the CPT combination on biochemical and immunological parameters in HCC patients. Following the PRISMA guidelines, a systematic review and meta-analysis were conducted using data from several databases, focusing on HCC and CPT studies. Review Manager 5.4 was used to perform the meta-analysis. Four studies involving 81 HCC patients met the inclusion criteria, with three included in the meta-analysis. Over three successive 30-day cycles of CPT treatment, significant reductions were observed in biochemical parameters including AST (SMD = 1.13, 95% CI: 0.29—1.97, p = 0.008), ALT (SMD = 0.33, 95% CI: 0.13—0.53, p = 0.001), and total bilirubin (SMD = 0.65, 95% CI: 0.45—0.85, p < 0.00001), while albumin levels showed no significant change (SMD = 0.00, 95% CI: -0.33—1.34, p = 0.98). Included studies indicated significant reductions in IL-10, CD25, miR-21, VEGF, CD4+CD25+%, and CD8+CD25+%, alongside increases in IFN-γ, CD4, CD8, IL-2, and IL-12 following CPT treatment. In conclusion, CPT combination therapy induced significant improvements in biochemical and immunological parameters across three treatment cycles, highlighting its potential as a promising natural therapeutic option for HCC management. Further research is necessary to validate these findings
Background: Desmoplastic nodular medulloblastoma (DNMB) is an uncommon but malignant variant of medulloblastoma that typically occurs in children. Although it is malignant in nature, children with DNMB have a high 5-year overall survival rate. Here, we present a complex case of a DNMB in a 6-year-old pediatric patient. This study highlights the importance of early and effective treatment approaches in DNMB through a challenging pediatric case. Case Presentation: A 6-year-old boy with a genetic condition of delayed motor and mental development and ischemic-hypoxic brain damage was brought to our center. He was observed to have drowsiness, whims, and seizures. An initial non-contrast-enhanced head computed tomography (CT) scan revealed occlusive hydrocephalus. Subsequently, a contrast-enhanced brain magnetic resonance imaging (MRI) showed a lesion at the posterior fossa, growing towards the corpora quadrigemina, with areas of growth towards the right cerebellar hemisphere and vermis. After a subtotal resection was achieved in the initial surgical intervention, a second surgical procedure was performed, during which the residual lesion was grossly totally resected. The patient’s treatment process was complicated by hydrocephalus, which was initially managed with Ommaya reservoir implantation, followed by ventriculoperitoneal shunt placement. The patient then received radiotherapy and adjuvant chemotherapy with cyclophosphamide, vincristine, carboplatin, and intravenous methotrexate. Conclusions: Despite its malignant nature, early diagnosis and appropriate treatment strategies, including gross total resection followed by chemoradiotherapy, significantly improve overall survival rates. Managing complex cases requires timely intervention and close postoperative monitoring, particularly in cases with fourth ventricle involvement, where hydrocephalus management is critical.
Background: Mammary Paget’s disease (MPD) accounts for 1—4% of all breast carcinomas. It can affect both men and women with a wide age range, 27 to 88 years old, and 20—30% affect premenopausal woman. Moreover, no specific risk factor has been identified for MPD, and the exact pathogenesis remains uncertain. For these reasons, the MPD clinicopathologically engages in case reports. Case Presentation: A 46-year-old woman with a palpable mass in the left breast for 6 months. The ultrasound examination showed hypervascularity accompanied by nipple abrasions, and the mammography results did not identify malignant calcification or mass formation. Routine histopathology revealed anaplastic cells with round cell morphology, and partially clear, extensive eosinophilic cytoplasm was seen. In addition, immunohistochemical examination showed estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) strongly positive with 60% Ki67 proliferation index. Conclusions: Based on clinical data, radiological, combined with histopathological and immunohistochemical examination, the case supports mammary Paget disease with ductal carcinoma in situ (DCIS). It has an excellent outcome, > 95% survival at 20 years
Introduction: Hepatoblastoma (HB) is a rare primary malignant tumor of the liver in children. Treatment procedures for HB usually involve surgery and even liver transplantation, in addition to neoadjuvant or palliative systemic chemotherapy. However, the recent development of transarterial chemoembolization (TACE) procedures has provided an additional option that is considered quite effective in treating HB. This treatment procedure is believed to have many advantages as a treatment option prior to surgery and/or liver transplantation. This case is interesting to discuss because this procedure is still rarely performed in Indonesia. Whereas in many countries it has shown success and is quite desirable option both as a bridge therapy before surgery and palliative therapy. Case Presentation: