Browsing by Author "Paunovic, I.R. (55990696700)"

Background: Parathyroid carcinoma as a cause of primary hyperparathyroidism is very rare. Clear consensus regarding the optimal management of patients with this condition is not available. We aimed to report our experience with this entity. Methods: We analyzed medical records of patients who were operated for primary hyperparathyroidism and parathyroid carcinoma in the Centre for Endocrine Surgery in Belgrade, between January 2000 and December 2007. Results: Seven patients (four men and three women) were operated for parathyroid carcinoma and primary HPT in our institution in this period. The age at initial diagnosis (mean ± SD) was 53.5 ± 7.6 years. All patients had hypercalcemia (mean 3.53 mmol/l) and very elevated parathyroid hormone (mean 1,530 pg/ml). Extirpation of the parathyroid tumor was performed in two patients, while in five patients parathyroidectomy was performed en block with all involved tissue. Average follow up was 47 months. One patient died for another disease, one was found to have increased calcium and parathyroid hormone levels postoperatively, while the remaining five were free of disease. Conclusions: Surgery remains central in the management of patients with parathyroid carcinoma. Still, further multicentric studies should be performed for consistent treatment guidelines. © 2012 Springer-Verlag Wien.

Background: Thyroid cancer is relatively rare, but it is the most frequent cancer among malignancies of the endocrine system. To evaluate the association between thyroid cancer and potential risk factors. Material and methods: A case-control study was conducted in Central Serbia, Yugoslavia. The case group consisted of 100 newly diagnosed patients with histologically confirmed thyroid cancer. The controls (100 patients with injuries) were individually matched with cases by sex, age and place of residence. McNemar's test and conditional logistic regression were used in the analysis. Results: According to logistic regression analysis the following factors were independently related with the occurrence of thyroid cancer: diagnostic X- ray during childhood and/or youth goiter, history of residence in endemic goiter area, anemia in personal history, history of previous malignant tumors, family history of any malignant tumor, spontaneous abortion and use of oral contraceptives. Conclusion: The present study supports the hypothesis that besides other risk factors, thyroid cancer in women is affected by some reproductive and probably hormonal factors.

Background: Anaplastic thyroid carcinoma (ATC) is relatively rare and represents one of the most aggressive tumours with poor prognosis, despite therapy. The aim of the study was to analyse demographic and clinical characteristics of ATC patients, and to identify survival rates and prognostic factors. Methods: In a retrospective study (1995-2005) ATC was found in 150 patients treated at our institution. Survival was calculated by Kaplan-Meier curve and log-rank test. Potential prognostic factors affecting survival were compared by Cox univariate and multivariate analyses. Results: Mean survival time was 56 weeks; median survival time was 16 weeks and 1 and 5-year survival were 17% and 8%. More than 10% died during the first month and 50% died up to the fourth month. Multivariate analysis showed that age, goitre and surgery were independent prognostic factors of survival in all ATC patients. Among operated patients, the extent of tumour resection, distant metastasis and multicentricity were independent prognostic risk factors of survival. Postoperative radiotherapy was a protective factor. Conclusions: There is still no successful treatment of ATC that can guarantee long term survival. Younger patients with pre-existing goitre, who undergo complete resection of unilocular early stage ATC without distant metastasis and with postoperative external radiotherapy, stand a better chance of long-term survival. © Acta Chirurgica Belgica.

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