Glucagonoma as a rare case of neuroendocrine tumor of the pancreas: a case report

Introduction: Glucagonoma is a rare neuroendocrine tumor with characteristic features such as the presence of the glucagon-producing tumor, diabetes, and necrolytic migratory erythema. Case presentation: the 60-year-old patient was admitted to hospital with periodic pain in the right and middle upper abdominal appearing after eating. Laboratory tests presented a high glucose level and anemia. Tumor of the body and tail of the pancreas passing the organ pouch has been found during the surgery. Diagnosis of glucagonoma was confirmed in histopathological examination in immunohistochemical stainings: a positive reaction was observed with chromogranin, synaptophysin and CEA. The proliferative activity of Ki-67 was less than 1%. Staining for glucagon also was positive so confirmed the presence of neuroendocrine tumor - glucagonoma. Conclusions: Glucagonoma sometimes may occur without characteristic features which may cause delayed diagnosis. Early diagnosis of glucagonoma is important because it increases the chances of successful recovery

Physiotherapy in women after breast cancer treatment – review

Introduction: Breast cancer is the most common malignant tumor in women in the Polish region. Surgery is a basic method of breast cancer treatment. Surgery often carries a lot of unwanted changes as follows: limitation of mobility in the shoulder joint on the operated side, secondary lymphoedema, post mastectomy pain syndrome (PMPS), reduction of muscle strength or disorders in body posture. Therefore, the implementation of physiotherapeutic activities that are designed to prevent and eliminate postoperative complications seems very important. The main aim of this work was to present physiotherapeutic management in women after mastectomy based on the analysis of available literature. The physiotherapeutic process can be divided into three periods: early hospital, early ambulatory and the late ambulatory period. In the first period, active slow exercises, self-support of the upper limb on the operated side and breathing exercises on the thoracic track are used to prevent circulatory disorders, pulmonary complications, and edema. The early ambulatory period includes corrective exercises, general improvement exercises, stretching and learning of automatic massage of the upper limb of the operated side. The last period should be enriched by recreational methods of physical activity such as swimming, cycling or Nordic walking to maintain physical fitness, proper mobility of the shoulder girdle and improve the patient's psychophysical state. It is very important the patient regular continues the rehabilitation program after curing of breast cancer as well. In the case of secondary lymphoedema of the upper limb, comprehensive rehabilitation physiotherapy is used, consisting of manual lymphatic drainage, healing exercises, compression therapy, and skin care. Conclusions: Physiotherapy in women after breast cancer surgery is a complex and long-term process. Physiotherapeutic methods are effective in treating complications after surgery of breast cancer surgery. It is necessary to constantly update the physio-therapy knowledge in women after breast cancer surgery

Spigelian hernia: a case report

Spigelian hernias constitute a minute fraction of all abdominal hernias. In this monography, we present a case report of this relatively seldom seen phenomenon which some general surgeons never get to see during their medical career

Assessment of the presence of pancreatic intraepithelial neoplasia in various diseases of this organ

Purpose: Pancreatic intraepithelial neoplasia (PanIN) is one of the most commonly occurring precancerous lesion in pancreas which leads to development of pancreatic ductal adenocarcinoma (PDAC). We assessed the presence and grade of pancreatic intraepithelial neoplasia in the course of various diseases of the pancreas and its correlations with chosen clinicopathological parameters. null Results: A total of 276 foci of PanIN were identified in 94 patients. The most common lesions were PanIN 1a and PanIN 1b which together constituted 68.2 % of all lesions, whereas the PanIN 2 was present in 21.7% and PanIN 3 in 10.1% of patients. No statistical differences were observed in gender tendency for the development of PanINs. There was correlation between age of patients and degree of PanIN (p=0.034). There is no statistical difference in PanIN frequency among patients with pancreatic ductal adenocarcinomas, neuroendocrine tumors, chronic pancreatitis and pancreatic cysts (p=0.592). Conclusions: Our study showed that important factor in development of pancreatic intraepithelial neoplasia is age and the presence of PanIN in nonneoplastic diseases in older people should be included to the group with increased risk of cancer development

Assessment of the presence of pancreatic intraepithelial neoplasia in various diseases of this organ

Purpose: Pancreatic intraepithelial neoplasia (PanIN) is one of the most commonly occurring precancerous lesion in pancreas which leads to development of pancreatic ductal adenocarcinoma (PDAC). We assessed the presence and grade of pancreatic intraepithelial neoplasia in the course of various diseases of the pancreas and its correlations with chosen clinicopathological parameters. null Results: A total of 276 foci of PanIN were identified in 94 patients. The most common lesions were PanIN 1a and PanIN 1b which together constituted 68.2 % of all lesions, whereas the PanIN 2 was present in 21.7% and PanIN 3 in 10.1% of patients. No statistical differences were observed in gender tendency for the development of PanINs. There was correlation between age of patients and degree of PanIN (p=0.034). There is no statistical difference in PanIN frequency among patients with pancreatic ductal adenocarcinomas, neuroendocrine tumors, chronic pancreatitis and pancreatic cysts (p=0.592). Conclusions: Our study showed that important factor in development of pancreatic intraepithelial neoplasia is age and the presence of PanIN in nonneoplastic diseases in older people should be included to the group with increased risk of cancer development