We present a case of an 8-month-old baby boy diagnosed with HB. The patient had a history of preterm birth. Hemoglobin (Hb) level was 7 g/dL, and platelet count was elevated. Alpha-fetoprotein (AFP) levels were elevated to 122,010 ng/dL. Ultrasonography showed a large solid mass in the right liver lobe, raising suspicion of malignancy. Contrast enhanced 3-phase computed tomography (CT) scan imaging showed a solid mass in the right lobe of the liver that was contrast-enhanced, hypovascularized, contained intra-tumor necrotic components, had ill-defined borders, and was not encapsulated. It measured approximately 9.02 x 9.94 x 9.93 cm, and appeared to cover almost the entire right lobe of the liver. This finding was diagnosed as PRETEXT III hepatoblastoma. An experienced interventional radiologist performed TACE with cisplatin agent. Subsequent evaluation 20 days after the first TACE, the size of the tumor mass had reduced by 20% from the previous size. This finding warrants consideration of the next optimal therapeutic approach, i.e., whether to proceed with surgical intervention or perform subsequent TACE prior to surgery. In our case, we proceeded with a repeat of TACE followed by surgery. Conclusions: Transarterial chemoembolization appears to be one of the effective treatment options for large and invasive HB, as experience has shown that TACE can shrink tumor size, provide clearer borders, and reduce alpha-fetoprotein (AFP) levels after the first TACE. TACE can thus facilitate more optimal surgical and transplantation procedures. Thus, we believe that TACE has the potential to become a recognized HB treatment option in the future.
Background: Giant Cell Tumor (GCT) is a non-metastatic bone tumor known for its local aggressiveness and recurrence risk. While commonly affecting the knee and distal radius, involvement of the distal fibula, particularly the lateral malleolus, is extremely rare. Standard surgical approaches may jeopardize joint mechanics in this critical load-bearing region. This case series highlights the application of ipsilateral autologous fibular head grafting to restore ankle stability following tumor resection. We aim to offer a practical reference for biological reconstruction in managing uncommon GCTs of the lateral malleolus. Case Presentation: Two female patients, aged 20 and 14 years old, presented with progressively enlarging, painful right lateral ankle masses. Both patients underwent Magnetic Resonance Imaging (MRI), revealing a well-defined lytic lesion with fluid-fluid levels and cortical thinning consistent with GCT. They underwent wide resection or reoperation followed by fibular head autograft, and one-third tubular plate (OTP) fixation. At 3-year and 6-month follow-up, both showed no recurrence and regained excellent function, with Musculoskeletal Tumor Society Score (MSTS) and American Orthopaedic Foot & Ankle Score (AOFAS) of 28/30, 94/100, and 26/30, 92/100, respectively. Conclusions: This case series supports the use of fibular head autografting as a joint-preserving solution following lateral malleolus GCT resection. Our findings provide preliminary evidence for a biologically favourable and functionally effective method applicable to similar rare presentations.
Background: Hormonal therapy is widely used in breast cancer treatment, yet its long-term effects on lipid profiles remain a concern, especially regarding the duration of treatment. This study aimed to analyze the association between the type and duration of hormonal therapy and changes in lipid profiles, including total cholesterol, triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL), among breast cancer patients with different menopausal statuses. Methods: A retrospective observational study was conducted using secondary data from 358 female breast cancer patients who received hormonal therapy, such as aromatase inhibitors, selective estrogen receptor modulators, or GnRH agonists, in 2024 at Dr. Moewardi Hospital. Clinical data included the type of hormonal therapy, treatment duration, age, menopausal status, and lipid profile parameters. Data were analyzed using non-parametric tests, with p-values < 0.05 considered statistically significant. Results: A statistically significant association was found between therapy duration and total cholesterol levels (p = 0.023). The highest mean total cholesterol was observed in the 1—2 years group (193.22 ± 58.56 mg/dL), followed by > 2 years (188.04 ± 41.72 mg/dL), and the lowest in < 1 year (174.40 ± 44.91 mg/dL). Post hoc analysis confirmed significant differences between the < 1 year group and both the 1—2 years (p = 0.042) and > 2 years groups (p = 0.032). No statistically significant associations were found between therapy duration and levels of TG, HDL, or LDL, nor between lipid profiles and menopausal status. Conclusions: The duration of hormonal therapy significantly affects total cholesterol levels in breast cancer patients, with longer durations associated with higher levels. These findings emphasize the importance of lipid profile monitoring during extended hormonal therapy to mitigate potential cardiovascular risks.
