Case Conference August 29th 2012

29-Aug-2012, Divisi Ginekologi Onkologi RSCM

Progressive cervical cancer stage IIIB

Identity

Mrs.TM, 53 yo 3578633

 

21/9/2011

Patient came to policlinic  with vaginal bleeding since 1 year , vaginal discharge (+) since 2 months

P2, married 2 times

Gen State : wnl

Gyn state :

Io: endophytic mass 4x4x2 , fragile, easily bleeding

RVT : endophytic mass 6X6X4 cm, extend to both parametrium and pelvic wall

 

US 23/12/2011

Cervical malignancy, made invasion to rectovaginal and parametrium

Enlarged cervix, consist inhomogenous mass with iregular shape and border 59x43 mm

 

PA (5/1/2012)

Keratinizing cervical squamous carcinoma cell, moderate differentiated

Staging dr Sigit SpOG

No LN enlargement

 

Assessment : Cervical cancer III B

Plan to have Chemoradiation (cisplatin and Ifosfamide), but the results of CCT (repeated 4 times) were low, so the patient only got radiation.

 

15/2/2012-3/5/2012

Complete Radiotherapy

 

16/5/2012

Patient was examined in policlinic

Gyn state

IO: smooth vaina, no mass at portio

RVT: fibrotic parametrium

LNs didint check

Plan to have another examination in 3 month later

 

14/8/2012

Patient was examined in the radiotherapy, doctor was found mass in the left supraclavicular

 

FNAB 20/6/12 (PA 121526)

Result: positif  adenocarcinoma metastase

 

4/7/2012- 14/8/2012

External radiation with cobalt 60, 60 Gy

Notes: initial clinically response: unresponse, reevaluation 3 month later

 

16/8/2012

Patient was examined in oncology policlinic

1.5cm of diameter of left supraclavicular mass; enlargement LN

Gynecological status:

Athrophy portio, no mass

 

US exam

No new mass growth

 

Discussion with DR.dr.Laila,obgyn(C) :

Plan to give chemotherapy for lenght of life, discussion in CC