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All Journal Medicina INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES E-Jurnal Medika Udayana Indonesian Journal of Cancer Jurnal Ilmiah Kedokteran Wijaya Kusuma ISM (Intisari Sains Medis) : Jurnal Kedokteran Majalah Patologi Indonesia Indonesian Journal of Cancer Journal of Global Pharma Technology

I Gusti Ayu Sri Mahendra Dewi

Departemen Patologi Anatomi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia

Author-ID : 2392701

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

Published : 49 Documents Claim Missing Document

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Articles

Title

Pheochromocytoma: A Clinicopathologic Case Series I Gusti Ayu Sri Mahendra Dewi; Desak Putu Gayatri Saraswati Seputra
Indonesian Journal of Cancer Vol 14, No 1 (2020): March
Publisher : National Cancer Center - Dharmais Cancer Hospital

Introduction: Pheochromocytoma is a rare neuroendocrine tumor derived from the chromaffin cells of adrenal medulla. The incidence ranges from 0.005% to 0.1% in the general population.Case Presentation: This case series reported 4 patients with pheochromocytoma who were diagnosed at Sanglah General Hospital Denpasar over a period of three years (2017–2019). The age ranged from 15–59 years with the mean age of 41 + 18.9 years. A similar proportion was found for both sexes. Clinical features include lumps, headaches, flank region pain, palpitations and cold sweat. Hypertension was found in 3 cases. Local examination revealed the solid mass in the flank region in all cases; enlarged lymph nodes were found in one case, namely in the paraaortic region. Abdominal MSCT examination findings showed: a solid mass with cystic components in suprarenal; sizes ranging from 1.9 x 2.6 x 2.2 cm to 21.6 x 14.3 x 17.8 cm; bilateral (1 case), unilateral (3 cases); contrast enhancement and hypervascularization, without calcification (4 cases); central necrotic (1 case). All patients underwent radical adrenalectomy. Microscopic features showed the tumor mass which consisted of the proliferation of chromaffin cells forming alveolar (Zellballen) and solid nest patterns separated by capillary blood vessels. The cells were polygonal-shaped with clear cytoplasm, round-shaped nucleus, and moderate pleomorphic. Mitosis was not found. These histomorphologic findings supported the diagnosis of pheochromocytoma.Conclusions: Diagnosis and optimal treatment plans can be established through rapid and precise recognition of pheochromocytoma in order to achieve better outcomes.

Loss of Phosphatase and Tensin Homologue (PTEN) Expression Associated with Higher Risk Grade Group Gleason Prostate Adenocarcinoma in Sanglah Hospital Denpasar Tjandra Kristiana; I Gusti Ayu Sri Mahendra Dewi; Luh Putu Iin Indrayani Maker; Herman Saputra; Ni Putu Sriwidyani; I Made Muliarta
Indonesian Journal of Cancer Vol 13, No 4 (2019): December
Publisher : National Cancer Center - Dharmais Cancer Hospital

Background: Prostate cancer is the second most common malignancy in men and the fifth most common cause of death worldwide. In Asia, 59.3% of patients come for the advanced stage treatment. PTEN inactivation is identified in about 20% of primary prostate tumors in radical prostatectomy and the loss of PTEN is associated with poor clinical and pathological outcomes. The purpose of this study is to prove that there is an association between PTEN expression and risk grade group Gleason prostate adenocarcinoma in Sanglah Public Hospital, Denpasar.Methods: This is a cross-sectional study. The sample size of this study was 35 paraffin blocks. These samples were selected by proportional stratified random sampling from hematoxylin-eosin preparation. Prostate adenocarcinoma was regrouped into 3 categories based on NCCN risk stratification: low risk grade group Gleason (Gleason score ≤ 6), intermediate risk grade group Gleason (Gleason score 7), and high-risk grade group Gleason (Gleason score 8–10). Immunohistochemistry examination of PTEN was performed and the expression was evaluated by scoring method. The data were analyzed by Chi-square and logistic regression.Results: The analysis result showed that there is an association between PTEN expression and risk grade group Gleason that is statistically significant. The loss of PTEN expression associated with higher risk grade group Gleason is of the higher proportion with p=0.001; PR 3.339; 95% CI: 1.296–8.599, but there is no association between the proportion loss of PTEN expression heterogeneously or homogeneously and the risk grade group Gleason with p=0.742; PR 0.663; 95% CI: 0.179–2.457.Conclusions: This study has proved that PTEN expression is associated with higher risk grade group Gleason prostate adenocarcinoma.

