Browsing by Author "Milenković, Svetlana (58376488100)"

Introduction. Gallbladder carcinoma is a rare malignancy with a poor prognosis because it is diagnosed late. There are only a few cases of ovarian metastasis from gallbladder carcinoma described in the literature. We presented a rare case of ovarian metastasis of gallbladder carcinoma and highlight the importance of differentiation between primary and metastatic ovarian tumors. Case report. A 55-year old women had cholecystectomy for suspected cholecystitis. However, histological findings showed invasive adenocarcinoma of her gallbladder. The patient refused further proposed treatment. Three months later, the same patient presented with abdominal pain and discomfort. Imaging diagnostic methods (magnetic resonance scan) showed no local tumour mass at the site of cholecystectomy, but large, bilateral, multilocular ovarian tumor of mixed consistency. During surgery, ovarian tumours and infiltration of omentum was found. A total abdominal hysterectomy with bilateral salpingo- oophorectomy and omentectomy was performed. Histological findings indicated adenocarcinoma but could not distinguish between a primary ovarian carcinoma and gallbladder metastatic tumor. An immunohistochemical examination clarified that the findings corresponded to metastatic ovarian adenocarcinoma from the gastrointestinal tract, i.e., adenocarcinoma originating from the gallbladder. Unfortunately, the patient did not successfully recover and died three months later. Conclusion. The presence of ovarian masses of unknown origin and a diagnostic dilemma between primary and metastatic tumor require careful clinical, radiological, intraoperative, and histological examination for the purpose of establishing a definitive diagnosis and providing optimal treatment. © 2018, Routledge. All rights reserved.

Background and Objectives: Cervical squamous cell carcinoma (SCC) usually showed an infiltrative growth pattern into endocervical stroma. In rare cases, SCC spreads superficially as an intraepithelial lesion to proximal uterine segments, and more rarely, involves invasive and more aggressive behavior on secondary sites. Materials and Methods: In this study, we present the case of an interesting form of cervical SCC growth and we discuss the possible reasons for that presentation. Results: After clinical examination and repeated histomorphological analysis, we found remarkable cervical epithelial dysplasia (a high-grade squamous intraepithelial lesion-H-SIL). A histopathology report after conization and hysterectomy showed squamocellular carcinoma with microinvasive focuses. Interestingly, squamocellular carcinoma was found in the proximal uterine and adnexal structure, as well as intraepithelial and microinvasive lesions. Conclusions: Our study described a rare presentation of primary cervical SCC with unusual adnexal involvement. This pattern of tumor growth should be especially considered for patients who are proposed for sparing surgical procedures. A detailed and multidisciplinary approach for every patient is very important because unpredictable cases are present. However, they are rare.

Background and Objectives: Ovarian cancer is the leading cause of death among gynecological tumors. PD-1/PD-L1 immunoregulatory mechanism is activated in ovarian cancers. Lymphocyte infiltration is a significant factor that affects its expression. We analyzed the correlation between localization of lymphocytic infiltrate and PD-L1 expression in epithelial ovarian tumors. Materials and Methods: PD-L1 expression was analyzed in 328 subjects, 122 with epithelial ovarian carcinoma, 42 with atypical proliferative tumor, and 164 with benign epithelial ovarian tumor. Expression in central and invasive tumor parts in epithelial ovarian carcinoma was combined with the most pronounced lymphocyte reaction. Immunohistochemical analysis was performed using the tissue microarray and correlated with a set of histopathology parameters. Results: PD-L1 expression was most prominent in epithelial ovarian carcinoma with different levels of expression observed between invasive and central tumor segments. A high level of PD-L1 expression on tumor cells was more frequently present in the invasive than in the central tumor parts (p < 0.001) only in high-grade serous ovarian carcinoma (HGSC). There was no significant correlation between peritumoral lymphocytic infiltrate and PD-L1 expression regardless of tumor segment. In the central tumor parts of HGSC, there was a correlation of intratumoral lymphocytic infiltrate with a higher level of PD-L1 expression (p = 0.003). Conclusions: The most prominent PD-L1 expression was observed in the invasive tumor parts of HGSC. Only the central parts of the HGSC exhibited significant PD-L1 expression in association with considerable intratumoral lymphocytic infiltrate. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Background and Objectives: Mutations in succinate dehydrogenase (SDH) and fumarate hydratase (FH) give rise to various familial cancer syndromes, with these alterations being characteristic of certain types of histomorphologically specific leiomyomas that hold significant predictive value. Materials and Methods: This study presents two cases of uterine leiomyomas exhibiting rare histomorphological and genetic characteristics, which are crucial for prognosis and further treatment. Results: Distinct histopathological features such as marked nuclear atypia, intracellular eosinophilic globules, and abnormal intratumoral vessels raise suspicion for specific leiomyoma subtypes, which carry predictive significance for additional hereditary cancer syndromes. Immunohistochemical analysis confirmed FH/SDH deficiency in both patients, who underwent careful follow-up. Conclusions: This study describes two cases involving unusual leiomyomas, the histopathological characteristics of which may easily go unrecognized. These features hold predictive significance because their specific mutations point to additional hereditary cancer syndromes, highlighting the need for further examinations. © 2024 by the authors.