BACKGROUND:Pleomorphic adenoma is a salivary gland tumour and mostly found in the parotid gland and quite uncommon in the submandibular gland. Pleomorphic tumours are a mixed tumour (benign mixed tumour) consisted of epithelium, myoepithelium, and mesenchyme and made of a view component variation of it.CASE REPORT:We reported a fifty-three years old man with pleomorphic adenoma that has been complaining swelling on the left neck for the last twenty years and treated with surgical excision. Computed tomography of the neck showed soft tissue tumour in the left submandibular.CONCLUSIONS:The best management for pleomorphic adenoma is surgery, the tumour tissue must be removed as a whole because the remaining parts of a tumour can easily become recurrent or turn into a malignant tumour.

BACKGROUND:Nasopharyngeal carcinoma (NPC) is uncommon and usually diagnosed at the advanced stage. A subfamily of mitogen-activated protein kinase which is called p38 mitogen-activated protein kinase (MAPK) involved in response to stress, and plays an important role in cell regulation. There is a suggestion that p38 mitogen-activated protein kinase could be a potential biomarker to determine the clinical stage of nasopharyngeal carcinoma.AIM:The aim of this study is for observing and analysing the correlation of p38 mitogen-activated protein kinase expression in regards to nasopharyngeal carcinoma patient’s clinical stage.METHODS:This study involved 126 nasopharyngeal carcinoma patients admitted to Haji Adam Malik General Hospital.RESULTS:The result of this study indicates that nasopharyngeal carcinoma mostly found in the age group 41-60 years, male, non-keratinizing squamous cell carcinoma, and stage IV group. In immunohistochemistry evaluation, most of p38 mitogen-activated protein kinase overexpressed in non-keratinizing squamous cell carcinoma, T3-T4, N2-N3 and clinical stage III-IV. Spearman’s test for categorical correlation yield p-value of < 0.001.CONCLUSION:In conclusion, there is a significant correlation between p38 mitogen-activated protein kinase expression and the clinical stage of nasopharyngeal carcinoma.

Pendahuluan: Tumor memerlukan proses pembentukan pembuluh darah baru untuk tumbuh dan bermetastasis yang dikenal sebagai proses angiogenesis. Angiogenesis dapat dinilai secara imunohistokimia dengan Microvessel Density (MVD). Proses angiogenesis dapat dipicu oleh berbagai faktor angiogenik. Beberapa penelitian menemukan ekspresi Cyclooxygenase-2 (COX-2) meningkat pada kanker. COX-2 dapat merangsang pengeluaran faktor-faktor angiogenik. Pada penelitian ini akan dilihat apakah angiogenesis, yang dinilai dengan MVD, pada karsinoma nasofaring memiliki korelasi dengan COX-2. Tujuan: Mengetahui korelasi ekspresi COX-2 dengan MVD pada penderita karsinoma nasofaring di RSUP H. Adam Malik Medan. Metode: Penelitian ini bersifat analitik dengan studi potonglintang. Dua puluh empat sampel diperiksa secara imunohistokimia untuk ekspresi COX-2 dan MVD. Kemudian hasil dianalisa dengan uji Spearman. Hasil: Ekspresi COX-2 positif ditemukan pada 17 (70,83%) subyek dan dijumpai negatif pada 7 (29,17%). Ditemukan 17 (70,83%) jaringan karsinoma nasofaring dengan MVD tinggi dan 7 (29,17%) dengan MVD rendah. Ditemukan adanya korelasi positif sedang antara ekspresi COX-2 dengan MVD (r=0,559; p=0,005). Kesimpulan: Ditemukan ada korelasi positif sedang antara ekspresi COX-2 dan MVD pada karsinoma nasofaring. Kata kunci : Karsinoma nasofaring, Cyclooxygenase-2, Microvessel density ABSTRACTIntroduction: Tumor needs new blood vessel formation to grow and metastasize. New blood vessel formation is known as angiogenesis. Angiogenesis is determined by Microvessel Density (MVD) using immunohistochemical examination. Angiogenesis was affected by various angiogenic factors. Recent studies found elevated COX-2 expression in cancers. COX-2 can stimulate angiogenic factors. This research assessed the correlation between COX-2 and angiogenesis, determined by MVD. Purpose: To find out the correlation between COX-2 and MVD in nasopharyngeal carcinoma in H. Adam Malik Hospital. Method: This is a cross sectional analytical research. Twenty four samples was observed by immunohistochemical examination for COX-2 expression and MVD. The results then were analyzed using Spearman correlation test. Result: Positive COX-2 expression was found in 17 (70.83%) subjects and negative in 7 (29,17%) subjects. High MVD was found in 17 (70.83%) subjects and low MVD was found in 7 (29.17%) subjects. There was moderate positive correlation between COX-2 expression and MVD (r=0,559; p=0,005). Conclusion: COX-2 is moderate positively correlated with MVD in nasopharyngeal carcinoma.Keywords :Nasopharyngeal carcinoma, Microvessel density, Cyclooxygenase-2.

AIM:This study aimed to observe the cyclooxygenase-2 expression and its correlation with tumour size and lymph node involvement in nasopharyngeal carcinoma.METHODS:This study was cross-sectional, that enrolled 126 samples diagnosed with nasopharyngeal carcinoma in Haji Adam Malik General Hospital, Medan, Indonesia which fulfilled the inclusion criteria.RESULTS:Based on this study, we found that the age peak incidence of nasopharyngeal carcinoma patients about a 41-60-year-old group (57.1%), dominated by men (71.4%). Through histopathological examination, non-keratinizing squamous cell carcinoma is the most predominant type (79.4%). We also found T3 is the most prevalent primary tumour size (32.5%) with prominent lymph node involvement N3 (45.2%), and stage IV (54.8%). Cyclooxygenase-2 overexpression is prevalent among nonkeratinizing squamous cell carcinoma (81.1%), T3 primary tumour size (41.1%), N3 node involvement (60.0%), and IV clinical stage (71.6%). In addition, we found a significant relationship between cyclooxygenase-2 expressions towards tumor size (p < 0.001) and lymph node involvement (p < 0.001) in nasopharyngeal carcinoma.CONCLUSION:It is proved that the overexpression of cyclooxygenase-2 will increase the susceptibility of nasopharyngeal carcinoma patients having advanced primary tumour size and lymph node involvement.

Introduction: Nasopharyngeal carcinoma (NPC) is one of the most common malignancies in Indonesia with over 13.000 new cases reported yearly, especially in the male. The TNF-α serum is reported as a new biomarker to predict bone invasion, post-therapy distant metastasis, and poor life sustainability in NPC. Objective: To identify the expression of TNF-α in regards to the clinical stage of NPC. Material and methods: This is an analytic study with 126 NPC samples of patients in Haji Adam Malik General Hospital. Results: NPC mostly found in age group 41-60 years (57.1%), male (71.4%),non-keratinizing SCC (79.4%), and stage IV group (54.8%). In immunohistochemistry evaluation, most of TNF-α overexpressed in non-keratinizing SCC(68.0%), T3-T4 (50.8%), N2-N3 (62.7%) and clinical stage III-IV (69.9%). Spearman's test for categorical correlation yield a p-value of <0,001. Conclusion: There is a significant correlation between TNF-α expression and the stage of NPC.