Primarni zloćudni melanom sluznice usne šupljine

Primary oral malignant melanoma usually presents as a dark brown or black lesion. It is a rare malignancy, accounting for less than 1% of all melanomas and 1.6% of all head and neck malignancies, thus forming up to 0.5% of all oral malignancies in the world literature. In general, the prognosis of oral melanoma is poor and worse than that of cutaneous melanoma. The preferred treatment is radical surgery alone or in combination with radiotherapy, chemotherapy, immunotherapy and immunomodulatory agents. A case is presented of a large malignant melanoma of oral cavity, noticed six months before initial biopsy and by history described as a rapidly growing mass.Primarni melanom sluznice usne šupljine obično je tamno smeđe ili crno pigmentirana lezija. Vrlo je rijetka zloćudna bolest koja se javlja u manje od 1% svih melanoma i čini 1,6% svih maligniteta glave i vrata tvoreći, kako navodi svjetska literatura, do 0,5% svih maligniteta u usnoj šupljini. Općenito, prognoza je lošija nego kod kožnih melanoma. Kirurška resekcija je jedan od najčešćih oblika liječenja, a pokušava se i radioterapijom, kemoterapijom, imunoterapijom i imunomodulatorima. Opisuje se slučaj velikog melanoma u usnoj šupljini ubrzani rast kojega je primijećen šest mjeseci prije biopsije i potvrđene dijagnoze

Frequency of tuberculosis at autopsies in a large hospital in Zagreb, Croatia: a 10-year retrospective study

Aim To assess the frequency and forms of pulmonary tuberculosis at autopsy in a high-traffic hospital in the capital city of a country with a low tuberculosis incidence. Methods We performed a retrospective search of autopsy data from the period 2000 to 2009 at Sestre Milosrdnice University Hospital Center, Zagreb, Croatia. We also examined patients’ records and histological slides. Results Of 3479 autopsies, we identified 61 tuberculosis cases, corresponding to a frequency of 1.8%. Active tuberculosis was found in 33 cases (54%), 23 of which (70%) were male. Of the 33 active cases, 25 (76%) were clinically unrecognized and 19 (76%) of these were male. Conclusion Clinically undiagnosed tuberculosis accounted for a substantial proportion of active tuberculosis cases diagnosed at autopsy. Autopsy data may be an important complement to epidemiological data on tuberculosis frequency

Imunohistokemijska analiza izraženosti antigena MAGE-A3/4 i NY-ESO-1 u metastatskom karcinomu pločastih stanica jednjaka

Squamous cell cancer is the most recent malignant esophageal cancer and makes up approximately 6% of all malignant cancers of gastrointestinal system, however it has a highly unfavorable prognosis and five year survival rate is less than 10%. As the therapy (surgery, radiotherapy, chemotherapy) up till now has given poor and actually overwhelming results, numerous researches are under way with the scope of detecting new methods of treatment. Antigens associated to tumour, so called tumour associated antigens-TAA, are specific antigens able to recognize cyitotoxic T lymphocyte within the main system of the gene tissue tolerance (Major Human Leukocyte Antigens-HLA) type I. The most important among antigens are „melanoma-associated antigens“(MAGE) and antigen NY-ESO-1 which discovery gave necessary momentum to the attempts of applying immunotherapy. In this study immunohistochemical method was used for analyzing the expression of the tumour antigens MAGE-3/4 and NY-ESO-1 in the samples of esophageal squamous cells cancer and their spreading to the lymph nodes, in order to determine the link between expression of individual antigens in primary lesion and in spreading to the lymph node, and compare the expression link of each antigen with hystological tumour grade, TNM classification, site and size of tumour, age and sex of the patient. It has been established that the antigen MAGE-A3/4 expression positively correlates with NY-ESO-1 expression in the same tumour (r=0.310), and antigen NY-ESO-1 expression positively correlates with the same in lymph node metastases (r=0.605, rho= 0.588). Finally it has been established that the only parameter displaying serious statistic importance in comparison to the antigen NY-ESO-1 expression is the age of a patient, negatively correlating with antigen expression in tumour (P=0.001, r= - 0.516, , rho= - 0.515)

