BAGIAN RADIOLOGI FAKULTAS KEDOKTERAN UNIVERSITAS PATTIMURA

REFERAT JANUARI 2014

Oleh: Miftahul Jannah Tatuhey

2008-83-031

Pembimbing: dr. Hendrik M. Manuputty Sp.Rad

DIBAWAKAN DALAM RANGKA TUGAS KEPANITERAAN KLINIK BAGIAN ILMU radiologi RSUD DR. M. HAULUSSY AMBON

Infeksi Bakteri
Infeksi Virus

Faktor predisposisi lainnya

Gambaran khas karsinoma prostat yaitu nodul hypoechoic di bawah kiri

Gambar 4. Male (60 year old) with PSA of 12,6. Biopsy later
confirmed prostatic adenocarsinomaof the left base.

Gambar 5. Axial transrectal ultrasonographic scan shows extensive hypoechoic area (arrows) in the right peripheral zone. Biopsy revealed prostatic adenocarcinoma.

Gambar 6. Axial transrectal ultrasonographic scan shows a hypoechoic area in left peripheral zone and a small hypoechoic area in right peripheral zone (arrows). Biopsy revealed an adenocarcinoma (Gleason grade 6).

Gambar 7. Axial transrectal sonogram in a patient with normal results during digital rectal examination and a prostate-specific antigen (PSA) level of 9 ng/mL. Image shows extensive bilateral, but predominantly left-sided, hypoechoic areas in the peripheral zone (arrows). Biopsy confirmed a Gleason grade 8 prostate cancer. Minor capsular irregularity is present on the left; this is consistent with a T3 tumor.

10

Gambar 8. Axial transrectal ultrasonographic power Doppler scan in the same patient as in the previous image. The patient had normal results with digital rectal examination and a prostate-specific antigen (PSA) level of 9 ng/mL. A generalized increase in vascularity was noted in the posterior aspect of the prostate (arrows). However, this finding is not specific to the hypoechoic area in the left peripheral zone, illustrating the difficulty of using Doppler techniques in the assessment of prostate cancer.

11

Gambar 9. Enlarged metastatic lymph node (arrow) in the left groin in a 67-year-old patient with prostate cancer
12

Gambar 10. Enlarged mediastinal nodes in a patients with widespread metastatic prostate cancer (PSA level, 544 ng ml-1)

13

Gambar 11. Large volume paraaortic lymph nodes in a patient previously treated with pelvic radiotherapy and no evidence of enlarged lymph nodes in the pelvis (PSA level, 185 ng ml-1)

14

15

Gambar 12. This patient, who had metastatic prostate cancer, developed proptosis of the right eye. CT shows a large destructive metastasis in the greater wing of the sphenoid bone. (a) bone window and (b) soft tissue window, no destruction of the lateral wall of the orbit (arrow) and a soft tissue mass extending into the right orbit. Proptosis is evident on CT.

Gambar 13. Large metastasis of the skull base in patient: (a) bone window and (b) soft tissue window, no destruction of part of the basiocciput and foramen magnum
16

Gambar 14. Metastatic prostate cancer (arrows) involves the soft tissues at the right side of the skull base. The patient presented with right-sided cranial nerveXII palsy.

17

Gambar 15. Coronal, T2-weighted magnetic resonance imaging (MRI) study of the prostate gland obtained by using an external coil. Low signal intensity (arrow) is seen on the left side of the prostate at the site of a biopsy-proven prostate cancer.

18

Gambar 16. Endorectal, axial, T2weighted magnetic resonance imaging (MRI) scan in a patient with a prostatespecific antigen level of 8 ng/mL and right-sided prostate cancer. Low signal intensity is demonstrated in the right peripheral zone (arrow).

19

Gambar 17. Patient with biopsyproven prostate cancer. Axial, T1weighted magnetic resonance imaging (MRI) scan of the pelvis shows an enlarged left obturator node (arrow).

20

Gambar 18. Isotopic bone scans show multiple areas of increased tracer activity from metastatic prostate cancer.
21

Gambar 19. Isotopic bone scans. Diffuse metastases demonstrate a superscan appearance. Note that no renal excretion of radioactive tracer is demonstrate

22

Pelvic radiograph shows widespread, osteoblastic, sclerotic metastases from prostate cancer

23

24

TERAPI
Tindakan yang dilakukan terhadap pasien karsinoma prostat tergantung pada stadium, umur harapan hidup, dan derajat diferensiasinya : Observasi

Prostatektomi radikal

Radiasi

Terapi hormonal
25

26

27

PROGNOSIS
Tumor terlokalisasi: ketahanan hidup 5 tahun 80%

Penyebaran lokal: ketahanan hidup 5 tahun 40%

Metastasis: ketahanan hidup 5 tahun 20%.

28

29