Background: Prostate cancer is the second most commonly diagnosed cancer in men worldwide and a leading cause of cancer-related mortality. Castration-resistant prostate cancer (CRPC) develops despite androgen deprivation therapy (ADT), often after treatment with abiraterone or enzalutamide. Statins have shown potential anticancer effects through inhibition of HMG-CoA reductase and related signaling pathways. This systematic review evaluated whether statin use improves survival and disease outcomes in patients with CRPC previously treated with abiraterone or enzalutamide. Methods: A systematic search of PubMed, ProQuest, SAGE, and Europe PMC was conducted following PRISMA and Cochrane guidelines. Studies published within the last 10 years were included if they involved adults with CRPC receiving ADT or orchiectomy and compared statin users with non-users. Risk of bias was assessed using RoB 2.0 for randomized controlled trials (RCTs) and ROBINS-I for non-randomized studies. Primary outcomes were overall survival (OS), cancer-specific survival (CSS), and prostate-specific antigen (PSA) response. Results: Eight studies (two RCTs and six retrospective cohort studies) involving 35,401 patients were included. Most studies had a low to moderate risk of bias. Results were heterogeneous. Two of four studies reported significantly improved OS among statin users, while the remaining studies found no significant association. One study showed improved CSS, and two studies reported higher PSA response rates with statin use. However, these benefits were not consistently observed throughout all studies. Conclusion: Statin use may improve survival outcomes and PSA response in patients with CRPC. However, current evidence remains
Background: Constipation is a common gastrointestinal complication among cancer patients undergoing chemotherapy, negatively affecting quality of life and treatment adherence. Non pharmacological interventions such as fruit-based dietary strategies may provide a safe and accessible alternative. This study aims to evaluate the effect of papaya—lime smoothie (Carica papaya L. & Citrus aurantiifolia) on constipation severity in breast cancer patients receiving chemotherapy. Methods: A quasi-experimental non-equivalent pretest—post-test control group design was conducted on 32 breast cancer patients at West Nusa Tenggara Provincial General Hospital. The intervention group (n=16) consumed 280 mL of papaya—lime smoothie daily for three days, while the control group (n=16) received standard care. Constipation severity was assessed using the constipation assessment scale (CAS). Statistical tests included the Wilcoxon signed-rank, the Mann-Whitney U, and the t-tests. Result: The intervention group showed a significant reduction in CAS scores from 10.38 ± 1.99 (moderate constipation) to 1.94 ± 1.69 (no constipation) (p < 0.001), while the control group decreased from 9.88 ± 1.99 to 5.19 ± 1.51 (mild constipation) (p < 0.001). Between-group differences were significant (Δ=8.44 ± 1.50 vs Δ=4.69 ± 2.27, p < 0.001). Conclusion: Daily consumption of papaya—lime smoothie effectively reduced constipation severity in breast cancer patients undergoing chemotherapy and may be considered as an alternative supporting non-pharmacologic therapy in cancer care.
Background: The increasing incidence of cancer has led to growing challenges in the provision of cancer patient care. To address these challenges, cancer patient navigation (CPN) has been developed and implemented in various countries with different models and approaches. This scoping review aims to explore the implementation of CPN across developed and developing countries. Methods: A scoping review was conducted using the six-stage framework. The Population Concept—Context (PCC) framework guided the review, with cancer patients or survivors as the population, CPN as the concept, and implementation or practice as the context. Literature searches were performed in seven databases: PubMed, EBSCO, ScienceDirect, Scopus, ProQuest, Sage Journals, and Wiley Online Library. Articles were screened, extracted, and analyzed collaboratively, then grouped into thematic categories. Results: Thirteen studies met the inclusion criteria. Four major themes of CPN implementation were identified: early detection, diagnosis, treatment, and survivorship. Early detection focused on screening and education; diagnostics aimed to reduce delays in cancer diagnosis; treatment addressed financial, psychosocial, and systemic barriers; and survivorship emphasized long-term support, including psychological rehabilitation, symptom management, and supportive care planning. Conclusions: Cancer patient navigation improves care coordination, reduces barriers, and enhances continuity across all stages of cancer care. Despite variations in implementation across countries, navigation consistently supports patient-centered care and addresses gaps within health systems. Standardized roles, integrating navigation into national cancer programs, and evaluating long-term outcomes are essential to optimizing its effectiveness and sustainability
