Modul 5

“Penatalaksanaan Awal Neoplastik”

Kelompok 8
Tutor : dr. Iskandar, Sp.OG
 Kelompok 7
1. Muhammad Idham L.
2. Rahmad Syukran
3. Refi Syifa G.
4. Rizqa Ramadhani
5. Nursadilah
6. Asri Aprillya
7. Dinda Fitria
8. Sucita Amalia
9. Bela Nur F
10. Kenty Andika
11. Afifah Izzatul Z.
12. Rara Enggola
 MODUL 5
Penatalaksanaan Awal Neoplasma

SKENARIO 5
Derita suami istri

Irma 50 tahun, bekas pekerja di POM Bensin datang ke puskesmas dengan keluhan batuk dan
terasa sesak nafas serta mengeluhkan suaranya parau. Dari anamnesis diketahui bahwa keluhan ini
dirasakan
sejak satu tahun yang lalu. Irma juga seorang perokok. Ia juga merasakan nyeri tenggorokan dan kesulitan
saat menelan makanan serta badan bertambah kurus.
Pada pemeriksaan fisik ditemukan konjungtiva anemis, faring hiperemis dan limfadenopati di regio
colli sinistra, dua buah, terfiksir dengan konsistensi keras. Dokter merujuk Irma ke Rumah Sakit Kabupaten
untuk dilakukan pemeriksaan lebih lanjut. Pada pemeriksaan laringoscopy direct supraglottis dan glottis
ditemukan massa tumor dengan permukaan tidak rata, kemerahan dan mudah berdarah. Dokter selanjutnya
melakukan FNAB kelenjar getah bening dan pemeriksaan rontgen colli dan thorax untuk mengetahui ada
tidaknya metastase. Irma teringat pada suaminya yang meninggal karena kanker paru yang menyebar ke
mediastinum. Pada biopsi ditemukan massa tumor dengan karsinoma sel skuamosa tidak berkeratin,
berdiferensiasi sedang. Dokter menjelaskan bahwa Irma menderita kanker yang berbeda dengan suaminya
baik jenis dan stadiumnya. Untuk pengobatan yang lebih tepat diperlukan penetapan stadium melalui
serangkaian pemeriksaan lanjutan. Dokter berharap bahwa kemoterapi memberikan respon yang baik pada
Irma.
Bagaimana menjelaskan kondisi yang di alami Irma?
 JUMP 1 : Terminologi
1. Konjungtiva Anemis : Suatu kondisi dimana konjungtiva pucat, yang
dipengaruhi adanya asupan darah.
2. Limfadenopati : Pembesaran kelenjar getah bening dengan ukuran
lebih besar dari 1 cm.
3. Regio colli sinistra : Leher (yang menghubugkan antara kepala dan
dada) sebelah kiri
4. Laringoscopy direct : Pemeriksaan laring secara langsung dengan
menggunakan kabel serat optik dan laringoskopi
kaku.
5. FNAB : (Fine Needle Aspiration Biopsy) merupakan suatu metode atau
tindakan pengambilan sebagian jaringan tubuh manusia
dengan suatu alat aspirator berupa jarum suntik yang bertujuan
untuk membantu diagnosis berbagai penyakit tumor.
 Jump 2 dan 3 : Rumusan Masalah dan Hipotesa
1. Mengapa Irma mengalami suara parau, batuk dan sesak nafas?
- Suara parau : adanya kanker laring, dimana masanya sudah menekan
N. Laringeus
- Batuk : dikarenakan adanya sekret sehingga mengganggu saluran napas
- Sesak napas : adanya obstruksi saluran napas

2. Apakah ada hubugan kerja, umur, jenis kelamin, dengan keluhan Bu

Irma?
Kerja benzena terhirup saluran napas aliran darah tersimpan disumsum
tulang eritrosit menurun

Benzena eritrosit dan leukosit menurun leukosit menurun menyerang enzim

topoisemerase II di dalam sumsum.
Topoisemerase II berinteraksi dengan DNA untuk bereplikasi, mengakibatkan kerusakan pada
kromosom tahap awal karsinoma
3.Mengapa ada nyeri tenggorokan dan kesulitan saat menelan makana
serta badan yang bertambah kurus?
- Nyeri tenggorokan:keluhan ini dapat bervariasi dari rasa goresan
sampai rasa nyeri yang tajam
- Kesulitan menelan:ditandakan karena adanya tumor pada laring
- Nafsu mka yang menurun menyebabkan BB menurun

4.Apakah hubungan rokok dengan keluhan pada ibu irma?

Asap rokok mengandung zat karsinogen dapat menginduksi kanker
 Jump 2 dan 3 : Rumusan Masalah dan Hipotesa
1. Mengapa Irma mengalami suara parau, batuk dan sesak nafas?
- Suara parau : adanya kanker laring, dimana masanya sudah menekan
N. Laringeus
- Batuk : dikarenakan adanya sekret sehingga mengganggu saluran napas
- Sesak napas : adanya obstruksi saluran napas

2. Apakah ada hubugan kerja, umur, jenis kelamin, dengan keluhan Bu

Irma?
Kerja benzena terhirup saluran napas aliran darah tersimpan disumsum
tulang eritrosit menurun

Benzena eritrosit dan leukosit menurun leukosit menurun menyerang enzim

topoisemerase II di dalam sumsum.
Topoisemerase II berinteraksi dengan DNA untuk bereplikasi, mengakibatkan kerusakan pada
kromosom tahap awal karsinoma
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