PPT SJL

8/19/2019 PPT SJL

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Referat

Sarkoma Jaringan

Lunak

Khumaisiyah, S.Ked

Pembimbing

Dr. Mulawan Umar, Sp.B(K) Onk

DEP!"EME# $%MU BED& !SM&'KU%"S KEDOK"E!# U#$E!S$"S

S!$*$+

P%EMB#-

8/19/2019 PPT SJL


PE#D&U%U#

Sark2ma +aringan

%unak (S+%)"um2r yang

3umbuh pada 4aringan penyangga

yang si5a3nya

in6l3ra3i5 dan ganas

S!

PEMBU%U&

%$ME

PEMBU%&

D!&$B!OS

D$POS

K!"$%-O

O"O"

8/19/2019 PPT SJL


S!KOM +$#-#

%U#K

LOK

ASI

USIA

7/ 891/8

19% 15%9%

8/19/2019 PPT SJL


"$#+U#

PUS"K

8/19/2019 PPT SJL


DE$#$S$

Tumor yang tumbuh pada jaringanpnyangga yang bra!a" dari "api!an

m!odrm !prti otot# karti"ago# jaringan "mak# jaringan $bro!a#pmbu"uh darah# pmbu"uh "im# dan

!ara yang !iatnya in$"trati dan gana!

8/19/2019 PPT SJL


&'I(&)IOLO*I

US

//: ; </ kasus denganm2r3ali3as =71/ kasus

/0; 00.>/ kasus denganm2r3ali3as =<// kasus

UK

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8/19/2019 PPT SJL


8/19/2019 PPT SJL


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8/19/2019 PPT SJL


8/19/2019 PPT SJL


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8/19/2019 PPT SJL


8/19/2019 PPT SJL


&TIOLO*I (A+ ,AKTO--ISIKO

K"O! -E#E"$K

-en#90

-en #9!S

-en

!B0?DK#

-enP7=

agn2s s r2m2s2m en

8/19/2019 PPT SJL


agn2s s r2m2s2mabn2rmal

en

l@e2lar

rhabd2my2sarA2ma

t./012.3503142

t.1012.p03142

'A67,K8-

'A67,K8-

l@e2lar s253 par3

sarA2ma

t.6012

.p11:/03/52

T,&7AS'L

ngi2ma32sis 6br2us

his3i2Ay32ma

t.1/012.310p112 ,US7AT,1

?lear Aell sarA2ma t.1/0//2.31031/2 &;S7AT,1?2ngeni3al

6br2sarA2ma'A2ngeni3al

mes2blas3iA

nephr2ma

t.1/0152.p103/52 &T<7+T-K

Derma326br2sarA2ma

pr23uberans

t.10//2.3//0312 '(,*=7

>OL1A1Desm2plas3iA small

r2und Aell 3um2r

t.110//2.p1031/2 &;S7;T1

End2me3rial s3r2mal

sarA2ma

t.012.p1503/12 JA?,17JJA?1

Ewings sarA2ma'peripheral primi3i@e t.110//2.3/4031/2t./10//2.3//0312 &;S7,LI1&;S7&-* &;S7

8/19/2019 PPT SJL


Diagn2sis Kr2m2s2m

abn2rmal

-en

%2w9grade

6br2myC2id sarA2ma

t.012.30p112 ,US7>-&=I/

$namma32rymy26br2blas3iA 3um2r

t.10/2.3//0p/2t./0192.p/0p12

t./012.p/03/2

T')7ALK T')47ALK >LT>7ALK

MyC2id lip2sarA2ma t.1/012.310p112

t.1/0//2.31031/2

TLS7>8O' &;S7

>8O'

