BackgroundCutaneous melanoma is a rare, aggressive skin malignancy with a high mortality rate. Although only contributing 7.6% of the cases worldwide, Asia is responsible for 18.6% of deaths from cutaneous melanoma. BRAF V600 mutation presents a potential prognostic predictor in melanoma. Unfortunately, studies on that mutation in melanoma, particularly nodular subtype, in Indonesia are still scarce. This research aimed to investigate the prevalence of BRAF V600 mutation in primary skin nodular melanoma in Yogyakarta and Central Java, Indonesia. Its association with clinicopathological parameters was also analyzed.MethodsForty paraffin-embedded tissue samples from primary skin nodular melanoma cases in 2011–2018 were collected from the two biggest referral hospitals in Yogyakarta and Central Java, Indonesia. The BRAF V600 mutation status was assessed using qualitative real-time PCR and its associations with age, sex, anatomic location, lymph node metastasis, tumor thickness, ulceration, mitotic index, necrosis, lymphovascular invasion, and tumor-infiltrating lymphocytes were analyzed.ResultsBRAF V600 mutations were found in 4 (10%) samples. These mutations were significantly associated with the central (non-extremity) region (p = 0.013) and presence of lymphovascular invasion (p = 0.005). However, it was not associated with any other variables analyzed in this study.ConclusionThe prevalence of BRAF V600 mutation in Indonesian primary skin nodular melanoma cases is low and significantly associated with anatomic location and lymphovascular invasion. It is lower than prevalences in other Asian populations as well as in Caucasian populations and suggests that melanoma cases in Javanese people may have distinct clinicopathological characteristics from other Asian ethnicities.
Controversy regarding the role of SIRT1 in pathology of cancers exists and is still under debate. SIRT1 could act as either a tumor supressor or tumor promotor. This study was conducted to evaluate the relationship between SIRT1 expression and tumor size, Proliferating Cell Nuclear Antigen (PCNA) expression and histological grading in rat breast carcinoma induced by dimethylbenz(á)anthracene (DMBA). Thirty female Sprague Dawley rats were randomly allocated into three groups with 10 rats in each group. Group 1 as negative control was just fed the standard food. Group 2 as vehicle control was fed the standard food and corn oil. Group 3 as induction group was fed the standard food and induced with DMBA at dose of 20 mg/kg body weight (BW) in corn oil twice a week for five weeks. All rats were palpated weekly to determine the appearance, size and location of tumors. Sixteen weeks after DMBA induction rats were sacrified and histological preparations of the breast carcinoma tissue were then processed for SIRT1 and PCNA expression examination as well as histological grading. The result showed that SIRT1 expression was significantly higher in breast carcinoma tissue compared to normal gland (26.12 vs 0.05; p = 0.004). SIRT1-positive was observed mostly in poor histological grade carcinomas (56.2%), and it was not observed in good histological grade carcinomas. However, there was no significantly difference between SIRT1 and histological grading (p = 0.097; r = 0.285). A significant correlation between SIRT1 expression and the tumor size (p =0.009; r =0.877), as well as PCNA expression (p =0.000; r =0.790) was observed. In conclusion, there is relationship between SIRT1 expression and tumor size as well as PCNA expression in rat breast carcinoma induced by DMBA. ABSTRAKKontrovesi mengenai peran SIRT1 dalam patologi kanker muncul dan masih diperdebatkan. SIRT1 dapat berperan sebagai penekan atau pemacu pertumbuhan tumor. Penelitian ini dilakukan untuk mengkaji hubungan antara SIRT1 dengan ukuran tumor, ekspresi Proliferating Cell Nuclear Antigen (PCNA) dan derajat histologi pada kanker payudara tikus yang diinduksi oleh dimetilbenz( )antrasen (DMBA). Tiga puluh tikus Sprague Dawley betina dibagi secara acak menjadi tiga kelompok dengan masing-masing kelompok 10 ekor. Kelompok 1 sebagai kontrol negatif hanya diberi 152 J Med Sci, Volume 45, No. 4, Desember 2013: 151-158 pakan standar. Kelompok 2 sebagai kontrol pembawa diberi pakan standar dan pembawa. Kelompok 3 sebagai kelompok induksi diberi pakan standar dan diinduksi dengan DMBA dosis 20 mg/kg berat badan (BB) dalam minyak jagung dua kali seminggu selama lima minggu. Semua tikus dipalpitasi setiap minggu untuk terjadinya tumor, ukuran dan lokasinya. Enam belas minggu setelah induksi DMBA, tikus dikorbankan dan dibuta preparat histologi jaringan kanker payudaranya untuk pemeriksaan ekspresi SIRT1 dan PCNA maupun derajad histologinya. Hasil penelitian menunjukkan ekspresi SIRT1 lebih tinggi secara nyata pada jaringan kanker dibandingkan jaringan normal (26,...
