Browsing by Author "Nikolic, Branka (36905814200)"

This is a case report of consequences that malignant gestational trophoblastic disease (GTD) can cause on reproductive health protruding into uterine wall and damaging uterine tissue. Transvaginal Doppler ultrasound examination can be of great value in detecting molar tissue, protrusion of malignant trophoblast in uterine wall, and neovasularization in malignant tissue. It is expected to measure a low resistance index in a field of neovascularization, because neovascularization in malignancy is not rare and those vessels do not have muscular stratum. This case is an example of possible irreversible serious and large damages that can be seen after successful treatment of GTD. They are warning on possible high degree of malignancy in GTD as well as on possible serious impact on reproductive health.

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.

[No abstract available]

Background and Objectives: Cervical ectopic pregnancy is one of the rarest forms of ectopic pregnancy. We present a single center case series of 10 cases of cervical ectopic pregnancy, where 3 patients underwent small-caliber hysteroscopy as a single treatment method. Methods: This was a retrospective study of women treated at our medical center with the diagnosis of cervical ectopic pregnancy from January 1, 2018 to December 31, 2020. Patient characteristics, medical history, obstetric history, diagnostic methods were collected. Small-caliber hysteroscopy treatment was performed in 3 patients and 7 patients underwent dilation and curettage (D&C). Results: We identified 10 patients diagnosed with cervical ectopic pregnancy who were treated at our center. Ultrasonography was used to diagnose all cervical ec-topic pregnancies Three patients underwent small-caliber hysteroscopy as a single treatment option, while D&C was performed in 7 patients. Patients who underwent small-caliber hysteroscopy had a median gestational age at diagnosis of 7 weeks and initial β HCG < 10,000 mIU/ mL. These patients had shorter hospital stay and a lower estimated blood loss than patients who underwent D&C. Conclusions: In our experience, small-caliber hysteros-copy is a safe and effective single treatment option for cervical ectopic pregnancy, but requires a skilled and experienced gynecologist. © 2021 by SLS, Society of Laparoscopic & Robotic Surgeons. Published by the Society of Laparoscopic & Robotic Surgeons.

[No abstract available]

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.