Myasthenia Gravis in Patients with Histopathologically Diagnosed Thymoma at Sanglah General Hospital: A Case Series Desak Putu Gayatri Saraswati Seputra; I Gusti Ayu Sri Mahendra Dewi
Indonesian Journal of Cancer Vol 15, No 2 (2021): June
Publisher : National Cancer Center - Dharmais Cancer Hospital

Introduction: Thymoma is a neoplasm of the thymus gland which arises from the epithelial tissue. Thymoma is frequently related to various paraneoplastic syndromes, most commonly myasthenia gravis. Up to 50% of patients with thymoma are reported to develop myasthenia gravis, whereas 10–15% of patients with myasthenia gravis are found to have thymoma. Case Presentation: This case series reported 3 patients with myasthenia gravis which co-occurred with thymoma at Sanglah General Hospital from 2018 to 2019. The patients’ ages range from 33 to 61 years (mean age 46 ± 11 years) with a 2:1 male-to-female ratio. The diagnosis of myasthenia gravis was made by the presentation of typical myasthenia gravis appearances, the fluctuating intensity of ocular and bulbar muscle weakness (all three cases), and limbs and axial muscle weakness (one case); no respiratory muscle involvement was found. Physical and supporting examinations including electroneuromyography results were coherent with myasthenia gravis. The diagnosis of thymoma was made by highly suggestive appearance in Thorax Multi Sliced Computed Tomography (MSCT) scan examination and histopathologic findings. MSCT scan examination showed a well-circumscribed ovoid solid mass in the mediastinum (left anterosuperior, superior, and anterior to middle right mediastinum) sized from 1.8x1.5x2.9 cm to 8.1x9.9x9.7 cm, enhanced with contrast injection with areas of calcification and central necrotic (1 case) and no dissemination to regional lymph node and neighboring organs. All cases received acetylcholinesterase inhibitors and underwent extended thymectomy. Histopathological examination showed accordance with thymoma features of subtype A, AB, and B1.Conclusions: Clinicians should be aware of the thymoma and myasthenia gravis co-existence possibility to ensure early recognition and appropriate management.

Kombinasi Pemeriksaan Potong Beku dan Imprint Meningkatkan Akurasi Diagnosis Intraoperatif Karsinoma Payudara I Gusti Ayu Sri Mahendra Dewi
Indonesian Journal of Cancer Vol 3, No 4 (2009): Oct - Dec 2009
Publisher : National Cancer Center - Dharmais Cancer Hospital

