Minimal apparent diffusion coefficient value of the solid component to differentiate borderline and malignant ovarian epithelial tumours: a preliminary report.

PURPOSE: Ovarian tumours are the second most common cause of death from gynaecological cancer. There are three types of ovarian cancer based on histopathological examination: benign, borderline, and malignant. However, it is difficult to distinguish the borderline and malignant tumours. Several studies used the apparent diffusion coefficient value to distinguish the ovarian tumour types, with various results. This preliminary report focused more on the use of the minimal ADC (mADC) value on the solid component, to differentiate borderline and malignant ovarian tumours. MATERIAL AND METHODS: In 21 cases of borderline ovarian tumours, of which 11 were regarded as malignant and 10 were regarded as borderline following histopathological examination, the mADC value was measured by two different radiologists by using free-hand technique. The intraclass correlation coefficient (ICC) was used to measure the reliability and agreement between the two radiologists. Receiver-operating characteristic (ROC) curves were then calculated to determine the optimum cut-off point. RESULTS: There were statistically significant (p = 0.001) of the mADC value between the borderline and malignant tumours. The intraclass correlation coefficient value showed excellent reliability and agreement between the examiners. The ROC curve showed the optimum cut-off point at 0.628 × 10-3 mm2/s (p = 0.001), which yielded 100% sensitivity and 80% specificity. CONCLUSIONS: The use of free-hand technique to measure the mADC value on the solid component can be valuable in differentiating borderline and malignant ovarian epithelial tumours. This result may assist clinicians in considering further treatment approaches.

Case Report: High-grade anterior prostate cancer previously undetected by transrectal biopsy, diagnosed with MRI-US fusion transperineal robotic prostate biopsy.

Seventy percent of anterior prostate cancer cases are diagnosed during rebiopsy. MRI-US fusion transperineal robotic prostate biopsy is an emerging diagnostic method and might be an effective one in diagnosing prostate cancers in difficult sites such as the anterior zone. We report a case of a high grade anterior prostate cancer previously undetected by transrectal biopsy, diagnosed with MRI-US fusion transperineal robotic prostate biopsy. This case report suggests that MRI-US fusion transperineal robotic prostate biopsy might be valuable in diagnosing prostate cancer especially in difficult sites - the anterior region in this case - and might be an imperative diagnostic method in suspicious cases with prior negative biopsy.

Intra-arterial chemotherapy for retinoblastoma: Our first experience in Indonesia.

Intra-arterial chemotherapy (IAC) has become the mainstay therapy for retinoblastoma group D and E for the past few decades. However, IAC had never been done in Indonesia before. In this report, we present a case of a 2-year-old girl with recurrent Group D retinoblastoma of the left eye that improved significantly after one session of IAC, the first IAC in Indonesia.

Female paraurethral leiomyoma in non-sexually active woman: A case report.

Leiomyomas are benign fibromuscular tumors that arise from smooth muscle cells. Paraurethral leiomyoma accounts for 5% of all paraurethral masses and occurs in 1 in 1000 women. We reported a case of a 43-year-old female presented with a palpable mass at the vaginal introitus with lower urinary tract symptoms. Patient had no pregnancy and sexual history before. A pelvic MRI demonstrated a 1.6 x 1.7 × 2.0 cm mass within the anterior part of the paraurethra. The excision of the mass was done via transvaginal approach and was successful. The final post-operative pathology report was confirmed as leiomyoma.