Comparison of expression of selected proteins in the cells of intestinal and diffuse type gastric cancer – immunohistochemical analysis

Introduction: Despite the progress in gaining knowledge about carcinogenesis, it is still unclear what processes are directly responsible for the differentiation of gastric cancer into its intestinal or diffuse form. Dividing of these two forms is based on one of the oldest, yet still commonly used classifications – the classification of Lauren. There are many factors that may influence the formation of gastric tumors of various aggressiveness. Purpose: To evaluate the expression of proteins: fragile histidine triad (FHIT), E-cadherin, α-catenin, γ-catenin, cathepsin B, epidermal growth factor (EGF), HER-2, MMP-9, MCM-2, Bak, Bax, BID, Bcl-XL, p53, FasL, Bcl-2, caspase-8, procaspase-3 in gastric cancer cells, depending on the type of tumor by Lauren classification. Materials and methods: Study group consisted of 91 patients treated surgically for gastric cancer in the Second Department of General and Gastroenterological Surgery, Medical University of Bialystok in years between 2000 and 2006. Results: It is shown, that the expression of E-cadherin was significantly higher in the Lauren I gastric cancer cells than in Lauren II. In case of caspase-8 there has been significantly less frequent expression of this protein in Lauren I gastric cancer cells compared to Lauren II. The authors describe no statistically significant differences in the expression of other proteins taken into consideration. Conclusions: These results suggest the role of adhesion and apoptosis-related proteins in the development of two different types of gastric cancer according to Lauren’s classification

Symptoms of colorectal cancer contributes to its localization and advancement

Introduction: Colorectal cancer is one of the most common cancers occurring in Poland. Unfortunately, this cancer is most often diagnosed at the time of great advancement. This is caused by the appearance of specific symptoms only in the late stages of cancer. Also, such low detection of early stages of adenocarcinoma may be caused by disregarding of slight symptoms. Purpose: To analyse symptoms in patients with colorectal cancer and correlate with chosen clinical-pathological parameters. Materials and methods: The study group consisted of 46 patients diagnosed with colorectal cancer. Information on symptoms associated with cancer (subjective and objective) have been selected from patients' medical history. The presence of these symptoms was correlated with the age and sex of patients, tumor location, histological type of cancer, grade of histological malignancy (G), stage of tumor (T stage), presence of lymph node metastases and distant metastases. Results: It has been shown that the presence of pain complaints described by the patient are associated with the occurrence of cancer in the colon. The painfulness and pathological resistance diagnosed by the physician are more often associated with cancer located in the colon. In the case of tumors located in the rectum, faecal admixtures appear more frequently. It has also been shown that the presence of admixtures of blood and mucus in the stool is associated with more advanced local tumors, infiltrating pericolorectal tissues (T3 + T4). Conclusions: Familiarity with clinical symptoms of colorectal cancer could make patients more sensitive to more often screening for cancer. Analysis of these symptoms could indicate to the physician the location or stage of the cancer

Immunohistochemical Fascin-1 expression correlate with lymph node and distant metastases in pancreatic ductal adenocarcinoma

Introduction: Pancreatic cancer is characterized by its aggressiveness and poor prognosis. Furthermore, mortality is one of the highest among all types of cancers. It has been observed that the expression of Fascin-1 (the actin-bundling protein which enables the motility of cells) is higher in cancer cells and is correlated with invasiveness and metastasis. Purpose: To investigate the expression of Fascin-1 in histopathological specimens from patients treated for pancreatic cancer and its relationship with histopathological parameters. Materials and methods: The study was performed on a group of 52 patients diagnosed with pancreatic cancer in the Medical University of Bialystok Clinical Hospital. The expression of Fascin-1 was evaluated in tissue samples using the immunohistochemical method and was rated as “present” or “absent”. The analysis of histopathological parameters was performed in correlation with Fascin-1 expression. Results: Fascin-1 expression was observed in the cytoplasm of cancer cells in 42/52 cases (80.8%). Fascin-1 expression occurred more frequently among patients with lymph node metastases (92.6%) than without this type of metastases (68%) (p=0.024). Likewise, the expression of the investigated protein was observed more often with the presence of distant metastases (100%) than without those metastases (74.4%) (p=0.043). There were no statistically significant differences about age, sex, histological type of cancer, grade of histological differentiation, desmoplasia, inflammatory infiltration, foci of hemorrhage, necrosis, and MVD. Conclusion: The expression of Fasicn-1 is correlated with the presence of metastases and can be a useful marker of pancreatic cancer involvement