Ultra-High-Risk Gestational Choriocarcinoma of the Ovary Associated with Ectopic Pregnancy

Gestational choriocarcinoma of the ovary is an exceptionally rare and highly aggressive tumor. Preoperative diagnosis of extrauterine choriocarcinoma is difficult due to nonspecific clinical presentation and its resemblance to ectopic pregnancy. Without molecular genetic analysis, it is not possible to reliably differentiate gestational from non-gestational choriocarcinoma. Here, we present a case of a 44-year-old woman who presented to our emergency department with complaints of pelvic pain, vaginal bleeding, and amenorrhea. Because of a recent history of conservatively managed ectopic pregnancy, the patient underwent emergency laparoscopy. Right-sided salpingo-oophorectomy was performed due to intraoperatively suspected ovarian ectopic pregnancy. Histopathology results revealed the diagnosis of ovarian choriocarcinoma of possible gestational origin. It was classified as FIGO stage IV and WHO ultra-high-risk, and she underwent multi-agent chemotherapy without major complications. She has remained in complete remission after a 12-month follow-up. Considering the rarity of this diagnosis, we conducted a literature review including all published cases of suspected gestational choriocarcinomas of the ovary. We conclude that due to the rarity of this entity, preoperative differentiating between ovarian ectopic pregnancy and ovarian choriocarcinoma is extremely challenging, and without molecular genetic analysis, it is not possible to identify the genetic origin of the tumor

Neuroendocrine Small Cell Carcinoma of the Breast – A Case Report

Neuroendocrine tumors are very rare tumors that occur most commonly in the gastrointestinal tract. The occurrence of neuroendocrine tumors outside gastrointestinal tract is very rare but not unknown. Thus, neuroendocrine tumors and their primary seat can be found in the bronchi and lungs, as well as in the testicles, ovaries, prostate, etc. The occurrence of neuroendocrine tumors as a primary seat in the breast is extremely rare phenomenon that is described in literature.We present the case of 55-year old female in where routine mammographic examination found suspicious lesions that we recommended for further processing. The patient made a breast ultrasound examination in which tumor formation was found in size 27x19 mm and cytological puncture found breast adenocarcinoma. Further pathohystologic and immunohistochemical analysis set the diagnosis of neuroendocrine carcinoma, small cell type, second grade. Tumor formation by ultrasound initially sized 27x19 mm and pathohistologic diagnosis showed tumor size 26x20x20 mm. The axillary lymph node biopsy did not found distant metastases in lymph nodes as well as gatherings in other organs. Neuroendocrine small cell carcinomas are exceedingly rare phenomena in the literature. By the year 2009 in the USA there were described only 50 cases of this extremely rare tumor of the breast

Performance characteristics of the temperature-modified ISO 9308-1 method for the enumeration of Escherichia coli in marine and inland bathing waters

This study defines performance characteristics of the temperature- modified ISO 9308-1 method for E. coli enumeration in bathing water. After a 4-hour resuscitation period at 36 ± 2 °C, the incubation temperature was changed to 44 ± 0.5 °C. Elevated incubation temperature significantly suppressed the growth of thermo- intolerant bacteria, and enhanced the selectivity of Chromogenic Coliform Agar (CCA) up to 49.5% for inland and up to 66.0% for coastal water. Consequently, most of the selectivity- related performance characteristics are improved. Relative recovery was determined by comparing an alternative method against the reference, ISO 9308- 1:2014 method, following the criteria set out in ISO 17994:2014. Temperature modification did not significantly alter the results and the methods were evaluated as “not different” for both, coastal and inland waters. Chromogenic Coliform Agar was assessed as a suitable medium for reliable E. coli enumeration in bathing water when incubated for 17–19 h at 44 ± 0.5 °C after the 4–5 h resuscitation period at 36 ± 2 °C