Browsing by Author "Arsenovic, Nebojsa (24757930100)"

Objective: The aim of the study was to investigate which anamnestic, laboratory and ultrasound parameters used in routine practice could predict the nature of adnexal mass, thus enabling referral to relevant specialist. Methods: Study involved the women treated for adnexal tumors throughout a period of 2 years. On admission, detailed anamnestic and laboratory data were obtained, expert ultrasound scan was performed, and power Doppler index (PDI), risk of malignancy index (RMI) and body mass index (BMI) were calculated for all patients. Obtained data were related to histopathological findings, and statistically analyzed. Results: The study included 689 women (112 malignant, 544 benignant, and 33 borderline tumors). Malignant and borderline tumors were more frequent in postmenopausal women (P=0.000). Women who had benignant tumors had the lowest BMI (P=0.000). There were significant (P<0.05) differences among tumor types regarding erythrocyte sedimentation rate, CA125 and carcinoembryonic antigen (CEA) levels. Among ultrasound findings, larger tumor diameter and ascites were more frequent in malignant tumors (P=0.000). Women with malignant tumors had highest values of RMI and PDI (P=0.000). Conclusions: Anamnestic data, ultrasound parameters and laboratory analyses were all found to be good discriminating factors among malignant, benignant and borderline tumors. © Chinese Journal of Cancer Research. All rights reserved.

Objective: The aim of the study was to investigate which anamnestic, laboratory and ultrasound parameters used in routine practice could predict the nature of adnexal mass, thus enabling referral to relevant specialist. Methods: Study involved the women treated for adnexal tumors throughout a period of 2 years. On admission, detailed anamnestic and laboratory data were obtained, expert ultrasound scan was performed, and power Doppler index (PDI), risk of malignancy index (RMI) and body mass index (BMI) were calculated for all patients. Obtained data were related to histopathological findings, and statistically analyzed. Results: The study included 689 women (112 malignant, 544 benignant, and 33 borderline tumors). Malignant and borderline tumors were more frequent in postmenopausal women (P=0.000). Women who had benignant tumors had the lowest BMI (P=0.000). There were significant (P<0.05) differences among tumor types regarding erythrocyte sedimentation rate, CA125 and carcinoembryonic antigen (CEA) levels. Among ultrasound findings, larger tumor diameter and ascites were more frequent in malignant tumors (P=0.000). Women with malignant tumors had highest values of RMI and PDI (P=0.000). Conclusions: Anamnestic data, ultrasound parameters and laboratory analyses were all found to be good discriminating factors among malignant, benignant and borderline tumors. © Chinese Journal of Cancer Research. All rights reserved.

Objective. The study aim was to investigate the diagnostic value of preoperative serum tumor markers in patients with adnexal masses. Methods. Study included all (358) consecutive patients treated for adnexal tumors at the Clinic of Ob/Gyn, Clinical Center of Serbia in 12 months. Tumor marker levels (Ca 125, CEA, HE 4, Ca 19.9, and Ca 15.3), taken from all women on admission, were compared with postoperative histopathological findings of extracted tumors. Results. Women with malignant tumors had the highest levels of Ca 125, CEA, and HE 4 (p<0.01). Mucinous adenocarcinoma produced the highest amounts of Ca 19.9 and CEA. Ca 15.3 was the highest in women with endometrioid carcinoma. There were no significant differences in the levels of all examined tumor markers (p>0.05) between women with benign and borderline tumors. Ca 125, HE 4, and Ca 15.3 can discriminate the malignant from other tumor types well. The highest sensitivity, specificity, positive and negative predictive values (91.04%, 87.6%, 67.9%, 77.2%, respectively) were achieved for the combination of Ca 125 and HE 4. Conclusions. Blood levels of examined tumor markers can be good predictors of the adnexal masses nature. For the most precise evaluation the combination of serum tumor markers should be used. © 2014 Versita and Springer-Verlag.

