Pemberian Kemoterapi pada Pasien Dugaan High Grade Astrocytoma tanpa Biopsi

I’anatul ‘Ulya*, Yudha Haryono**
* Peserta PPDS 1 Neurologi FK Universitas Airlangga/RSUD Dr. Soetomo Surabaya
** Staf Pengajar SMF/Departemen Neurologi FK Universitas Airlangga/RSUD Dr. Soetomo Surabaya

Abstract

         Pendahuluan: High grade astrocytoma adalah tumor astrositik paling ganas. Insidennya 5 per 100.000 penduduk pada semua umur, dengan usia puncak mulai 50 hingga 60 tahun. High grade astrocytoma merupakan derajat tinggi WHO, yaitu derajat III-IV. Kejang sering dijumpai, serta gejala lain seperti kesulitan berbicara, perubahan sensibilitas, gangguan penglihatan dan motorik. Pada tumor low grade astrocytoma, kejang dijumpai pada 80% kasus, lebih besar bila dibandingkan dengan high grade, yaitu sebesar 30%. Pemeriksaan fisik dan pemeriksaan penunjang yang teliti dapat menegakkan diagnosis dengan tepat.1-5 Kasus: Laki-laki, 65 tahun, memiliki keluhan utama tidak bisa menahan kencing sejak 2 minggu dan ngompol. Keluhan lainnya adalah kesemutan separuh tubuh kanan (+), kelemahan separoh tubuh (-), sakit kepala (+) di seluruh permukaan kepalanya, gangguan konsentrasi (+), sering bingung (+), cenderung diam (+), tidak mau bekerja (+), kejang (-), mual(-), muntah(-), wajah merot (-), tersedak (-). Pemeriksaan neurologis: hemiparesis kanan, paresis N. VII dan N. XII kanan tipe sentral. Pemeriksaan penunjang MRI menunjukkan massa intra aksial ukuran 4,6 x 4,2 x 4,5 cm di korpus calosum dan periventrikel lobus frontalis kanan dan kiri disertai edema perifokal di sekitarnya yang mencurigakan suatu butterfly glioma dd astrositoma. Kesimpulan: Berdasarkan klinis dan pemeriksaan MRI, kasus ini adalah suspect high grade astrocytoma (GBM).

Kata kunci:
diagnosis, high grade astrocytoma, kemoterapi, klinis, radiologi.

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