Background: Chimeric Antigen Receptor T-cell (CAR T-cell) therapy targeting CD19 on B-cells has emerged as a promising treatment for B-cell malignancies such as B-Acute Lymphoblastic Leukemia (B-ALL) and Diffuse Large B-cell Lymphoma (DLBCL). Despite its success, resistance mechanisms, including immune checkpoint inhibitors, persistent antigen stimulation, T-cell exhaustion, antigen loss, lineage switch, tumor heterogeneity, impaired death receptor signalling, and the tumor microenvironment, pose significant challenges. Understanding these mechanisms is crucial to advancing CAR T-cell therapy and improving its efficacy. Methods: This literature review was conducted by analyzing peer-reviewed articles and clinical trials focusing on CAR T-cell therapy for B-ALL and DLBCL. Key mechanisms of resistance were identified, and their biological underpinnings were evaluated to highlight trends and potential strategies for overcoming resistance. Sources included PubMed, Science Direct, Google Scholar, and Google database using keywords such as ‘CD19,’ ‘CAR T-cell,’ ‘B-ALL,’ and ‘DLBCL’. Most articles were published within the past five years and were selected from journals with a high impact factor, and some older publications were included for foundational and theoretical insights. Results: The review identifies multiple resistance mechanisms, including persistent antigen stimulation leading to T-cell exhaustion, immune checkpoint inhibitors suppressing effector functions, and tumor intrinsic factors like antigen loss and lineage switch. The role of the tumor microenvironment, with its immunosuppressive components, also contributes significantly to treatment failure. These findings underscore the complexity of resistance pathways and the need for combinatory and innovative approaches to enhance therapeutic outcomes. Conclusions: Resistance to CAR T-cell therapy presents a significant challenge in treating B-cell malignancies. Addressing these mechanisms requires further research into combination therapies, multi-antigen targeting, and tumor microenvironment modulation. These strategies have the potential to optimize CAR T-cell efficacy and improve patient survival rates
Introduction: Non-Down syndrome acute megakaryocytic leukemia (Non-DS-AMKL) is a rare leukemia. Pediatric acute myeloid leukemia (AML) accounts for only 4—15% of all leukemia cases, while AMKL accounts for only 3-10% of pediatric AML. Most AMKLs are Down syndrome (DS) (> 75%). Diagnostic criteria require a minimum of 20 % blasts in the bone marrow, of the megakaryocytic lineage, in a person without Down syndrome. Flow cytometry in blast cells must reveal expressions of one or more platelet markers (CD41a, CD42b, or CD61). Genetic test differentiates treatment and prognosis. This is the first AMKL report in Indonesia that approaches comprehensive genetic testing. Case Presentation: The patient was a 26-month-old boy who had bruises over his tummy, arm, and legs. He was anemic, having splenomegaly with Schuffner 2, hemoglobin level 9.1 g/dL, leucocyte 7,200/uL, platelet 12,000/uL, erythrocyte sedimentation rate 22 mm/hour. The bone marrow was hemodiluted with 53% blasts dominated by large cells with a high nucleus cytoplasmic ratio, nucleoli were found, irregular fine chromatin, basophilic cytoplasm with prominent cytoplasmic projection/blebs consistent with megakaryoblast. These blasts were expressing CD45 dim, CD36, CD41a, CD33, HLA-DR and CD13 dim. A genetic test using fluorescence in situ hybridization (FISH) and next-generation sequencing (NGS) revealed lysine methyltransferase 2A/KMT2A/MLL positive. Therefore, the patient was confirmed as the Non-DS AMKL with positive KMT2A, which confers a dismal outcome compared to the GATA-binding factor1/GATA1/Erythroid transcription factor mutation. Conclusions: Non-DS AMKL is a challenging diagnosis in terms of morphology, immunophenotypic, signs, symptoms, and genetics. Genetic profile will contribute important scientific understanding to decide and improve AMKL treatment and prognosis, particularly unsatisfactory prognosis AMKL, such as a patient with KMT2Ar/MLL
Background: Oral cancer ranks as the 16th most common malignancy, with a disproportionately higher incidence in Asia. The 5-year overall survival (OS) of oral cancer shows differences in many countries. In Indonesia, many patients present at advanced stages, making adequate surgery followed by appropriate adjuvant therapy crucial for optimal outcomes. This study aims to evaluate the factors affecting OS, focusing on the comparison between adjuvant radiotherapy and chemoradiotherapy in oral cancer patients at Dharmais Cancer Hospital. Method: A retrospective study was conducted on 51 samples collected from patients’ medical record started in January 2017 to January 2024, and patients were followed up by phone. Overall survival was calculated with Kaplan-Meier analysis, and prognostic factors were analyzed using the Cox-Regression. Result: The 5-year OS rate for oral cancer patients was 58.1%, while patients who underwent adjuvant radiotherapy and chemoradiotherapy had rates of 51% and 40%, respectively (p-value 0.35); this difference was not statistically significant. Cox-regression analysis showed that comorbidities (HR, 2.8; 95 CI, 1.05—7.4; P = 0.04), tumor grade (HR, 11.3; 95% CI, 1.88—67.94; P = 0.008), and stage (HR, 0.11; 95% CI, 0.01—0.9; P = 0.04) were associated with OS in oral cancer patients. Conclusion: Five-year OS of oral cancer patients in Dharmais Cancer Hospital was 58.1%. Patients who received adjuvant radiotherapy tended to have better OS than those who received adjuvant chemoradiotherapy, although the difference was not statistically significant. Additionally, comorbidities, tumor grade, and stage were found to be significantly associated with OS in oral cancer patients.