Dermal cylindromas are rare benign skin appendageal tumors that has two clinical presentation, solitary and multiple form. The diagnosis is unusual. However, it must be considered in clinical practice.A 51-year-old woman hadpainless nodule on right arm. Skin examinatipn revealedtwo fragmented nodules, 1x0.5x0.5cm, tan to white, and rubbery. Histopathological findings revealed a well demarcated and an unencapsulated epithelial dermal tumor, composed of numerous oval and polygonal nests molded into a "jig-saw" or "mosaic" appearance at low power. The nests of cells were composed of basaloid cells with scant cytoplasm and hyperchromatic nuclei and paler cells at the center. Nests of epithelial cells were surrounded and penetrated by a thickened band of basement membrane material that was PAS-positive. Immunohistochemistry (IHC) staining with p63 showed positive staining on basaloid cells. Langerhans dendritic cells in the surrounding nests stained positive with CD1a. Solitary dermal cylindroma occurred sporadically in patients without family history of cutaneous cylindromas.Combination of morphologic, histochemystry and immunohistochemystry staining were needed for accurate diagnosis.
Introduction After hemorrhoidectomy, anal stenosis occurs, which is an uncommon but severe consequence. The majority of severe cases require advancement flap anoplasty. Presentation of case A 50-year-old female patient with a history of hemorrhoidectomy 10 months prior to admission complained of difficulty defecating, pain, and incomplete evacuation sensation, as well as a hole on the right side of the anal canal through which feces unintentionally passed. On the physical examination, we found that the anal lumen was partially obstructed, which did not allow the insertion of a finger. There was an impression of a perineal fistula at 5 and 7 o'clock, which was connected to the anal canal 3 cm from the edge of the anus. The patient was diagnosed with severe anal stenosis with perianal fistula. The patient underwent fistulectomy and advancement flap with perianal skin. In the outpatient follow-up clinic in the first and second weeks, the patient showed no complications, and no recurrence of her complaints was found. Discussion Several corrective surgical techniques have been applied to restore a healthy lining to the constricted portion of the anal canal. We performed a combination of simple cutaneous advancement flap and fistulectomy to manage the patient with severe anal stenosis following hemorrhoidectomy with concurrent anal fistula. Conclusion A combination of fistulectomy and simple cutaneous advancement flap anoplasty is a simple, safe, and effective surgical option for the management of severe anal stenosis with concomitant anal fistula.
Objective: We aimed to investigate the prevalence and type of BRAF V600 mutations and the associations with clinicopathological variables in primary skin nodular melanoma cases in Yogyakarta and Central Java, Indonesia using pyrosequencing. Results: BRAF V600 mutations of the V600E type were found in 21 (53.85%) specimens. The variant allele frequencies (VAFs) ranged from 5.07 to 94.70%, averaging 29.05%. However, most cases had low VAFs, with 13 (61.9%) specimens below 20% and 4 (19.05%) below 10%.
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