ABSTRAKObjectives: To report the characteristics of the patients of Gestational Trophoblastic Neoplasia (GTN) and its management at Dr. Soetomo Hospital, Surabaya, Indonesia. Case Report: There were 41 cases GTN at dr. Soetomo hospital within 3 years, data were collected from January 2015 to December 2017, which are 11 cases develop drug resistance. Conclusion: GTN is a chemosensitive neoplasia but can also experience resistance to chemotherapy. It is important to monitor the levels of beta-HCG for at least 12 months before the patient can get pregnant again.Tujuan: Melaporkan karakteristik pasien Tumor Trofoblas Gestasional (GTN) dan tatalaksananya di RSUD Dr. Soetomo, Surabaya, Indonesia. Laporan Kasus: 41 kasus GTN di rumah sakit umum daerah (RSUD) dr. Soetomo dalam kurun waktu 3 tahun (Januari 2015 -Desember 2017), dimana didapatkan 11 kasus GTN yang resisten kemoterapi. Simpulan: GTN merupaka neoplasia yang bersifat kemosensitif akan tetapi dapat juga mengalami resistensi pada pemberian kemoterapi. Pemantauan kadar beta-HCG penting untuk dilakukan minimal selama 12 bulan sebelum pasien boleh hamil kembali.

Background: Clear cell ovarian carcinoma is rare and accounts for 1%-12% of ovarian epithelial carcinomas, depending on ethnicity. The prevalence of clear cell ovarian carcinoma in Asian, White, and Black women is 11.1%%, 4.8%, and 3.1%, respectively. Magnetic resonance imaging (MRI) shows that clear cell ovarian carcinomas are typically unilocular cyst-solid (34.9%) or multilocular-solid (41.4%); only 23.7% are solid with papillary projections. MRI can detect clear cell ovarian carcinoma with a sensitivity and specificity of 90% and 87%, respectively. Notably, sometimes ovarian masses have a solid feature and should be differentiated from uterine masses. Clear cell ovarian carcinoma has a better prognosis compared to serous carcinoma when diagnosed at an early stage, but it has a poorer prognosis at an advanced stage. The absence of a residual tumor is a favorable prognostic factor in patients with advanced-stage clear cell ovarian carcinoma. Herein, we present a case in which clear cell ovarian carcinoma was misdiagnosed as uterine sarcoma because imaging showed a mass with a solid uterine-like and necrotic area. In the present case, cytoreductive surgery was performed to remove the entire tumor and its infiltration to the sigmoid colon and left ureter. Hence, the patient had a better prognosis. Case report: A 57-year-old Indonesian woman presented to our hospital (Dr. Soetomo General Hospital) with post-menopausal bleeding, a large solid pelvic mass, and abdominal discomfort. The patient was diagnosed with uterine sarcoma due to the solid feature observed during ultrasonography and MRI. During the surgery, the mass was observed to originate from the left ovary, and primary debulking surgery with a multidisciplinary team was performed with zero residual tumor tissue. The tumor was histopathologically confirmed as clear cell carcinoma. Conclusion: MRI of clear cell ovarian carcinoma can be misdiagnosed as uterine sarcoma due to its solid feature. Additionally, the enlarged mass distorts the anatomical landmarks. Surgery with no residual tumor improves the prognosis for advanced-stage clear cell ovarian carcinoma.