Case Conference February 6th 2013

06-Feb-2013, Divisi Ginekologi Onkologi RSCM

CLINICAL CONFERENCE

Ginekologi Onkologi

 

Mrs. N, 64 yo, 3775317

21/01/13

•         Referred from PMI Bogor Hosp with Vaginal Carcinoma

•         Bleeding since 1 year ago

•         At PMI bogor Hosp did Biopsi à PA Result : Hemangioma Endotelioma susp malignancy

•         P3

•         Menopause 6 years ago

•         BP : 120/80 mmHg

•         Height : 158 kg   Weight : 67,5 kg 

•         General Stat : WNL

 

Gyn St (05/02/2013)

I : v/u normal

Io : Mass at anterior vaginal and lateral vaginal diameter 5x6x4 cm. portio couldn’t be evaluated

RVT : uterus WNL, mass palpable size 7x3x4 cm at anterior until lateral wall of vagina. Smooth rektum mucosa.

 

 

PA From PMI Bogor (29/11/20120) :

          Hemangioma Endotelioma susp malignant

Review Slide RSCM (19/12/2012) : No PA 1210165

          Sarcoma more likely fibrosarcoma

Chest X Ray (17/12/2012)

          Cor and Pulmo WNL, No sign of metastasis

Rectoscopy (19/12/2012)

          No sign of metastasis, WNL

Cystoscopy evaluated and biopsy

          Bladder neck WNL, mucosa buli hiperemis at trigonum area à performed biopsy

          Result à Cystitis Polipoid, no sign of metastasis

 

US OncoGyn (20/12/2012)

          Mass at anterior wall vagina size 5,6x2,3x3,1 cm, Cerviks coudnt be evaluated because covered by vaginal mass. Uterus size 4,1x2,3 cm, AF, echostructure parencime normal homogen, miometrium normal, EL 2mm. Serviks couldn’t identified.

 

MRI (16/01/2012)

          Intravaginal mass sugestig malignant extended to the cervix and corpus uterus anterior wall. No sign of enlargement of the limfe.

 

Direct examination by Prof.DR.dr. Andriono Obgyn (C) :

          Clinically mass unoperable although if we looked to the MRI look like operable mass. Is it operable or not correspond to the MRI (consulted to dr.Arman, SpRad) if mass operable considered to do vaginal examination in analgetic and what kind of technic that we are going to take .