Browsing by Author "Goldner, Branislav (24830026000)"

The objective of this study was to present some clinical and radiological manifestations of PNS in relation to bronchogenic carcinoma (BC) and to evaluate the usefulness of imaging findings in the diagnosis of asymptomatic BC. In the study group of 204 patients (146 male and 58 female) with proven bronchogenic carcinoma, PNS was present in 18 (8.62%) patients. The patients with PNS were divided into two groups. The first one consisted of 13 (72.2%) patients with symptoms related to primary tumours while the second one consisted of 5 (27.7%) patients with symptoms, at initial appearance, indicative of disorders of other organs and systems. The predominant disorder was Lambert-Eaton Syndrome, associated with small-cell carcinoma. Endocrine manifestations included: inappropriate antidiuretic hormone production syndrome (small-cell carcinoma), a gonadotropin effect with gynaecomastia and testicular atrophy (planocellular carcinoma, small-cell carcinoma), a case of Cushing Syndrome (small-cell carcinoma), and hypercalcaemia, due to the production of the parathyroid hormone-related peptide, which was associated with planocellular carcinoma. A rare case of bilateral exophthalmos was found as PNS at adenocarcinoma. Digital clubbing and hypertrophic osteoarthropathy (HO) were associated with planocellular and adenocarcinoma, while clubbing was much more common than HO, especially among women. The differences between the two groups were related to the time of PNS appearance. In the first group, PNS occurred late on in the illness, while in the second group, PNS preceded the diagnosis of BC. Alternatively, the disappearance of a clinical or a radiological manifestation of PNS after surgery or chemotherapy may be an indicator of an improvement in health or PNS may be the first sign of illness recurrence. Radiological manifestations of PNS in asymptomatic patients may serve as a useful screen for identifying primary BC. In symptomatic patients, it may be an indicator of a higher likelihood of metastatic disease.

We report severe nodulocystic acne in a 21-year-old man associated with ectrodactyly of the right foot and soft-tissue syndactyly of the third and fourth left fingers, and the first to fourth left toes. His acne was resistant to conventional topical (clindamycin phosphate, erythromycin, tretinoin, peeling agents) and systemic (tetracycline, erythromycin) antiacne medications. Moderate improvement was achieved with systemic isotretinoin. Apart from presenting this case, we imply the disparity of the clinical characteristics of our case and those of Apert syndrome, a rare congenital condition with craniofacial anomalies, symmetric syndactyly of the digits, and acneiform eruption. We discuss the possible explanation for the association of acne lesions and bone deformities based on recent reports of mutations of fibroblast growth factor receptor 2 in the great majority of patients with this syndrome, as well as current experimental data on the involvement of the keratinocyte growth factor in the process of hair follicle growth, development, and differentiation.

Introduction Malignant cystic renal tumour is a rare variant of renal malignancy. Cystic neoplasm results from haemorrhage, necrosis and colliquation of a solid tumour or tumour occurring within the wall of a cyst. That pathoanatomic substratum reflects characteristic sonographic features indicating its malignant nature. It is important to distinguish a simple cyst (not requiring surgery) from intracystic malignant lesion because it requires surgery. Case outline The authors present a 59-year-old woman with a sonographic finding of a simple cyst in the upper pole of the right kidney revealed during gynaecological ultrasonography. Immediately afterwards, the radiologist performed renal sonography and its finding was a cystic lesion suggestive of malignancy. Further evaluation by CT scan showed that the lesion was clearly malignant. After surgery, the histological finding verified cystic renal cancer. Conclusion Ultrasonography may reveal a complex cyst and solid mass but requires an experienced sonographer. Contrast CT scan would be performed to examine the "suspicious" lesion because it clearly shows if a cystic lesion is benign or malignant.

