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"The melanocytic skin lesion infobase, available at http://synthesis.melanoma.pl also http://synteza.melanoma.pl, in Polish, referred to as INP is currently undergoing a complete modification of the way in which the internal synthesis algorithms and the classification of lesions are performed. We investigated 29 new real images of melanocytic skin lesions, focusing on how humans perform classification based on experience. In conclusion we suggest to add a new color connected with the depth of a lesion to the K term of Asymmetry, Border and linear Combination of colors and structures method referred to as ABK."

"Approximately 60% of patients who die due to melanoma have gastrointestinal metastases at autopsy, yet ante mortem diagnosis is uncommon. The small bowel is the most frequent intestinal site of metastasis and prognosis is very poor with a median survival after operation was 6.2 months (range: 1-42 months). Bowel metastases may appear radiologically as polypoid mucosal lesions, submucosal nodules, diffuse infiltration with thickening of the intestinal wall, or serosal implants. Bowel obstruction due into intussusceptions is common clinical presentation of gastrointestinal metastasis; other presentation include gastrointestinal bleeding, perforation and large masses.We reported a case of m eta static melanoma to small bowel, whose had hematemesis melena, abdominal pain, diarrhea and weight loss without primary cutaneus melanoma. Gastroduodenoscopy appeared normal. The ultrasonography of bowel showed a"doughnut" configuration with concentric rings of bowel wall. Left lateral decubitus abdominal radiographies showed free air appearances. Laparatorny reported three location of invaginalion (intussuception) with multiple polyposis at ileo-jejttnal segment (29 pieces of polyp) and jejunum perforation. Resection and end-to end anastomosis of the. affected segment had been performed with no serious complication after this. Miscroscopical examination of specimen showed metasiatic melanoma malignant in 3 lymph nodes. Eight weeks later patients died with distant metastases to brain."

"Latar Belakang : Melanoma malignum (MM) merupakan tumor ganas yang berasaldari proliferasi sel melanosit dan dapat ditemukan pada kulit, mukosa dan okular. Angka mortalitas MM cukup tinggi, terutama pada stadium lanjut yang ditandai dengan metastasis. Metastasis MM dipengaruhi berbagai faktor risiko yang dapat berbeda pada MM kulit, mukosa dan okular, salah satunya yaitu proses imunologi tumor yang dapat dinilai dari Tumor Infiltrating Lymphocyte (TIL). Komponen TIL yang berperan dalam proses penghindaran sistem imun pada MM adalah sel T regulator dengan penanda yang paling spesifik sampai saat ini adalah Foxp3. Hubungan Foxp3 dengan stadium MM masih kontroversial dan sampai saat ini belum ada penelitian mengenai hubungan Foxp3 pada TIL dengan stadium MM di Indonesia. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan karakteristik klinikopatologik dan ekspresi Foxp3 pada TIL dengan stadium MM. Metode: Penelitian analitik pada sediaan MM di Departemen Patologi Anatomik FKUI/RSCM selama periode Januari 2010 hingga Desember 2021. Pengambilan sampel penelitian dilakukan secara total sampling dari kasus yang memenuhi kriteria inklusi sesuai perhitungan besar sampel untuk masing-masing kelompok. Pemeriksaan imunohistokimia menggunakan antibodi primer monoklonal Foxp3. Data imunoekspresi dianalisis untuk mengetahui hubungannya dengan stadium MM. Hasil: Didapatkan 54 kasus MM, 19 kasus diantaranya merupakan MM kulit, 29 kasus MM okular, dan 6 kasus MM mukosa. Mayoritas kasus (63%) merupakan stadium lanjut.Tebal tumor dan mitosis berhubungan dengan stadium klinis MM kulit dan keseluruhan.Jenis kelamin perempuan, tebal tumor >2 mm, mitosis >16/10 LPB, adanya invasi limfovaskular dan invasi perineural umumnya mempunyai ekspresi Foxp3 yang rendah.Pada MM kulit dan MM keseluruhan, ekspresi Foxp3 yang rendah ditemukan padastadium klinis lanjut meskipun tidak didapatkan hubungan yang signifikan.Kesimpulan: Tebal tumor dan mitosis berhubungan dengan stadium klinis MM kulit dan keseluruhan. Karakteristik klinikopatologik tidak berhubungan signifikan dengan ekspresi Foxp3