Objective: The study aim was to investigate the diagnostic value of measuring preoperative serum tumor markers in patients with adnexal masses. Methods: The study included all (358) consecutive patients treated for adnexal tumors at the Clinic of Obstetrics and Gynecology, Clinical Center of Serbia during 12 months. Tumor-marker levels (Ca 125, CEA, HE 4, Ca 19.9 and Ca 15.3) obtained from all women on admission were compared with histopathological findings in cases in which tumors were removed. Results: Women with malignant tumors had the highest levels of Ca 125, CEA and HE 4 (p<0.01). Mucinous adenocarcinoma produced the highest amounts of Ca 19.9 and CEA. Ca 15.3 was the highest in women with endometrioid carcinoma. There were no significant differences in the levels of all serum tumor markers between women with benign and borderline tumors (p>0.05). Malignant forms of tumors were well indicated by Ca 125, HE 4 and Ca 15.3 levels. The combination of Ca 125 and HE 4 resulted in the highest sensitivity, specificity, and positive or negative predictive value (91.04%, 87.6%, 67.9%, 77.2%, respectively). Conclusions: Blood levels of tumor markers can be effective? predictors of the nature of adnexal masses. For the most precise evaluation, a combination of serum tumor markers should be used. © 2014 Versita and Springer-Verlag.

Objective: The aim of the study was to assess which clinical, laboratory and ultrasound characteristics of adnexal masses might predict the histopathological nature of the disease. Materials and Methods: The study involved all women treated at the Clinic of Gynecology and Obstetrics Clinical Centre of Serbia for adnexal tumors between July 1, 2010 and December 31, 2011. On admission, detailed anamnestic and laboratory data were obtained, expert ultrasound scan performed and RMI was calculated for all patients. Data were related to histopathological findings and statistically analyzed. Results: The study included 540 women out of which 85 had malignant (seven diagnoses), 435 benign (seven diagnoses) and 20 borderline tumors. All types of malignant and borderline tumors were more frequent in postmenopausal women (p=0.000). Only papillary adenocarcinoma significantly more often produced early metastases (p=0.000). Ascites is a common finding in Krukenberg tumors, granulose cell tumors and papillary adenocarcinomas. There were significant differences between tumor diagnoses regarding the levels of Ca 125 and CEA, erythrocyte sedimentation rate (ESR) and risk of malignancy index (RMI) (p<0.05). No significant differences were found within the group of malignant tumor types regarding the levels of all examined tumor markers, ESR as well as RMI (p>0.05). Conclusions: In the light of our results, patient age, menopausal status, blood levels of Ca 125, CEA and ESR, as well as calculated RMI, can predict the nature of adnexal masses. Unfortunately, none of the examined parameters can accurately determine the exact histopathological diagnosis of the adnexal tumor. © Polskie Towarzystwo GinekoLogiczne.

Lupus mastitis represents a subset of breast-limited lupus panniculitis, and occurs very rarely in patients with systemic lupus erythematosus. We report a case of a 33-year-old white woman with a previous history of systemic lupus erythematosus, complaining of an acute tenderness and pain in the right breast associated with localized skin erythema. Ultrasound and mammography reports from a private breast clinic, where she was scheduled for core needle biopsy, aroused suspicion of a breast tumor. Clinically the patient had a painful mass suggestive of an inflammatory lump with an abscess. Her double-stranded DNA antibody level, white blood cell count and erythrocyte sedimentation rate (ESR) were increased; and her renal function was impaired and serology findings negative. All other laboratory tests were within the normal ranges. The patient underwent urgent surgical incision and excisional biopsy of the lesion, and histology revealed lupus mastitis. Lupus mastitis very rarely may appear as a breast lump and therefore presents a great diagnostic challenge for clinicians, occasionally for radiologists and rarely for pathologists. © 2008 The Authors.

We present a 42-year-old female admitted for a 4 month history of increasing pelvic discomfort and pain. Clinical examination revealed a large tumor obstructing the vagina. Tumor markers (CA 125, CEA, AFP and CA 19-9), white blood cells and biochemical tests were all within the normal limits. Pelvic ultrasound and magnetic resonance imaging scan confrmed the presence of a large retroperitoneal/pelvic mass. The tumor was surgically excised and pathohistologically diagnosed as a well differentiated leiomyosarcoma, staged IB. Six years after surgery the patient is well and disease free. © Versita Sp. z o.o.