The association between renal cell carcinoma and arterial hypertension has been the subject of various studies. These studies have not been consistent in clarifying the relationship between the two. Some authors contend that arterial hypertension is a consequence of renal cell carcinoma, which secretes vasoactive peptides. Others claim that arterial hypertension is a risk factor for the development of renal cell carcinoma. The purpose of our study is to assess if there is a direct connection between arterial hypertension and renal cell carcinoma. Out of 16,755 patients who were examined by ultrasonography, 40 were diagnosed with renal tumors. Of the 40 patients, 29 had malignant renal tumors, and 11 had benign renal tumors. These diagnoses were confirmed by CT scan, renal biopsy, and histology. Most of the patients with renal cell carcinoma (79.3%) had arterial hypertension. The group with benign renal tumors served as a control group. Out of the 29 patients with malignant renal cell carcinoma, 24 patients were treated with total nephrectomy, one had a partial nephrectomy, and four patients were too unwell for surgical intervention. In the group of those with benign renal tumors, seven patients had partial nephrectomies for the removal of angiomyolipomas. The personal histories were taken at the initiation of the study, and vital signs were obtained before and after surgery. Statistical analyses were performed using the Statistical Package for Social Sciences, version 10.0. In the malignant group, the systolic blood pressure (SBP) before surgery was 157.41 ± 27.86 mmHg, and the diastolic blood pressure (DBP) was 97.24 ± 15.33 mmHg, while in the benign group, SBP was 134.55 ± 17.53 mmHg, and DBP was 88.18 ± 14.01 mmHg. In the malignant group in those who had undergone nephrectomies, the mean systolic pressure was 136.82, and the diastolic pressure was 85.90. In the benign group, the systolic and diastolic blood pressures were normal before and after surgery. In the group of patients with both renal cell carcinoma and arterial hypertension, their hypertension was resolved after they underwent nephrectomies. In conclusion, our data suggest that renal cell carcinomas may cause arterial hypertension. © 2009 Japanese Society of Nephrology.

The association between renal cell carcinoma and arterial hypertension has been the subject of various studies. These studies have not been consistent in clarifying the relationship between the two. Some authors contend that arterial hypertension is a consequence of renal cell carcinoma, which secretes vasoactive peptides. Others claim that arterial hypertension is a risk factor for the development of renal cell carcinoma. The purpose of our study is to assess if there is a direct connection between arterial hypertension and renal cell carcinoma. Out of 16,755 patients who were examined by ultrasonography, 40 were diagnosed with renal tumors. Of the 40 patients, 29 had malignant renal tumors, and 11 had benign renal tumors. These diagnoses were confirmed by CT scan, renal biopsy, and histology. Most of the patients with renal cell carcinoma (79.3%) had arterial hypertension. The group with benign renal tumors served as a control group. Out of the 29 patients with malignant renal cell carcinoma, 24 patients were treated with total nephrectomy, one had a partial nephrectomy, and four patients were too unwell for surgical intervention. In the group of those with benign renal tumors, seven patients had partial nephrectomies for the removal of angiomyolipomas. The personal histories were taken at the initiation of the study, and vital signs were obtained before and after surgery. Statistical analyses were performed using the Statistical Package for Social Sciences, version 10.0. In the malignant group, the systolic blood pressure (SBP) before surgery was 157.41 ± 27.86 mmHg, and the diastolic blood pressure (DBP) was 97.24 ± 15.33 mmHg, while in the benign group, SBP was 134.55 ± 17.53 mmHg, and DBP was 88.18 ± 14.01 mmHg. In the malignant group in those who had undergone nephrectomies, the mean systolic pressure was 136.82, and the diastolic pressure was 85.90. In the benign group, the systolic and diastolic blood pressures were normal before and after surgery. In the group of patients with both renal cell carcinoma and arterial hypertension, their hypertension was resolved after they underwent nephrectomies. In conclusion, our data suggest that renal cell carcinomas may cause arterial hypertension. © 2009 Japanese Society of Nephrology.

Ductal carcinoma in situ (DCIS), the noninvasive breast malignant tumor originates from the terminal ductal-lobular units (TDLU). The typical feature of DCSI is the formation of calcifications. Up to 90% of DCIS are diagnosed on mammographic examinations, as clinically asymptomatic. Between 10% and 20% of DCIS remain mammographically occult due to the lack of calcifications and/ or small tumor dimensions. Contrast-enhanced breast magnetic resonance imaging (MRI) detects mammographically occult breast lesions, thus defining morphologic features of the lesion and the dynamics of signal intensity changes due to contrast enhancement. Distribution of contrast enhancement - signal intensity increase in DCIS most frequently includes segmental, ductal and linear patterns, followed by regional enhancement pattern, while the intralesional contrast uptake most frequently includes the nodular pattern with the areas of confluence. Postcontrast signal intensity increase in DCIS is most frequently fast in the initial phase (wash-in), while the whole dynamic of contrastenhancement includes either of the three possible time-intensity curve (TIC) types (persistent, plateau or washout), although the plateau TIC is considered to be more frequent. Breast MRI has high sensitivity in the diagnosis of invasive breast cancer, varying from 90% to 100%; the sensitivity in the diagnosis of DCIS is lower (77-96%). For the time being, the primary role of MRI in DCIS is planning of breast-conserving surgery (BCS) for the evaluation of lesion extension. Further development of MRI in the diagnosis of DCIS includes the implementation of the principles of functional and molecular imaging.