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Background: Malignant melanoma (MM) is a malignant tumor originating from

proliferation of melanocyte cells and can be found in skin, mucosa and ocular. The

mortality rate for malignant melanoma is quite high, especially at advanced stage

characterized by metastases. Various risk factors can predispose MM into metastases,

which can be different in cutaneous, mucosal and ocular MM, one of which is the

immunological process of the tumor which can be assessed from Tumor Infiltrating

Lymphocyte (TIL). TIL components that play a role in the process of avoiding the immune

system in malignant melanoma are regulatory T cells, whose the most specific marker so

far is Foxp3. The association of Foxp3 with clinical stage of malignant melanoma is still

controversial and until now there has been no research on the association of Foxp3 in

TIL with clinical stage of MM in Indonesia.

Aims: This study aims to determine the association between clinicopathological

characteristics and Foxp3 expression in TIL with MM clinical stage.

Methods: Analytic study on malignant melanoma diagnosed at Anatomical Pathology

Department FKUI/RSCM during January 2010 until December 2021. Sampling was

carried out by total sampling from cases that met the inclusion criteria according to the

calculation of the sample size for each group. Immunohistochemical examination using

Foxp3 monoclonal primary antibody. Immunoexpression data were analyzed to

determine its relationship with clinical stage of malignant melanoma.

Result: There were 54 cases of MM: 19 cases were skin MM, 29 cases of ocular MM, and

6 cases of mucosal MM. Majority of cases (63%) were in advanced stages. Tumor

thickness and mitosis associated with clinical stage of cutaneous and overall MM. Female

gender, tumor thickness >2 mm, mitoses >16/10 HPF, presence of lymphovascular

invasion and perineural invasion generally had low Foxp3 expression. In cutaneous MM

and overall MM, low Foxp3 expression was found at advanced clinical stage although

no significant association was found.

Conclusion: Tumor thickness and mitosis associated with clinical stage of cutaneous and

overall MM. Clinicopathological characteristic was not statistically significant with

Foxp3 expression. Low Foxp3 expression was associated with advanced clinical stage

although no statistically significant association was found."

"Praktek residensi Keperawatan Medikal Bedah peminatan Onkologi yang telah dilaksanakan di RS Kanker Dharmais menetapkan satu kasus kelolaan utama yaitu Melanoma Malignan Metastase Paru dan 30 kasus resume kasus-kasus kanker dengan menggunakan pendekatan teori peaceful end of life. Saat melakukan praktek residensi telah dilakukan berbagai rangkaian kegiatan yang berhubungan dengan permasalahan pasien kanker yaitu dengan memberikan asuhan keperawatan secara professional dan komprehensif kepada pasien-pasien kanker dan salah satu diantaranya adalah kanker Melanoma Malignan dengan menggunakan pendekatan teori peaceful end of life., melakukan suatu penerapan intervensi keperawatan yang berdasarkan Evidence Based Nursing yaitu penerapan terpai komplementer Abdominal Massage untuk mengurangi konstipasi akibat kemoterapi pada pasien kanker dan penerapan suatu proyek inovasi yaitu untuk mengatasi kecemasan pada pasien persiapan opersai kolorektal, dimana hampir sebagian besar pasien kanker mengalami anxietas atau kecemasan sehingga penerapan berupa edukasi terhadap pasien dengan persiapan operasi kolorektal dapat diatasi.

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The Medical Surgical Nursing residency practice specializing in Oncology which was carried out at the Dharmais Cancer Hospital identified one main case of management, namely Lung Metastases Malignant Melanoma and 30 resume cases of cancer cases using the peaceful end of life theory approach. When carrying out residency practice, various series of activities related to the problems of cancer patients have been carried out, namely by providing professional and comprehensive nursing care to cancer patients, one of which is Malignant Melanoma cancer, using the peaceful end of life theory approach. nursing intervention based on Evidence Based Nursing, namely the application of complementary Abdominal Massage therapy to reduce constipation due to chemotherapy in cancer patients and the implementation of an innovation project, namely to overcome anxiety in patients preparing for colorectal surgery, where almost the majority of cancer patients experience anxiety or anxiety so the application takes the form of education in patients preparing for colorectal surgery can be addressed.