MyC2idAh2ndr2sarA2ma

t.90//2.3//031/2t.90152.3//03/12

t.9012.3//03112

&;S7>8+ T,>1/7>8+ TA,/+7>8+

Syn2@ial sarA2ma [email protected] SS617SBT SS6/7

SBT SS647SBT

) t i 5 ),8

8/19/2019 PPT SJL


-A(IASI

-I;ABATK&LUA-*A

K&-USAKA+SIST&) LI),&

'AJA+A+=A8A+

KI)IA;I

T-AU)A

)uta!i gn p5 ),8#angio!arkoma#

"imangio!arkoma

8rditrC nuro$bromato!i!#rtinob"a!toma# Sindrom Li7

,raumni

Inki $"aria!i!# "imdma

kongnita"# po!t di!k!i nodu" a@i""a "imangio!arkoma

A!am nok!ia!tik# k"orono"#

kar!inognik

8/19/2019 PPT SJL


'ATO,ISIOLO*I

K"O!!$S$KO

de5ek a3au mu3asi pada D#

perubahan 5ungsi penga3uranpr2322nk2gen dan 2nk2gen

Merusak'mengin@asi s3ruk3ur

s3ruk3ur 4aringan

ne2@askularisasi danrusaknya ba3as k2mpar3emen

4aringan

8/19/2019 PPT SJL


KLASI,IKASI#2 +aringan sal #ama 3um2r

0 Jaringan Ikat ,ibro!a ibr2sark2ma

Jaringan

,ibrohi!tio!itik

Malignan3 ibr2us

his3y2Ay32ma

= Jaringan Lmak %ip2sark2ma

F Otot 'o"o! %ei2my2sark2ma

7 Otot Sk"ta" !habd2my2sark2ma

1 'mbu"uh (arah &emangi2sark2ma

: 'mbu"uh Lim %im5angi2sark2ma

> 'riDa!ku"ar Malignan3

&emangi2periAy32ma

< SynoDia" Syn2@ial Sark2ma

0/ 'aragang"ionik Malignan3 Paragangli2ma

00 Mes23helial Malignan3 SAhwann2ma

8/19/2019 PPT SJL


#2 +aringan sal #ama 3um2r0 Karti"ago &k!tra!k"ta"

dan O!!u! E!ot partF

K2ndr2sark2ma Eks3raskele3al

Os3e2sark2ma Eks3raskele3al

0= S" )!nkim'"uripotn

Malignan3 MesenAhym2ma

0F Jaringan Sara #eur2blas32ma

Ewings Sark2ma

Eks3raskele3al

#eur26br2sark2ma

#eurilem2ma Maligna07 %ain9lain l@e2lar S253 Par3 SarA2ma

Epi3hel2id SarA2ma

Malignan3 EC3ra !enal

!habd2id Sark2ma

Desm2plas3iA Small ?ell "um2r

8/19/2019 PPT SJL


*rada!i 8i!topato"ogi

• Tingkat !"u"arita!

• (irn!ia!i

•

'"omor$• +kro!i!

• Jum"ah mito!i!

8/19/2019 PPT SJL


%2w9 grade

sarA2ma

&igh9grade

sarA2ma

-22ddiGeren3ia3i2n

'oor diGrntiation

&yp2Aellular 8yprH""u"ar

$nAreased s3r2ma )inima" !troma

&yp2@asAular 8yprDa!Hu"ar

Minimal neAr2sis )uHh nHro!i!

H 7 mi32ses per9

high p2wer 6eld

5 mito!! pr7high

por $"d

8/19/2019 PPT SJL


,ibro!arkoma

)a"ignant ,ibrou!

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)a"ignant ,ibrou!8y!tioHytoma

Lipo!arkoma

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Lipo!arkoma

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Liomio!arkoma

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-abdomio!arkoma

A i k

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Angio!arkoma

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Limangio!arkoma

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)a"ignant8mangiopri!itoma

i i " k

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SinoDia" Sarkoma

k k " " i

8/19/2019 PPT SJL


&k!tra!k"ta" &ing!Sarkoma

A" " S ' S k

8/19/2019 PPT SJL


A"Do"ar Sot 'art Sarkoma

8/19/2019 PPT SJL


Kapo!i Sarkoma

8/19/2019 PPT SJL


(ASA- (IA*+OSIS

#M#ES$S

Idnti$ka!i Ada bnjo"anLoka!i ;arna Ukuran Jum"ah Kon!i!tn!i'rmukaan )obi" +yrirM radia!i rM k"uarga*ja"a "ain

Ada bnjo"an di tmpat "ainLoka!i ;arna Ukuran

Jum"ah Kon!i!tn!i'rmukaan )obi"

+yri tu"ang S!ak naa!

T

+)

8/19/2019 PPT SJL


'&)&-IKSA

A+ ,ISIK

"ampak ben42lanI*arnaI PermukaanIUkuranI +umlahI$n6l3asi ke kuli3I

"eraba massa a3auben42lanI K2nsis3ensiIM2bileI #yeri 3ekanIPembesaran K-BI

Keadaan Umum(@i3al sign)

8/19/2019 PPT SJL


• ,oto po"o!

• )-I M >T7!Han

• Angiogra$

• ,oto thorak!