Pemeriksaan potong beku intraoperatif memegang peranan penting dalam penatalaksanaan penderita, tetapi mempunyai beberapa keterbatasan dalam hal pengambilan sampel, teknik, serta pengalaman dan pengetahuan ahli patologi yang baik karena keputusan diagnostik harus dibuat dalam waktu yang singkat. Penelitian ini menilai akurasi kombinasi pemeriksaan potong beku dan imprint intraoperatif untuk diagnosis karsinoma payudara, dengan blok parafin sebagai baku emas. Kasus diperoleh dari penderita tumor payudara yang bahan biopsinya dikirim untuk pemeriksaan potong beku ke Bagian/SMF Patologi Anatomi FK UNUD/RSUP Sanglah, Denpasar, dari 1 Januari 2006 sampai 31 Desember 2008. Selama periode tersebut didapatkan 35 kasus, terdiri dari 23 kasus karsinoma dan 12 kasus nonkarsinoma. Akurasi dihitung untuk masing-masing pemeriksaan potong beku, imprint, dan kombinasi keduanya. Sensitivitas, spesifisitas, nilai prediksi positif, dan nilai prediksi negatif untuk potong beku berturut-turut adalah 91,3%; 91,7%; 95,5%; dan 84,6%. Sensitivitas, spesifisitas, nilai prediksi positif, dan nilai prediksi negatif untuk imprint berturut-turut adalah 86,9%; 91,7%; 95,2%; dan 78,6%. Sensitivitas, spesifisitas, nilai prediksi positif, dan nilai prediksi negatif untuk kombinasi keduanya berturut-turut adalah 95,7%; 100%; 100%; dan 92,3%. Pemeriksaan kombinasi potong beku dan imprint intraoperatif dapat meningkatkan akurasi diagnosis karsinoma payudara.Kata kunci: akurasi, potong beku, imprint, karsinoma payudara.

Tethered Cord Syndrome in Patient with Lipomyelomeningocele: A Case Study I Gusti Ayu Sri Mahendra Dewi; Ni Putu Sriwidyani; Desak Made Cittarasmi Saraswati Seputra
Indonesian Journal of Cancer Vol 16, No 2 (2022): June
Publisher : National Cancer Center - Dharmais Cancer Hospital

Introduction: Tethered Cord Syndrome (TCS) is a condition that occurs due to spinal cord traction caused by the attachment of the spinal cord to the surrounding tissues. The incidence of TCS is quite rare, approximately 0.25 per 1,000 live births Case Presentation: We reported a 4-year-old female patient with a lump on her sacral region since birth which enlarged over time. The patient experienced intermittent fever for 1 month before hospital admission and constipation since infancy. Physical examination revealed a lump with a diameter of 6 cm on her sacral region with no neurological abnormality. Ultrasonography examination showed an anechoic lesion with multiple linear structures on supragluteal sinistra with a size of 2.2 x 2.5 x 2.1 cm. MSCT findings showed spina bifida at L5 until S2 level with features of lipomyelomeningocele and tethered cord started from L2 level. Bilateral hydronephrosis, hydroureter, and distended bladder (pine tree appearance) with the possibility of the neurogenic bladder were also found on MSCT examination. The patient underwent surgery to excise the lump and to release the tethered cord. Microscopic findings from excised mass showed a group of neuronal and glial cells, the syncytial sheet pattern of meningothelial cells, and foci of calcification which supported lipomyelomeningocele diagnosis. Conclusions: : Intensive follow-up care and observation must be carried out in children with spinal dysraphism because it may be associated with TCS which may be asymptomatic at an early stage.

Differences in Pre-Operative Mean Serum Concentration of Thyroid Stimulating Hormone (TSH) and Free Thyroxin (FT4) in Patients with Benign Thyroid Nodules and Thyroid Carcinoma at Sanglah General Hospital Denpasar I Gusti Ayu Sri Mahendra Dewi; Desak Putu Gayatri Saraswati Seputra
Indonesian Journal of Cancer Vol 16, No 1 (2022): March
Publisher : National Cancer Center - Dharmais Cancer Hospital