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"ABSTRAKRuang lingkup, bahan dan cara penelitian : Telah dilakukan penelitian retrospektif di Departemen Patologi Anatomik FKUI RRSUPN CM. Sampel diambil dari Arsip Departemen PatoIogi Anatomik dari tahun 1995 sampai dengan tahun 2003. Gambaran histologik melanoma malignum dinilai uang, yaitu tipe Nodular Melanoma, tipe Superficial Spreading Melanoma dan tipe Acral Lenligineous Melanoma.Dilakukan pewarnaan ulang HE dan imunoperoksidase dengan menggunakan antibodi Ki67. Penghitungan jumlah mitosis dilakukan dengan menghitung jumlah mitosis/kuadrat milimeter pada 10 LPB secara acak. Penilaian ketebalan tumor dilakukan menurut Breslow. Perkalian antara ketebalan tumor dan jumlah mitosis dilakukan untuk penentuan indeks prognosis. Penghitungan positifitas Ki67 pada inti sel yang berwarna coklat tua dilakukan pada 500 sel secara acak. Untuk mengetahui hubungan berbanding terbalik antara ekspresi Ki67 dengan indeks prognosis dilakukan uji korelasi non parametrik 2x2 dengan uji Pearson. Uji korelasi parametrik dilakukan dengan uji Tukey dan Duncan.Hasil dan kesimpulan: Dan 20 kasus MM (11 kasus NM, 5 kasus ALM dan 4 kasus SSM), didapatkan 17 kasus MM (10 kasus NM, 4 kasus ALM dan 3 kasus SSM) yang positif mengekspresikan Ki67, 3 kasus yang tidak mengekspresikan Ki67 terdiri atas 1 kasus NM, 1 kasus ALM dan I kasus SSM. Dua puluh kasus MM menunjukkan 12 kasus dengan Breslow > 4 mm (8 kasus NM dan 4 kasus ALM), sedangkan 8 kasus dengan Breslow < 4 mm (3 kasus NM , 1 kasus ALM dan 4 kasus SSM).Pada 4 kasus SSM 3 kasus mengekspresikan Ki67 positif 1 dan 1 kasus tidak mengekspresikan Ki67. Hasil uji korelasi menunjukkan adanya hubungan bermakna antara ketebalan tumor Breslow dengan indeks proliferasi Ki67. Dari hasil penelitian ini dapat disimpulkan, bahwa antibodi monoklonal Ki67 sebagai petanda proliferasi dapat digunakan sebagai indikator dalam memprediksi prognosis dan kemungkinan terjadinya early metastasis pada penderita MM yang mempunyai nilai ketebalan Breslow rendah, seperti pada jenis SSM."

"Melanoma is an increasingly important public health problem. Although the cause of most malignant melanomas, over-exposure to ultraviolet light, is well known, effective treatment has remained challenging.The past several years have been marked by extraordinary developments in melanoma treatment in the arena of targeted therapeutics. This book describes these ground-breaking discoveries and their implications for clinical use. As melanoma biology is increasingly understood, so the development of targeted therapies for this disease is spurred ahead. This book covers both established signal transduction inhibitors and the fascinating emerging realm of molecularly-guided immunotherapies.This benchmark book provides the most up-to-date information on the new breed of melanoma therapies. Composed of the works of major researchers and clinicians, this book offers new insights, novel approaches, and promising data for effective treatment planning. "

"This research present asymmetry, border irregularity, color variation, and diameter (ABCD) feature extraction of image dermatoscopic for melanoma skin cancer diagnosis. ABCD feature is the important information based on morphology analysis of image dermatoscopic lesion. ABCD feature is used to calculate Total Dermatoscopic Value (TDV) for melanoma skin cancer diagnosis. Asymmetry feature consist information of asymmetry and lengthening index of the lesion. Border irregularity feature consist information of compactness index, fractal dimension, edge abruptness, and pigmentation transition from the lesion. Color homogeneity feature consist information of color homogeneity and the correlation between photometry and geometry of the lesion. Diameter extraction is diameter of the lesion. There are three diagnosis that is used on this research i.e. melanoma, suspicious, and benign skin lesion. The experiment uses 30 samples of image dermatoscopic lesion that is suspicious melanoma skin cancer. Based on the experiment, the accuracy of the system is 85% that there are four false diagnoses of 30 samples.

