| ARTIKEL ASLI |
|---|
| EKSISI MELANOMA NODULAR DILANJUTKAN POTONG BEKU DAN TANDUR KULIT PADA PASIEN KARSINOMA TONSIL |
| Glennarda Triharsa, Muslimin, Lewie Suryaatmadja |
| Bagian/SMF IK Kulit dan Kelamin FK Universitas Diponegoro/RSUD Dr. Kariadi - Jl. Dr. Wahidin 16, Semarang |
| ABSTRAK |
Telah dilaporkan kasus seorang pria usia 74 tahun dengan keluhan benjolan di tumit kiri sejak 2 tahun yang lalu. Pasien juga mengeluh batuk, suara serak, nyeri telan, dan benjolan di leher kanan sejak 3 bulan yang lalu. Pemeriksaan fisik pada tumit kiri tampak massa tumor berdiameter ± 2,5 cm, berwarna hitam, asimetris, berdungkul-dungkul tak teratur seperti kembang kol, melekat pada dasar, tampak makula hiperpigmentasi di sekelilingnya. Palpasi tumor teraba lunak, tanda dimple negatif. Pada submandibula kanan tampak tumor diameter ± 2 cm, lunak, mobile. Tonsil kanan tampak tumor diameter ± 3 cm, tidak teratur, lunak, tidak berdarah. Pemeriksaan potong beku sediaan sesuai dengan nodular melanoma, Clark level IV. Tepi dan dasar tumor bebas lesi. Pemeriksaan histopatologik dari tonsil sesuai dengan karsinoma anaplastik. Penatalaksanaan nodular melanoma dengan eksisi luas, potong beku dilanjutkan dengan tandur kulit FTSG, sedangkan untuk karsinoma tonsil diberikan kemoterapi. |
| ABSTRACT |
A case of nodular melanoma in a 74-year old man was reported with the chief complain was tumor on the left heel since 2 years ago. The patient also complained for cough, husky voice, pain in swallowing, and tumor on the right neck since 3 months ago. In physical examination of the left heel we found tumor ± 2,5 cm in diameter, black, asymmetric, nodular, irregular just like cauliflower, stick to the base, with hyperpigmented macules around its borders. On palpation the tumor was soft and negative dimple sign. On right submandibular region we found tumor ± 2 cm in diameter, soft, mobile on palpation. On right tonsil we found tumor, ± 3 cm in diameter, irregular, soft, not easily bleed. Frozen section of the tumor matched with nodular melanoma, Clark level IV, free tumors in its margins and base. Histopathologic examination from tonsil matched with anaplastic carcinoma. The nodular melanoma was treated with wide excision, frozen section, then skin graft and the carcinoma tonsil was treated with chemotherapy. |