Professional Documents
Culture Documents
PEMERIKSAAN KLINIS
1. KELUHAN UTAMA
2. ANAMNESIS :
- RIWAYAT PENYAKIT SEKARANG
( TNM )
- RIWAYAT PENYAKIT DAHULU
- FAKTOR RESIKO
- KOMORBIDITAS
TUMOR
PAYUDARA
1. Anatomi payudara
2. BSE
3. CBE :
- Status
generalis
- Status lokalis
- Status
regionalis
Dischar
ge or
bleedin
g
Change in
size or
contours of
breast
15
Redness or
pitting of skin
over the
breast, like the
skin of an
Changeorange
in
color or
appearance
of areola
Status lokalis :
INSPEKSI : - Simetris ? ( Ukuran dan bentuk )
- Kulit payudara :
- warna, massa/tumor, skin
dimple, peaud orange,
venaectasi, borok
- Niple-areolar complex :
- retraksi, discharge,
dermatitis
Status lokalis :
Ada tidaknya massa /
tumor :
1.
2.
3.
4.
5.
6.
7.
8.
lokasi
jumlah
ukuran
konsistensi
batas
permukaan
mobilitas
nyeri tekan
STATUS REGIONALIS :
1. KGB aksila
2. KGB infra klavikula
3. KGB supra
klavikula
Jumlah,
ukuran,
konsistensi,
mobilitas
BREAST CANCER
Sites of distant
metastases
Brain
Lymph nodes
Pleura
Skin
Lung
Liver
Bone
'In-transit Metastasis'
in melanoma, a metastatic deposit occurring in the
lymphatic pathway between the primary tumor and its
draining lymph nodes.
Satellite metastases
Areas of visible tumor growth extending beyond the
primary melanoma.
Satellite lesions
which are skin or subcutaneous lesions within 2 cm of the
primary tumor that are considered intralymphatic
extensions of the primary mass.
AJCC, 2008
Evolution of Nevi
Evolution of Melanoma
Junctional Nevi
Melanocyte Hyperplasia
Compound Nevi
Dermal Nevi
Dysplastic Nevi
Dysplastic Nevi
Superficial spreading
Klasifikasi Histopatologis
Lentigo Malignant Melanoma
(LMM)
Superficial Spreading Melanoma
(SSM)
Nodular Malignant Melanoma
(NMM)
Acral Lentiginous Melanoma
Lentigo maligna
Nodular melanoma
Clark staging
Based upon histologic level of
invasion
Level I Epidermis only (in situ)
Level II Invades the papillary dermis, but not
to the papillary-reticular interface
Breslow staging
Based upon absolute depth
of invasion
Stage
Stage
Stage
Stage
I < 0.75 mm
II 0.76 1.5 mm
III 1.51 4.0 mm
IV - > 4.0 mm
Charles M. Balch, MD; Seng-Jaw Soong, PhD; Michae ,An Evidence-based Staging System for Cutaneous Melanoma,
AJCC staging
AJCC staging
AJCC staging
Stage I
< 0.75 96 %
0.75 1.5 87 %
Stage II
1.5 2.49 75 %
2.5 3.99 66 %
> 4.0 47 %
Stage III
One node 45 %
Two nodes < 20 %
Stage IV
8 10 %
SQUAMOUS CELL
CARCINOMA
1. LUKA BAKAR
2. IRITASI KRONIS
3. MARJOLINE ULCERS
4. SEPERTI BUNGA KOL
5. RAPUH, MUDAH
BERDARAH
6. SERING DI
EKSTREMITAS
7. BER METASTASIS (+)
KLINIS
Metastasis 4 11% kasus tumor ganas jaringan lunak :
Paru 34%
Hepar 25%
Tulang 23%
SSP 3%
Lokasi tumor
Ukuran tumor
Histopatologi tumor
ENNEKING
CLASSIFICATIO
N FOR
SURGICAL
PROCEDURES
ON STS
ACCORDING TO
THE MARGINS
ACHIEVED
LR
6080%
LOWEST
LR
LR
30%
LR
100%
TERIMAKASIH