Browsing by Author "Plešinac-Karapandžić, Vesna (23474669800)"

Introduction Colorectal cancer is the third most common cancer and one of the leading causes of cancer-related deaths in men and women worldwide. The contemporary multidisciplinary approach has decreased rates of local recurrence and improved outcomes in metastatic colorectal cancer. We present a case of a primarily metastatic rectal cancer patient who underwent multidisciplinary planned treatment and showed complete response with now three years disease-free survival. Case outline A 61-year-old female was diagnosed with a T4N2M1a rectal adenocarcinoma at the age of 58. She underwent six cycles of systemic chemotherapy capecitabine-oxaliplatin plus bevacizumab with partial response confirmed by diagnostic imaging procedures. According to multidisciplinary board decision, preoperative radiotherapy treatment was administered with concomitant capecitabinebased chemotherapy. A 50.4 Gy total dose was delivered with 1.8 Gy fraction dose. After concomitant chemoradiotherapy treatment, two more cycles of systemic chemotherapy capecitabine-oxaliplatin plus bevacizumab were administered. One month after completion of systemic chemotherapy, primary rectal cancer was operated with a complete response on histopathologic specimens. Six weeks following previous surgery, metastasectomy of lung deposits was performed; histopathology confirmed metastatic adenocarcinoma of colorectal origin. Three more cycles of postoperative chemotherapy capecitabine-oxaliplatin plus bevacizumab were administered. Conclusion On regular follow-up, no evidence of disease was shown, with disease-free survival of three years. The treatment improved the patient’s quality of life. © 2021, Serbia Medical Society. All rights reserved.

Objectives The aim of this study was to contribute to the standardization of the numeric positive enhancement integral (PEI) values in breast parenchyma, ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) and to evaluate the significance of the difference in PEI values between IDC and parenchyma, DCIS and parenchyma and IDC and DCIS. Materials and Methods In the prospective trial, we analyzed the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of 60 consecutive patients with histologically confirmed unilateral DCIS (n = 30) and IDC (n = 30) and defined the PEI values (range; mean ± SD) for the lesions and the breast parenchyma. Tumor-to-non-tumor (T/NT) ratios were calculated for DCIS and IDC and compared. PEI color maps (PEICM) were created. The differences in PEI values between IDC and parenchyma and between DCIS and parenchyma were tested according to t-test. Analysis of variance (ANOVA) was used to test the differences between the mean PEI values of parenchyma, DCIS and IDC. Results IDC showed highly statistically different PEI numeric values compared to breast parenchyma (748.7 ± 32.2 vs. 74.6 ± 17.0; p < 0.0001). The same applied to the differences in the group of patients with DCIS (428.0 ± 25.0 vs. 66.0 ± 10.6; p < 0.0001). The difference between IDC, DCIS and parenchyma were also considered highly statistically significant (p < 0.0001) and so were the T/NT ratios for IDC and DCIS (10.1 ± 2.4 vs. 6.6 ± 1.4; p < 0.0001). Conclusions PEI numeric values may contribute to differentiation between invasive and in situ breast carcinoma. © 2014 Elsevier Ireland Ltd.

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.