Objective: The aim of this study was to investigate the validity of the risk of malignancy index (RMI) in premenopausal and postmenopausal patients with adnexal masses. Materials and Methods: The study involved all women treated for adnexal tumors throughout an 18-month period in the Clinic for Gynecology and Obstetrics, Clinical Center of Serbia (Belgrade, Serbia). On admission, detailed anamnestic and laboratory data were obtained and an expert ultrasound scan was performed. The RMI was calculated for all patients and the obtained data were related to histopathological findings of the tumors. For statistical analysis, we used descriptive and analytical statistics methods and an SPSS computer program. Results: From a total number of 540 women, 85 women had malignant tumors; 20 women, borderline tumors; and 435 women, benign adnexal tumors. The RMI was reliable in 84.6% of all patients; in 77% of premenopausal patients, and in 81.1% of postmenopausal patients. The sensitivity of the RMI in the overall population was 83.81%; the specificity was 77.24%; the positive predictive value (PPV) was 47.06%, and the negative predictive value (NPV) was 95.18%. In premenopausal women, the RMI sensitivity was 83.87%; specificity, 80.31%; PPV, 28.89%; and NPV, 98.12%. In postmenopausal women the RMI sensitivity was 83.78%; specificity, 68.18%; PPV, 63.92%; and NPV, 74.71%. Conclusion: The RMI was a reliable factor for differentiating benign from malignant adnexal masses in premenopausal and postmenopausal patients. © 2013, Taiwan Association of Obstetrics & Gynecology.

Purpose: To evaluate the reliability of ultrasound scan (US) findings in the preoperative assessment of the nature of adnexal masses infernales. Methods: After detailed history, a preoperative US examination was performed in all women. Tumor diameter, localization, the presence of solid, cystic and multilocular components, excrescences, metastasis and free fluid were assessed. Doppler scan was done and pulsatility (PI) and resistance indices (RI) were determined. These data were compared with postoperatively obtained histopathological findings and statistically analyzed. Results: The study included 609 women out of which 20.7% had malignant, 73.7% benign, and 5.6% borderline tumors. Patients with malignant tumors were oldest (p<0.001). There were significantly more positive US parameters in malignant than in benign tumors (p<0.001). Also, there were significant differences (p<0.001) between malignant, benign and borderline tumors regarding all examined US and Doppler parameters except tumor multilocularity. RI had sensitivity 75%, specificity 61.2%, positive predictive value (PPV) 42.70% and negative predictive value (NPV) 96.16%. PI had sensitivity 50%, specificity 35.3%, PPV 8.37% and NPV 25.93%. Sensitivity of US characteristics was 94.34%, specificity 30.62%, PPV 22.27% and NPV 96.25%. Conclusions: US pattern characteristics and Doppler parameters were found to be moderately reliable in discriminating malignant, benign and borderline adnexal tumors. Tumor of solid or mixed consistency, presence of ascites and excrescences were the best predictors of malignancy.

Purpose: To evaluate the reliability of ultrasound scan (US) findings in the preoperative assessment of the nature of adnexal masses infernales. Methods: After detailed history, a preoperative US examination was performed in all women. Tumor diameter, localization, the presence of solid, cystic and multilocular components, excrescences, metastasis and free fluid were assessed. Doppler scan was done and pulsatility (PI) and resistance indices (RI) were determined. These data were compared with postoperatively obtained histopathological findings and statistically analyzed. Results: The study included 609 women out of which 20.7% had malignant, 73.7% benign, and 5.6% borderline tumors. Patients with malignant tumors were oldest (p<0.001). There were significantly more positive US parameters in malignant than in benign tumors (p<0.001). Also, there were significant differences (p<0.001) between malignant, benign and borderline tumors regarding all examined US and Doppler parameters except tumor multilocularity. RI had sensitivity 75%, specificity 61.2%, positive predictive value (PPV) 42.70% and negative predictive value (NPV) 96.16%. PI had sensitivity 50%, specificity 35.3%, PPV 8.37% and NPV 25.93%. Sensitivity of US characteristics was 94.34%, specificity 30.62%, PPV 22.27% and NPV 96.25%. Conclusions: US pattern characteristics and Doppler parameters were found to be moderately reliable in discriminating malignant, benign and borderline adnexal tumors. Tumor of solid or mixed consistency, presence of ascites and excrescences were the best predictors of malignancy.