• US* hpar

• ,ung!i ginja"

• =iop!i

'&)&-IKSAA+'&+U+JA+*

STA(IU)

8/19/2019 PPT SJL


STA(IU)" Primary 3um2r"/ ; #2 e@idenAe 25 primary3um2r"0 ; "um2r H7 Am in grea3es3dimensi2n "0a ; Super6Aial 3um2r "0b ; Deep 3um2r" ; "um2r J7 Am in grea3es3dimensi2n "a ; Super6Aial 3um2r "b ; Deep 3um2r # !egi2nal lymph n2des#/ ; #2 regi2nal lymph n2deme3as3asis#0 ; !egi2nal lymph n2deme3as3asis M Dis3an3 me3as3asisM/ ; #2 dis3an3 me3as3asisM0 ; Dis3an3 me3as3asis

S3age -r2uping ("#MSys3em 13h edi3i2n, //)

S3age $ %2w grade "0a #/ M/

%2w grade "0b #/ M/

S3age $B %2w grade "a #/

M/ %2w grade "b #/

M/S3age $$

&igh grade "0a #/M/ &igh grade "0b #/M/S3age $$B

&igh grade "a #/M/

STA(IU)

8/19/2019 PPT SJL


STA(IU)

S3adium $ ;

%2w -rade ; "0a#/ M/

%2w -rade ; "0b #/ M/S3adium $B ;%2w -rade ; "a

#/ M/

%2w -rade ; "b #/ M/S3adium $$ ;%2w -rade ; "0a #/ M/&igh -rade ; "0b #/ M/S3adium $$B ;&igh -rade ; "a #/ M/

S3adium $$$ ;&igh -rade ; "b #/ M/S3adium $ ;Semua -rade ; semua " #0

M/Semua -rade ; semua "

semua # M0

8/19/2019 PPT SJL


TATALAKSA+A

'mbdahan

Kmotrapi

-adia!i

• &k!trmita!

•

<i!Hra"Mrtropritona"• =agian tubuh "ain

• SJL dngan mta!ta!i! jauh

&k!trmita!

8/19/2019 PPT SJL


&k!trmita!-!kta

b"

Tidak

8/19/2019 PPT SJL


Tidak-!ktab"

-!idi

8/19/2019 PPT SJL


-tropritona"

8/19/2019 PPT SJL


Kmotrapi

Tungga"• (o@orubiHin

Kombina!i• (o@orubiHin N Io!amid• (o@orubiHin N (aHarbain

• >y<A(I>• (o@orubiHin N Io!amid P

)!na N (aHarbain

8/19/2019 PPT SJL


'-O*+OSIS

UKU-A+

U)U-

Tip8i!to"ogi

*-A(ASI8ISTO'ATOL

O*ILoka!i

Stadium

8/19/2019 PPT SJL


Ukuran

$ns3i3usi 7 year Sur@i@alQ 5 Hm J 7 Am

!2swell

Park

Mem2rial

$ns3i3u3e

5 % F/ 8

Mem2rial

Sl2an9

Ke33ering

?anAer

?en3er

1= 8 F1 8

Ti 8i t " i

8/19/2019 PPT SJL


Tip 8i!to"ogi$ns3i3u

si

7 year Sur@i@al

,ibro

!arkom

a

Liomy

o

!arkom

a

Lipo

!arkom

a

+uro$

bro

!arkom

a

-habdo

myo

!arkom

a

)a"ignant

,ibrou!

8i!tyoHitoma

Syn2@i

al

SarA2

ma

!PM$ 5R % 41 % 1 % % 1 % % =F 8

MSK?

?

:/ 8 71 8 F/ 8 F> 8 F7 8

8/19/2019 PPT SJL


*rada!i 8i!topato"ogi

Ukuran 7 year Sur@i@al

Lo

*rad

&igh

-rade

H 7 Am % 1= 8

7 Am 7> 8 == 8

8/19/2019 PPT SJL


S3adium

Klinik

Persen3ase Ke3ahanan &idup

(LSur@i@al !a3e)1 yar / yar 5 yar 0/ year

$ 9 % 9 % . %2 (:7 8)

$B % R % / % (7> 8)

$$ .9R %2 .9 %2 .59 %2 (F0 8)

$$B % ./ %2 .5 %2 (F/ 8)

$$$ 4 % .1 %2 4/ % : 8$$$B % 4 % / % 01 8

$$$? .5 %2 .4 %2 ./ %2 (= 8)

$ =: 8 0< 8 : 8 = 8

8/19/2019 PPT SJL


8/19/2019 PPT SJL


"E!$MKS$&

8/19/2019 PPT SJL


'rtanyaan

1: =agaimana trapi pada !j" rtropritona"dngn in$"tra!i k ginja" dan ko"on

/: =agaimna rkurn!i pada !arkoma

jaringan "unak: >ara pngambian biop!i yang

dianjurkan

4: Apakah bi!a mmbdakan tip !arkoma jaringan "unak brda!arkan anamn!i!dan pmrik!aan $!ik

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PPT SJL