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Penelitian ini menyajikan ekstraksi fitur citra dermatoskopik untuk diagnosis kanker kulit melanoma berdasarkan asymmetry, border irregularity, color variation, dan diameter (ABCD). Fitur ABCD adalah informasi yang penting berdasarkan analisis morfologi lesi citra dermatoskopik. Fitur tersebut digunakan dalam perhitungan Total Dermatoscopic Value (TDV) untuk diagnosis kanker kulit melanoma. Fitur asymmetry terdiri dari informasi asimetri dan indeks perpanjangan luka. Fitur border irregularity terdiri dari informasi indeks compactness, dimensi fraktal, edge abruptness, dan transisi pigmentasi dari lesi. Warna fitur homogenitas terdiri dari informasi homogenitas warna dan korelasi antara fotometri dan geometri lesi. Ekstraksi diameter adalah diameter lesi. Ada tiga diagnosa yang digunakan pada penelitian ini yaitu melanoma, diduga melanoma, dan benign skin lesion. Percobaan ini menggunakan 30 sampel dari lesi citra dermatoskopik kanker kulit melanoma yang mencurigakan. Berdasarkan percobaan, akurasi dari sistem ini adalah 85% dan terdapat empat diagnosa palsu dari 30 sampel."

"Latar Belakang: Melanoma konjungtiva adalah keganasan konjungtiva yang jarang dijumpai, namun berpotensi agresif. Rekurensi melanoma konjungtiva pada kasus melanoma konjungtiva mencapai 40% disertai persentase mortalitas yang tinggi (18%). Aktivitas mitosis dan ekspresi pulasan imunohistokimia (IHK) Ki-67 sebagai penanda proliferasi memiliki potensi sebagai prediktor prognosis kondisi ini. Penelitian ini bertujuan menilai hubungan aktivitas mitosis dan ekspresi Ki-67 dengan faktor prognosis klinis dan histopatologi pada melanoma konjungtiva yaitu lokasi tumor, invasi lokal, keterlibatan kelenjar getah bening (KGB), rekurensi, metastasis jauh, tipe sel, invasi limfovaskular, dan penyebaran pagetoid. Metode: Penelitian ini dilakukan dengan pengumpulan data rekam medis dan blok parafin pasien melanoma konjungtiva di Rumah Sakit Cipto Mangunkusumo selama periode Januari 2013 – Desember 2023. Sampel dikaji ulang dan dilakukan pewarnaan hematoksilin-eosin (HE) serta pulasan IHK menggunakan antibodi Ki-67. Hasil hitung mitosis dan ekspresi Ki-67 selanjutnya dicek silang dengan faktor-faktor prognosis lain yang ditemukan dari rekam medis dan sampel yang diuji. Kemudian dilakukan analisis statistik untuk mengetahui hubungan keduanya. Hasil: Didapatkan 34 sampel penelitian yang memenuhi kriteria inklusi dan eksklusi. Tidak ditemukan adanya hubungan yang signifikan secara statistik antara aktivitas mitosis dan ekspresi Ki-67 dengan faktor prognosis klinis dan histopatologi yang diuji (p>0.05). Mayoritas pasien melanoma konjungtiva pada penelitian ini memiliki aktivitas mitosis tinggi (85.3%), temuan ini melebihi persentase proporsi pada penelitian-penelitian sebelumnya. Kesimpulan: Tidak terdapat hubungan yang bermakna secara statistik antara aktivitas mitosis dan ekspresi Ki-67 dengan faktor prognosis buruk klinis dan histopatologi pada pasien melanoma konjungtiva. Terdapat ketimpangan proporsi populasi berupa ditemukannya hampir seluruh pasien dengan aktivitas mitosis tinggi.

