Uterine leiomyoma is a benign gynecological tumor of the uterine myometrium layer in the female reproductive system, with clinical incidence in approximately 25% of women. In rare instances, it is possible for it to grow into a giant uterine leiomyoma (weighing 11.4 kg or more). Surgery on a giant mass is challenging because the enlargement mass affects the normal anatomical position of the internal genital organs. We report a case of a giant uterine leiomyoma with surgical difficulty. A 45-year-old woman came to the gynecology outpatient department referred from a district hospital with a suspected malignant ovarian cyst. The signs and symptoms were enlargement of the abdomen in the last 15 years, abdominal pain, and menstrual blood clots. An abdominal pelvic computed tomography (CT) scan with contrast revealed a regular cystic mass with multiple solid components and thick septa, probably from the adnexa. The biochemical examination revealed an increase in CA-125 serum (102.6 U/mL) with a risk of malignancy index (RMI) score of 308. Considering the size of the mass, fixed to the abdomen with umbilical hernia and suspicions of uterine or ovarian malignancy, the patient was planned for a laparotomy with collaborating digestive surgeon and urologist. The intraoperative findings were enlargement of the uterus with cystic degeneration of the leiomyoma at the posterior wall of the uterus. Due to the size of the mass, the anatomical position of the internal genital organs was deviated. The ovaries and fallopian tubes were normal, and total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The mass measured 57 × 51 cm in size and 26 kg in weight. Histopathological examination revealed a uterine leiomyoma with cystic degeneration.

Psoriasis is a chronic inflammatory disease characterized by skin inflammation, epidermal hyperplasia, increased risk of arthritis, cardiovascular morbidity, and psychosocial challenges. Previous studies revealed the association of psoriasis with cardiometabolic diseases, in which dyslipidemia is a common feature. The objective of the study is to identify the correlation between lipid profile and disease severity in psoriasis patients. This study employed a cross-sectional design by using primary data from patients visiting the outpatient department of Dr Soedirman Kebumen District Hospital, Central Java. Disease severity was examined using Psoriasis Area and Severity Index (PASI) score. The levels of triglyceride, HDL-and LDL-cholesterol, and total cholesterol were measured from fasting blood plasma on the same day. Data were compared by utilizing one-way ANOVA or Kruskal-Wallis test as appropriate, and correlation between lipid levels and PASI score was analyzed by utilizing the Spearman correlation test. There were 33 psoriasis patients (20 male and 13 female) enrolled in this study; mean age was 43,6 ± 16,7 years old, and mean disease duration was 8,2 ± 9,5 years. Disease severity was mild in 19 (57,5%), moderate in 5 (15,2%), and severe in 9 (27,3%) patients, and mean PASI score was 12,8 ± 10,1. There were no significant differences of triglyceride levels (p = 0,700), HDL-cholesterol levels (p = 0,743), LDL-cholesterol levels (p = 0,840), and total cholesterol (p = 0,890) among groups of disease severity. There was no significant correlation between PASI score and triglyceride (r = 0,028; p = 0,879), HDL-cholesterol (r = −0,052; p = 0,775, LDL-cholesterol (r = −0,043; p = 0,812) and total cholesterol levels (r = −0,028; p = 0,875). However, there was a significant correlation between PASI score and disease duration (r = 0,423; p = 0,014). Meanwhile, there was no significant correlation between disease severity and lipid profile in psoriasis patients.

Objective: To investigate the therapeutic response and toxicity in cervical cancer patients with stage IIB-IIIC who undergo external radiation. Methods: This was a retrospective study using the medical records of the Obstetric Oncology and Radiotherapy Department at Prof. Dr. R. D. Kandou Hospital Manado. The research subjects were stage IIB-IIIC cervical cancer patients who underwent external radiation from September 2016 to December 2020. External radiation was administrated using 60Cobalt. The statistical analysis assessments in this study was carried out using descriptive analysis, while the analysis of the relationship was carried out using the Chi-Square method. The toxicity assessments were carried out from first day started external radiation up until 1 month after the therapy was deemed completed. Results : As many as 413 cervical cancer patients underwent external radiation during the study. However, only 192 cervical cancer patients with stage IIB-IIIC met the inclusion criteria in this study. The complete response to the therapy based on the findings was 65.6%, the partial response was 31.8%, the stable response was 1.6%, and the progressive response was 1%. In statistical analysis there was a significant association between cervical cancer stage and Overall Treatment Time with response to external radiotherapy. However, no significant association between tumor size and histopathological type with response to external radiotherapy. There were hematological toxicity (45.8%), skin toxicity (45.3%), gastrointestinal toxicity (6.3%) and urinary tract toxicity (2.6%). Conclusions: External radiotherapy response was a complete response where there was an association between cervical cancer stage and Overall Treatment Time with response to external radiotherapy, whereas there is no significant association found between the tumor size and histopathological type based on this research's findings. Most toxicity were hematology with complaints of anemia and thrombocytopenia Keywords: cervical cancer, external radiation response, toxicity.   Abstrak   Tujuan: Untuk mengetahui respon terapi dan efek samping pasien kanker serviks stadium IIB-IIIC yang menjalani radioterapi eksterna. Metode: Penelitian ini adalah penelitian deskriptif rektrospektif dengan menggunakan rekam medis Poli Onkologi Kandungan dan Instalasi Radioterapi RSUP Prof. Dr. R. D. Kandou Manado. Subyek penelitian adalah pasien kanker serviks stadium IIB-IIIC yang menjalani radiasi eksterna mulai September 2016 sampai Desember 2020. Radiasi eksterna dilakukan dengan sinar 60Cobalt. Penilaian analisis statistika pada penelitian ini menggunakan analisis deskriptif dan analisis hubungan menggunakan metode Chi Square. Penilaian efek samping dilakukan sejak hari pertama pasien memulai radiasi eksterna sampai 1 bulan setelah dinyatakan selesai menjalani radioterapi eksterna. Hasil: Selama periode penelitian didapatkan 413 pasien kanker serviks yang menjalani radiasi eksterna namun hanya 192 pasien kanker serviks stadium IIB-IIIC yang memenuhi kriteria inklusi pada penelitian ini. Respon terapi komplit sebesar 65,6%, respon terapi parsial sebesar 31,8%, respon terapi tidak berubah sebesar 1,6%, dan respon terapi progresif sebesar 1%. Pada analisis statistik terdapat hubungan bermakna stadium kanker serviks dan Overall Treatment Time dengan respon radioterapi eksterna, dan tidak terdapat hubungan bermakna ukuran tumor dan jenis histopatologi dengan respon radioterapi eksterna. Didapatkan efek samping hematologi (45,8%), efek samping kulit (45,3%), efek samping gastrointestinal (6,3%) dan efek samping traktus urinarius (2,6%). Kesimpulan: Respon radioterapi eksterna berupa complete response dimana terdapat hubungan bermakna antara stadium kanker serviks dan Overall Treatment Time dengan respon radioterapi eksterna. Tidak terdapat hubungan bermakna antara ukuran tumor dan jenis histopatologi. Efek samping terbanyak yaitu hematologi dengan keluhan berupa anemia dan trombositopenia. Kata kunci:  efek samping, kanker serviks, respon radiasi eksterna.