Browsing by Author "Filimonovic, D. (23990830300)"

During routine examination of a 32-year-old patient, a cervical polyp was found and CIN III was confirmed by biopsy. After performing colposcopy, biopsy and establishing CIN III as well as performing gastroscopy where a duodenal polyp was found, thorough diagnostic exams and therapy were carried out. Complete duodenal resection and conization were performed. The medical board decided that neither further radiation nor chemotherapy was needed.

Objective: The objective of the present study was to evaluate the accuracy of the sentinel lymph node (SLN) detection procedure in Serbian sample of women with early-stage endometrial cancer (EC). Materials and Methods: In the period from March, 2015 to May 2016, all consecutive patients with histologically confirmed EC, were considered for enrolment in the study. Exclusion criteria included preoperative FIGO Stages II-IV, previous surgery that could influence the uterine lymphatic drainage, history of congenital uterus anomalies, duplex malignancies or deep vein thrombosis on lower extremities, and allergies to the contrast agent. Finally, 27 patients underwent SLN detection, followed by systematic pelvic lymphadenectomy. Demographic, surgical, and pathologic data on all patients were evaluated. Results: The SLNs were identified in 25 patients, with overall detection rate of 92.6%. Twenty-two (81.5%) patients had bilateral, while 11.15% had unilateral intraoperative visualization of SLNs. Of the seven females with positive SLNs, at definitive histology evaluation, pelvic non-SLNs were metastatic in four (57.1%) cases and negative in three (42.9%) cases. The false-negative rate of sentinel procedure was 0%. The evaluation of prognostic values of SLN status, for prediction of presence of metastases in non-SLNs showed the negative predicive value of 100%, and the positive predictive value of 57.1%. Additionally, the sensitivity of SLN method in sample of women with early-stage EC was 100%, while the specificity was 86.9%. Conclusions: SLN procedure has good diagnostic performance and is reliable in prediction of the metastatic status of the regional pelvic lymph nodes in women with early-stage EC.

Endometrial hyperplasias and endometrial adenocarcinomas present a morphological continuity. In 1,150 cases of patients admitted to two hospitals over the past two years with diagnosed irregular bleeding, suspected ultrasonography findings and positive family history, we performed, not only hormonal examinations, but also fractioned explorative curettage after receiving patient consent.

We examined a young primipara with increased alpha-fetoprotein (AFP) values and cystic tumefaction of the right ovary. Having in mind a mild decrease in ovarian artery resistance index (RI) and suspected findings of fetal kidney, this situation was delicate due to its double pathology which was later confirmed. Wilms' tumor is the most common urogenital tumor in childhood, and it is detectable in the prenatal period by ultrasound examination. In utero kidney biopsy confirms diagnosis and facilitates decisions concerning the course of pregnancy. Relative risk of intervention limits this diagnostic procedure for indicated cases.

Ovarian carcinoma may appear regardless of age, including during childhood. Predisposing factors for the development of ovarian carcinoma are age (usually over 40), positive family history, mumps parotitis, small number of deliveries, environmental factors, persistant ovulation, etc. Metastases may appear in the ovary from almost all primary sites.

At the Institute of Gynecology and Obstetrics we examined 24 women who were radically operated on and received massive transfusions during the intraoperative and postoperative period. Twelve developed massive transfusion complications such as urticaria, fever, and respiratory insufficiency known as TRALI (transfusion-related acute lung injury).

A uterine tumor resembling an ovarian sex cord tumor (UTROSCT) shows a poly phenotypic immunophenotype with coexpression of epithelial, myoid, and sex cord markers, as well as hormone receptors. The authors present a case of a 59-year-old multiparous woman admitted to the Institute of Gynecology and Obstetrics Clinical Centre of Serbia in January 2010 due to prolonged vaginal bleeding and abdominal discomfort. The vaginal ultrasound showed an enlarged uterus size of 100 x 74 x 81 mm, with extended cavity with an unhomogenic content and myomas sized 54 x 69 mm located in fundus with secondary changes. She underwent abdominal hysterectomy with adnexectomy. Microscopic examination revealed submucosal uterine tumor with variabile histological organization that had anastomotic trabeculae with solid cellular grupations. Rare mitotic figures (2/10 HPF) were found. Additional imunohistochemistry showed immunophenotype: the sex cord areas were positive for vimentin(++), aSMA(++), AE1/AE3(+), PR(+), and ER(+). The poly phenotypic immunophenotype can be useful in differential diagnosis from other neoplasms but also suggests an origin of UTROSCT from uncommitted stem cell enabling for multidirectional differentiation.