Browsing by Author "Pazin, V. (24169602000)"

This is a case report of an extremely rare Carney complex (CNC) syndrome in a 17-year-old patient. After the decision made by a team of cancer specialists, the patient was admitted to the hospital for surgery because of adnexal tumor associated with ascites and increased Ca 125 tumor marker level. The patient underwent cardiac surgery twice. Adnexal mass and ascites, revealed by transvaginal ultrasound (TVUS) and confirmed by magnetic resonance imagings (MRI), indicated the malignant alteration. Surgery was performed and surgical pathological staging was refined according to the FIGO guideline and included a staging laparotomy. After surgery, general condition of the patient was good, without ascites and pain, with Ca 125 marker levels within reference ranges.

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.

Objective: The objective of this study was an analysis of interobserver variability and positive predictive value (PPV) for BI-RADS categories requiring pathohistological evaluation: 4A, 4B, 4C, and 5. Material and Methods: Interobserver variability for each of descriptors as well as PPV for final BI-RADS categories requiring pathohistological evaluation was measured in a retrospective study which included 30 ultrasonographic reports, with pathohistological verification, randomly selected from ultrasonographic reports from Institute for Oncology and Radiology of Serbia where about 1,100 breast cancers are verified every year. Ten observers, seven gynecologists, and three radiologists, independently rated each ultrasonographic report according to the fourth edition of BI-RADS atlas. Interobserver variability was measured with k coefficient. Results: There was most conformity for a category of orientation (k = 0.79). Substantial degree of conformity was also present for both boundary (k = 0.71) and shape (k = 0.65) categories. Moderate degree of conformity was achieved for posterior features (k = 0.54) and margins (k =0.41) descriptors, while there was poor conformity in echogenicity (k = 0.38). In case of a final score, common conformity for all BI-RADS 4A, 4B, 4C, and 5 categories was (k = 0.51); it was the greatest for category 5 (k = 0.50), and it was less for categories 4C (k = 0.37), 4B (k = 0.32), and 4A (k = 0.29). Conclusions: Interobserver conformity for ultrasonographic descriptors and final evaluation of BI-RADS 4A, 4B, 4C, and 5 categories is good. PPV implies that not only division into categories 4 and 5, but also classification into categories 4 and subcategories 4A, 4B, and 4C are justified and clinically applicable.

This is a case report of Herlyn-Werner-Wunderlich syndrome in a 28-year old patient. She was admitted to hospital for the surgical treatment of pelvic mass accompanied by painful menstruational periods. This syndrome was diagnosed by ultrasound and MR imaging and it was treated by hemi-hysterectomy with vaginectomy and ovarian resection because of endometriosis. After the surgery, the patient has regular and painless menstruations. © Copyright 2013, CIC Edizioni Internazionali, Roma.