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Background: Conjunctival melanoma is a rare but potentially aggressive conjunctival malignancy. Local recurrence of conjunctival melanoma cases reaches 40% with a high mortality rate (18%). Mitotic activity and Ki-67 immunohistochemistry (IHC) staining expression as proliferation markers can predict this condition's prognosis. This study aims to assess the association between mitotic activity and Ki-67 expression with clinical and histopathological prognostic factors in conjunctival melanoma, namely tumor location, local invasion, lymph node involvement, recurrence, distant metastasis, cell type, lymphovascular invasion, and pagetoid spread. Methods: This study was conducted using data from medical records and paraffin blocks of conjunctival melanoma patients at Cipto Mangunkusumo Hospital from January 2013 - December 2023. Samples were reviewed, hematoxylin-eosin (HE) stained, and IHC stained using Ki-67 antibody. The mitotic count and Ki-67 expression results were then cross-checked with established prognostic factors. Then, statistical analysis was performed to determine the association between these two. Results: 34 research samples met the inclusion and exclusion criteria. There was no statistically significant association between mitotic activity and Ki-67 expression with the clinical and histopathological prognostic factors tested (p>0.05). Most conjunctival melanoma patients in this study had high mitotic activity (85.3%); this finding exceeds the percentage proportion in previous studies.Conclusion: In conjunctival melanoma patients, there was no statistically significant association between mitotic activity and Ki-67 expression with poor clinical and histopathological prognostic factors. There was an imbalance in the population proportion in the form of almost all patients with high mitotic activity."

"Kanker kulit termasuk salah satu kanker dengan kasus terbanyak di seluruh dunia dan menjadi penyebab kematian terbanyak adalah kanker kulit melanoma. Pendeteksian dan diagnosis dini berhasil meningkatkan angka survival rate untuk melanoma tingkat awal sebesar 95%. Oleh karena itu, analisis gambar medis sangat penting dalam upaya pengobatan penyakit kulit sedini mungkin. Cara pendeteksiaan saat ini yang menggunakan metode manual masih kurang handal dan memakan banyak waktu. Adanya pengembangan teknologi deep learning dan computer vision dapat membantu dokter dalam melakukan segmentasi lesi kulit dengan lebih cepat dan akurat. Penelitian ini mengusulkan penggunaan arsitektur Recurrent Residual U-Net (R2U-Net) dalam melakukan tugas segmentasi lesi kulit. Arsitektur ini menggunakan recurrent residual block yang terinspirasi dari residual connection dan Recurrent Convolutional Layer (RCL) ke dalam arsitektur berbasis U-Net. Unit residual dengan RCL membantu mengembangkan model lebih dalam yang efisien. Dataset yang digunakan pada penelitian ini adalah dataset yang berasal dari International Skin Imaging Collaboration (ISIC) 2018. Penelitian ini berhasil meningkatkan kinerja model dalam memprediksi segmentasi lesi kulit pada nilai Dice Similarity Coefficient (DSC), jaccard index, akurasi, sensitivitas, spesifisitas, dan presisi masing-masing sebesar 88,16%, 79,03%, 94,07%, 87,25%, 96,98%, dan 89,50%, dengan rata-rata kenaikan sebesar 2,4%.

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Skin cancer is one of the most common cancers in the world and the leading cause of death is melanoma. Early detection and diagnosis can increase the survival rate for early-stage melanoma by 95%. Therefore, analysis of medical images is very important in efforts to treat skin diseases as early as possible. The current detection method that uses the manual method is still less reliable and takes a lot of time. The development of deep learning technology and computer vision can assist doctors in segmenting skin lesions more quickly and accurately. This study proposes the use of the Recurrent Residual U-Net (R2U-Net) architecture in performing the task of segmenting skin lesions. This architecture uses a recurrent residual block inspired by the residual connection and recurrent convolutional layer (RCL) in a U-Net-based architecture. Residual units with RCL help develop efficient deeper models. The dataset used in this study is a dataset from the International Skin Imaging Collaboration (ISIC) 2018. This research succeeded in improving the model's performance in predicting skin lesion segmentation on the Dice Similarity Coefficient (DSC), jaccard index, accuracy, sensitivity, specificity, and precision values of each respectively 88.16%, 79.03%, 94.07%, 87.25%, 96.98%, and 89.50%, with an average increase of 2.4%."