Morphological Index of Sassone for Predicting Serous Type of Epithelial Ovarium Cancer: Indeks Morfologi Sassone untuk Memprediksi Kanker Ovarium Epitelial Tipe Serous

Objective:  To obtain whether there was a correlation between the Sassone morphological index and CA 125 tumour markers for suspecting epithelial ovarian cancer with serous types.Methods: This research was analysis correlation and diagnostic test using cross-sectional design. This study was conducted in Dr. Zainoel Abidin Hospital, from November 2018 until April 2019. Results: There were 30 samples of patients with suspected malignant ovarian tumours. The Mann-Whitney test has been performed and the results show no relationship between the Sassone morphological index and epithelial ovarian cancer with serous type (p-value 0.627) and there was no correlation between CA 125 tumour marker and epithelial ovarian cancer with serous types (p-value 0.251). The diagnostic test was performed to examine the sensitivity and specificity for the Sassone morphological index in epithelial ovarian cancer with serous type, resulting in 60% and 28%, respectively. In this study, the sensitivity and specificity for CA 125 tumour marker in epithelial ovarian cancer with serous type were 80% and 40%, respectively. Conclusion:  There was no correlation between the Sassone morphological index and CA 125 tumour marker for suspecting epithelial ovarian cancer with serous types. Keywords:  CA 125 tumour marker, 0 epithelial ovarian cancer with serous types, morphological index of Sassone.   Abstrak Tujuan: Untuk mengetahui adakah korelasi antara indeks morfologi Sassone dan penanda tumor CA 125 dalam memprediksi kanker ovarium epitelial tipe serous. Metode: Penelitian ini menggunakan rancangan potong lintang dengan melakukan uji korelasi dan diagnostik.Penelitian dilakukandi RSUD Dr. Zainoel abidin, dalam kurun waktu November 2018 sampai dengan April 2019.Hasil : Selama penelitian didapatkan 30 sampel penderita tumor ovarium suspek ganas. Dilakukan analisis dengan uji Mann-Whitney, didapatkan tidak terdapat hubungan antara indeks morfologi Sassone terhadap kanker ovarium epitelial tipe serous (p-value 0,627) dan tidak terdapat hubungan antara penanda tumor CA 125 terhadap kanker ovarium epitelial tipe serous (p-value 0,251). Kemudian dilakukan uji diagnostik dimana didapatkan nilai sensitivitas, spesifisitas dari indeks morfologi Sassone pada kanker ovarium epitelial tipe serous adalah 60% dan 28%. Sedangkan nilai sensitivitas dan spesifisitas penada tumor CA 125 pada kanker ovarium epitelial tipe serous pada penelitian ini didapatkan 80% dan 40%.Kesimpulan: Tidak ada hubungan antara indeks morfologi Sassone dan penanda tumor CA 125 dalam memprediksi kanker ovarium epitelial tipe serous.Kata kunci: indeks morfologi Sassone, kanker ovarium epitelial tipe serous, penanda tumor CA 12

A choledochal cyst type IVa in a child treated with Roux-en-Y hepaticojejunostomy

A choledochal cyst is a bile duct anomaly that disrupts the transportation of bile from the liver to the gallbladder and small intestine. Choledochal cysts are rare, occurring in approximately one out of every 100,000 to 150,000 children in Western countries, with a girls-to-boys ratio of 4:1. Immediate surgery to excise the cyst and construct a biliary-enteric continuity is necessary to treat this condition. This case-report aimed to present a child with choledochal cyst type IVa who underwent a Roux-en-Y hepaticojejunostomy. A 3-year-11-month-old girl with an abdominal mass experienced jaundice, nausea, and vomiting over the past two years, which worsened in the last month. Abdominal ultrasonography indicated intrahepatic biliary dilatation. Abdominal computed tomography (CT) scan results confirmed a choledochal cyst type IVa, characterized by fusiform cyst dilatation at the bilateral intrahepatic bile duct, common hepatic duct, cystic duct, and common bile duct. The cyst exerted pressure on the pancreas and small intestine. Before the surgery, the patient was treated with ceftriaxone 100 mg/kg/day and gentamicin 5 mg/kg/day. Roux-en-Y hepaticojejunostomy was performed, involving the complete excision of the extrahepatic bile duct to reconstruct the biliary system. During the surgery, a retroperitoneal cyst measuring 20 cm x 10 cm with a volume of 200 cc was discovered. Following the surgery, the patient showed clinical improvement. Patient follow-ups indicated that no complications such as wound infection, acute pancreatitis, and the formation of pancreatic or biliary fistula occurred. This case highlights that Roux-en-Y hepaticojejunostomy proves to be an effective surgical approach for managing choledochal cyst type IVa in children, helping to prevent further complications