Ida Ayu Jasminarti Dwi Kusumawardani
Department Of Pulmonology And Respiratory Medicine, Faculty Of Medicine, Universitas Udayana, Denpasar, Bali, Indonesia

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Journal : Jurnal Respirasi (JR)

EGFR Mutated Lung Adenocarcinoma with Secondary Glaucoma as Early Manifestation: A Case Report Ida Ayu Jasminarti Dwi Kusumawardani; Venny Singgih; Ni Wayan Candrawati; Putu Yuliawati; Herman Saputra; I Gusti Ayu Sri Mahendra Dwi
Jurnal Respirasi Vol. 7 No. 1 (2021): January 2021
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (482.313 KB) | DOI: 10.20473/jr.v7-I.1.2021.14-18


Background: Orbital metastases are rare in pulmonary adenocarcinoma and can be manifested as glaucoma.Case: A 64-year-old male patient complained of swelling, redness, painful and protruded left eye. Physical and radiological examination revealed mass in the right lung, retrobulbar intraconal mass of the left oculi, and metastases in the ribs, liver, brain, and vertebrae. Result of bronchial mucosal biopsy showed adenocarcinoma. Epidermal growth factor receptor (EGFR) mutation examinations detected exon 19 deletions, therefore Gefitinib was given. Left orbital exenteration was performed and obtained a biopsy result of adenocarcinoma metastases.Conclusion: Orbital metastasis occurs by hematogenous pathway due to direct access of systemic circulation to left orbital blood flow. Glaucoma as a symptom of orbital metastases can appear before primary tumor symptoms, because lung cancer often does not show specific symptoms until advanced stage. Definitive treatment consists of targeted therapy and surgical management for metastases.
Risk Factors and Challenging Management of Lung Adenocarcinoma in Young Adult Women: Case Series Ida Ayu Jasminarti Dwi Kusumawardani; Luh Komang Ayu Widhiaty Karang; Ni Wayan Candrawati; Herman Saputra; Ni Putu Sriwidyani; Nornazirah Binti Azizan
Jurnal Respirasi Vol. 8 No. 2 (2022): May 2022
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (548.441 KB) | DOI: 10.20473/jr.v8-I.2.2022.94-98


Introduction: Lung cancer found in young age is relatively rare with a percentage of cases only 1.4% of overall lung cancer cases in the world. Case: We reported two cases of lung adenocarcinoma in young women aged less than 30. The first case was lung adenosquamous carcinoma in a 28-year-old woman, a passive smoker, who had a family history of cancer. She had the mutation of epidermal growth factor receptor (EGFR) exon 19 deletion and received 1st generation of tyrosine kinase inhibitor. Since the patient was diagnosed at advanced stage with poor performance status, she died within 2 months after being diagnosed. The second case was lung adenocarcinoma in a 23-year-old woman. The patient was a passive smoker and had a history of cancer in the family. She was diagnosed at an advanced stage but with good performance status. The patient underwent chemotherapy with Pemetrexed-Platinum in 6 cycles and 15 cycles of radiotherapy. Conclusion: Lung cancer at a young age is more common in non-smoking female with the histopathology type adenocarcinoma. Non-specific early symptoms become a problem in the early enforcement of lung cancer at a young age. Many cancer-related issues occur in young cancer patient such as premature death, increased dependence on parents, difficulty in school and work due to medication, and reproductive disturbance.
Challenging Treatment of Drug-Resistant Tuberculosis during Pregnancy: A Case Report Ni Luh Putu Eka Arisanti; Ni Putu Ayu Widiasari; Ni Wayan Candrawati; Ida Ayu Jasminarti Dwi Kusumawardani; Ida Bagus Ngurah Rai; Made Ary Sarasmita
Jurnal Respirasi Vol. 8 No. 3 (2022): September 2022
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (356.221 KB) | DOI: 10.20473/jr.v8-I.3.2022.153-160


Introduction: Globally, drug-resistant tuberculosis (TB) still has a high number of cases. Pregnant women are one of the high-risk populations for TB infection, especially multidrug resistance (MDR)/Rifampicin resistance (RR) TB. Physiological differences in pregnant women and the safety of the fetus make drug resistance TB treatment challenging. Case: A 20-year-old woman was 22 weeks pregnant while undergoing the third month of the late phase for short-regimen. Thus, Kanamycin was one of her early phase treatment combinations during the first trimester of pregnancy. After we consulted with other departments, especially the obstetric department, we decided not to change her regimen. Her chief complaint before treatment was cough with white sputum and fluctuated shortness of breath for two months. The patient only experienced minor side effects in the early treatment phase. The patient was cured of MDR TB on 8 October 2020 at 34 weeks of gestation. Her baby was born on 10 November 2020 at 37 weeks without congenital abnormality. Observation for her baby continued by the pediatric department. The last follow-up of her baby in the middle of 2022 found no abnormality in the child’s growth and development. Conclusion: Drug-resistant TB therapy in pregnant women requires the collaboration of a multidisciplinary team to consider the benefits and risks of the therapy based on gestational age and disease severity.