Background: Thyroid Stimulating Hormone (TSH) and Free Thyroxin (FT4) concentration are currently highlighted in their relation to thyroid carcinoma development in thyroid nodule patients. This study aimed to identify the difference in the pre-operative mean serum concentration of TSH and FT4 in patients with benign thyroid nodules and thyroid carcinoma at Sanglah General Hospital Denpasar.Methods: : This study was a case-control study that involved 110 patients with thyroid nodules who underwent thyroidectomy at Sanglah General Hospital from January until December 2019, whose specimens were examined histopathologically at the Anatomical Pathology Laboratory of Sanglah General Hospital. Cases were patients with thyroid carcinoma. Controls were patients with benign thyroid nodules. The data were collected from medical records. Results: Most subjects in the thyroid carcinoma group were female (72.7%). The thyroid carcinoma group had a higher mean age at the time of thyroidectomy (47.33 ± 13.4) compared to the benign thyroid nodule group (46.07 ± 12.5) (p = 0.61). Significant difference was found regarding the nodule size between the two groups (p < 0.001). There were no significant differences in terms of nodule lateralization (p = 0.56) and the number of nodules (p = 0.58). Papillary thyroid carcinoma was the most common type of thyroid carcinoma (89.1%). A significantly higher pre-operative mean serum TSH concentration was found in cases (1.0 ± 0.23 IU/mL) compared to controls (0.8 ± 0.23 IU/mL) (p < 0.001). The pre-operative mean serum FT4 concentration was significantly lower in cases (1.1 ± 0.25 IU/mL) compared to controls (1.2 ± 0.22 IU/mL) (p = 0.006). The optimal TSH and FT4 cut-off values for thyroid carcinoma were > 1.0 IU/mL (61% sensitivity, 71% specificity) and < 1.1 IU/mL (61% sensitivity, 51% specificity), respectively Conclusions: : Higher pre-operative mean TSH concentration and lower mean FT4 concentration were found in patients with thyroid carcinoma. There were statistically significant differences between patients with thyroid carcinoma and benign thyroid nodules in terms of these two laboratory parameters.

Co-Authors Anak Agung Ayu Ngurah Susraini and I G. Alit-Artha annie minerva datui Desak Made Cittarasmi Saraswati Seputra Desak Putu Gayatri Saraswati Seputra Desak Putu Gayatri Saraswati Seputra Desak Putu Gayatri Saraswati Seputra Diah Widityasari, Diah E. Joewarini Efrisca M Br Damanik Firman Parulian Sitanggang Gde Ngurah Idraguna Pinatih Herman Saputra Herman Saputra Herman Saputra Herman Saputra I Gusti Alit Artha I Gusti Bagus Lulut Premana Mulia I Gusti Bagus Mulia Agung Pradnyaandara I Gusti Ngurah Bagus Rai Mulya Hartawan I Kadek Adi Purnama Sandhi I Ketut Suwiyoga I Made Gotra I Made Muliarta I Made Muliarta I MADE MULIARTA . I Made Naris Pujawan I Made Wirya Sastra I Wayan Juli Sumadi I Wayan Juli Sumadi IB Caka Gunantara Ida Ayu Eugenia Natasha Blanco Oka Ida Ayu Ista Nariswari Ida Ayu Jelantik Astuti Ida Ayu Krisna Cantika Dewi Ida Ayu Meilasari Dewi Ida Bagus Ardya Kurnia Wilananda Ivana Juliarty Sitanggang Jovi Carina Handoko Kadek Agus Suhardinatha Putra Kadek Dwi Pradnyawati kadek pramesti dewi Katrin Rotua Simbolon Luh Ayu Widayanti Luh putu Iin Indrayani Luh Putu Iin Indrayani Maker Made Dwi Hartayati Moestikaningsih Moestikaningsih Ni Ketut Ari Widhiasih, Ni Ketut Ari Ni Made Mahastuti Ni Putu Ekawati Ni Putu Sriwidyani Ni Wayan Winari Ni Wayan Winarti Nur Silfiah Nyoman Srie Laksminingsih Popi Imelda Margareth Sitompul Putu Ayu Widya Pramesti Putu Ayu Winda Wirastuti Giri Putu Dony Astika Wiguna Putu Risky Yoga Pradnyana Shameni Subramaniam Silvia Nuhyil Indriani Sylvi Diahningrum Tjandra Kristiana Volman Tampubolon

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Journal : Indonesian Journal of Cancer