Introduction: In addition to reducing tumor size, radiotherapy in head and neck cancer patients can lead to several negative effects, such as dysphagia, xerostomia, and mucosal infections. The prevalence of dysphagia due to head-neck radiation reaches 60% to 75%. If this condition is not treated properly, it will cause malnutrition, reduce the quality of life, and increase mortality rates. Therapy for post-radiation side effects of the head and neck generally uses medications. However, the price is quite high and may cause additional side effects. This case report aims to provide another alternative to treat post-radiation side effects without additional side effects and to prevent complications due to the side effects of head and neck radiation Case Presentation: A 54-year-old male patient had complaints of hypersalivation and dysphagia after radiotherapy due to sinonasal squamous cell carcinoma. This complaint was accompanied by the presence of blisters and hard yellowish plaques in the patient's mouth. The patient came to the acupuncture clinic with a pain score of 5, as measured by the Numeric Rating Scale (NRS), drooling severity and frequency scale (DSFS) was 4, and quality of life score of 2 and 53.08 by the MD Anderson Dysphagia Inventory (MDADI). He received manual acupuncture therapy on the face, ears, neck, hands, and feet with a frequency of twice per week and a duration of 30 minutes per session, for a total of 12 sessions. After complete acupuncture therapy, the pain decreased from NRS 5 to NRS 0, DSFS 4 to DSFS 1, and quality of life from MDADI 2 and 53.08 to MDADI 5 and 72.68. These results lasted until the end of follow-up at week 4 without side effects. Conclusions: Acupuncture can reduce complaints of post-radiotherapy head and neck side effects, especially dysphagia and hypersalivation. Also, improve the quality of life of cancer patients.
Introduction: Diffuse Large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma (NHL), accounting for 25% to 30% of NHL cases. Diffuse large B-cell lymphoma (DLBCL) commonly happens in the seventh decade and often arises in the lymph nodes but can also present as an extra nodal disease. Nodal DLBCL involves the lymph nodes and does not involve the organ under the lymph nodes. In this case, we want to report a case of 25 men diagnosed with intussusception caused by nodal mesocolon enlargement, and histomorphology examinations revealed that the nodal enlargement is DLBCL. Here we reported a case of 25 years old man diagnosed with invagination caused by nodal mesocolon enlargement and, histomorphology examinations revealed the nodal enlargement is DLBCL. Case Presentation: We reported a case of 25 years old man complaints nausea, vomiting, abdominal pain, and was diagnosed with intussusception. Macroscopic examination showed nodal enlargement without colon mucosal involvement. Microscopic examination showed a relatively uniform and monotonous distribution of lymphoid cells with large cell sizes, enlarged nuclei with a round to oval shape, vesicular chromatin, amphophilic cytoplasm and some foci of tumour cells arranged in loose stroma. Macrophage and atypical mitoses were found. Immunohistochemical examination results were as follows: CD 117 (-), DOG 1 (-), CK (-), CD 45 (+), Myogenin (-), MyoD1 (-), CD20 (-), CD3 (-), Ki67 >50%, CD 20 (+), CD3 (-), CD 10 (-), BCL6 (-), MUM1 (+). Conclusion: Diffuse large B-cell lymphoma (DLBCL) can occur in gastrointestinal as extra nodal lymphoma. The mesocolon contains many lymph nodes, but gastrointestinal lymphoma usually involves the gastrointestinal tissue. This case reports a case of 25 years old man who presents with intussusception caused by DLBCL in nodal mesocolon without colon involvement.
