Archive for January 27th, 2009

Lately, I think I’ve short of time. So many cases that I have to handle, to be examined first by me and later on be processed by my technician which at last I have to look at the microscope to see and finally reveal the diagnoses.

BREASTThe first case was a radical mastectomy from a 37 years old woman with breast cancer. One week ago this patient was done a biopsy on a 6 centimeters lump of her right breast, which already diagnosed with Invasive Ductal Carcinoma. The specimen was measured 15x 15x 3 cm, with nipple and skin attached on it. I have to see diligently, if all the margins of the operation : cranial, caudal, medial, lateral and base of the section were all free from tumor cells. So did to the possibility of vascular invasion or tumor emboli and lymph nodes dissected from her axilla or her right armpit. I found there were massive vascular invasions and infiltration of tumor cells to all the twelve lymphnodes of her right armpit.

OVARYThe second case was a huge ovary cancer of a 43 years old woman. The specimen measured 16x 9x 7 cm, with a hard portion almost to the entire specimen. The outer surface was glistening, greyish-white. On slicing, I found an enormous greywhitish fleshy mass with rubber to hard consistency which later on I’ve made a diagnosis of Solid Embryonal Carcinoma of the Ovary. Under light  microscope the morphology was almost like seminoma, but without lymphocytes infiltration in the stroma. I think the malignancy of this Solid Embryonal Carcinoma of the ovary is moderate. This patient has a bleak prognosis, because there’s already metastases to the peritoneum with adhesions to her bowels and many nodules on her liver..

MYOMAThe third case was a huge fibroid tumor of the womb or Benign Uterine Leiomyoma . The specimen measured 16 centimeters in diameter. On cut surfaces it looked fleshy fresh with  bleeding spots. This specimen from a woman, 42 years of age. Imagine how big was her stomach before the operation  taken to throw out her solid benign tumor of her womb which she has had for 3 years’ time.

ThyroidThe fourth case was a male patient, 56 years of age with a lump on his thyroid gland left lobus measuring 4 centimeters in diameter. This lump was known only 3 months before visiting my laboratory. Rubber consistency and a bit painful on palpation. He admitted that he got fever and difficulty in swallowing and feels short of breath. I’ve done a fine needle aspiration biopsy to his lump. And ultimately my diagnosis was Subacute Thyroiditis or de Quevain’s Thyroiditis. Lucky for him that his tumor need not to be operated, and will be fine and back to normal within 2-3 weeks time with only antibiotic and steroid tappering off therapy.

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  • About

    Dr. Sukma Merati, DSPADr. Sukma Merati is founder and owner of Riau Pathology Center in Pekanbaru, Riau. Dr. Merati has had various international experience and training, including as a fellow doctor at The Mount Sinai Hospital in New York City, NY, USA (2000-2002). More >

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