Introduction Fibroadenoma is the most common benign tumor found in young women. Transformation for Fibroadenoma to borderline phyllodes tumor is rare. Phyllodes tumor tends to recur locally due to the aggressive nature of the phyllodes tumor tissue, which tends to become malignant when recurrence occurs. Presentation of case We report an 18-year-old woman with a lump in the right breast for one year, a mass in the upper lateral quadrant measuring 20x15x10cm; the lump felt mobile, supple, cystic. 2 years earlier, lumpectomy surgery with anatomical pathology of fibroadenoma mammae with 6 cm. A biopsy was performed, the result was a borderline phyllodes tumor. Neoadjuvant chemotherapy was performed with tumor reduction >50%, followed by wide excision surgery with tumor-free margins. The first one-year evaluation showed no signs of recurrence, and no signs of distant metastases were found. Conclusion Our patient had a juvenile relapse FA which progressively changed to borderline tumor phyllodes borderline. We report this case to the need for continuous follow-up for fibroadenoma cases and the possibility of recurrence and becoming malignant.

Introduction: Chemotherapy is claimed to cause lymphatic drainage damage because of the tumor cell’s apoptosis process. This event might cause decreased marker (radioactive solution and/or blue dye) absorption on sentinel lymph nodes (SLN). In this study, the researchers used methylene blue only and wished to evaluate the methylene blue absorption of the SLNB procedure on early-stage breast-cancer patients after neoadjuvant chemotherapy (NAC). Materials and methods: The method used was the historical cohort study conducted from 2016-2019 in Indonesia. Samples were collected from 117 patients of stage I and II breast cancer with clinically negative axillary lymph nodes, who were then grouped into post-NAC and no-NAC (control group), in which SLNB procedures were conducted on the two groups by using single-method methylene blue. The results of methylene blue absorption were then analyzed by the Chi-square hypothesis test. Results: From the total of 564 early-stage patients who were referred to surgical oncologists, 117 patients were found to meet criteria of inclusion, consisting of the control group (52 patients) and the post-NAC group (65 patents). Of 65 patients who had undergone NAC treatment and SLNB procedure, it was found that 40 patients (61.5%) showed positive blue SLN. Of 52 pre-NAC breast-cancer patients, it was found that 47 patients (90.4%) showed methylene blue absorption on SLN with the p-value of 0.000 (P<0.05, significant). The relative risk value amounted to 0.522. Post-NAC patients had a tendency of decreased absorption of methylene blue. Conclusion: Neoadjuvant chemotherapy can cause the decrease of methylene blue absorption on SLNB procedure.

Research Background: This study aimed to scrutinize the chemotherapy’s effect on estradiol levels in patients with triple-negative breast cancer (TNBC) at low-resource country. Methods: This prospective analytic observational cohort study involved patients with TNBC who had undergone surgery and had never received chemotherapy or hormonal therapy before. Patients were checked for estradiol levels before and after chemotherapy. This study was conducted at the Surgical Oncology Department of Regional Public Hospital Dr. Moewardi, Surakarta Indonesia, from April 2020 to March 2021. Descriptive data were presented in a frequency table based on age, menopausal status, parity status, breastfeeding status, hormonal contraception, hormonal contraception duration, family history, stage, and histological grade. Differences in estradiol changes before and after chemotherapy (mean+sd) were then reported. Results: From a total of 23 patients, 21 patients (91.3%) experienced a decrease in estradiol levels, while two patients (8.7%) underwent an increase in serum estradiol levels after chemotherapy. The mean decrease was 11.57 pg/ml. The two samples that experienced an increase in estradiol levels had a mean increase of 16.5 pg/ml. There was a significant difference between estradiol levels before and after undergoing chemotherapy, with p-value=0.001. Conclusions: In this research, chemotherapy reduced estradiol levels in TNBC patients. Statistically significant reductions in estradiol levels were based on the disease stage.

Background: Appendicitis is an inflammation that occurs in appendix vermiformis and is the most common cause of abdominal pain. Appendicitis is also an indication of emergency abdominal surgery in children. The incidence of child appendicitis is 1.66 per 1000. If the diagnosis is delayed, 97% of cases of acute appendicitis will lead to perforation with a mortality rate of 5.1 per 1000 cases. The most common etiology of appendicitis is lymphoid tissue hyperplasia which represents one of the immune responses to infection. One of the infection factors was the poor personal hygiene level. This research aimed to discover personal hygiene level description in pediatric non complicated appendicitis.Methods: This research used descriptive quantitative observational research conducted in Moewardi General Hospital Surakarta. The sampling method was total sampling in appendicitis patient with, 33 respondents. Assessment in patients was calculated using personal hygiene scale questionnaire consisting of 12 items. The independent variable in this research was personal hygiene level, and the dependent variable was the incidence of pediatric appendicitis. Data were analyzed statistically for descriptive analysis.Results: The result showed that 51.5% of patients with pediatric appendicitis had poor personal hygiene.  Conclusions: Pediatric appendicitis patient had poor personal hygiene level.

Introduction: A gastric perforation is a form of hollow digestive organ perforation in which the entire thickness of the stomach wall is injured. Perforation of hollow organs can be suspected based upon the clinical picture, and the diagnosis becomes obvious through an image of free air on imaging performed. Methods: Data of patient characteristics were observed retrospectively from medical records of patients diagnosed with gastric perforation between January and December 2018. Results: Between January and December 2018, 45 patients with gastric perforation were identified, with data distributed by gender. There were 36 women (80%) and 9 men (20%) in the group. Based on the age group, 32 patients (71%) were distinguished by the age group over 40 years and 13 patients (29 %) under 40 years of age. When viewed from the location of the gastric perforations, it was found that 4 patients (9%) had a perforation in the antrum, 36 patients (80%) in the Prepylorus, and 5 patients (11.2%) in the major curvature. Data on analgesic use revealed 32 patients (71%) had a history of taking analgesics and 13 patients (29%) without a history of taking analgesics. Conclusion: In 2018, the majority of gastric perforation patients at Dr. Moewardi Hospital were female (80%), with the highest age group being over 40 years (71%) and the most gastric perforations occurring in the pylori (80%). The number of patients with gastric perforation who had previously used herbs and analgesics was higher (70%) than those who had not. Thus, the results of this retrospective study are consistent with previous research findings and can be used to continue research into the relationships (correlations) between the aforementioned variables.