Clinicopathological Characteristics of BRAF V600E Mutated Melanomas in the Dalmatian Region of Croatia

A high proportion of cutaneous melanomas harbor activating mutations of the BRAF or NRAS genes, which are components of mitogen-activated protein kinase (MAPK) signal transduction pathway. The importance of BRAF V600E mutation in melanoma is not only related to the possibility of the administration of the targeted therapy, but also to the fact that BRAF V600E mutated melanomas have distinct clinicopathological features. We investigated the clini-copathological features of 80 primary skin melanomas with known BRAF V600E mutation status excised in the Dalmatian region of Croatia, with comparison of these features between the mutated and wild-type group. The frequency of BRAF V600E mutation was 47.5%. In comparison with wild-type melanomas, BRAF V600E mutated melanomas were significantly associated with younger age and female sex (P=0.014 and P=0.011, respectively). The mutated melanomas were more often located on the extremities, of a nodular type, ulcerated, and with higher median of mitotic index but without significant difference in comparison with wild-type tumors. There were no differences in the depth of invasion and the presence of lymphovascular invasion, tumor infiltrating lymphocytes, and regression between the investigated groups. The frequency of BRAF V600E mutation in our cohort of primary skin melanomas and the clinicopathological features of mutated tumors were similar to those reported in the literature, except for the higher proportion of women observed in our group with mutation

Desmoplastični tumor malih okruglih stanica – DSRCT – prikaz slučaja

Desmoplastic small round cell tumor (DSRCT) is a rare malignant neoplasm of adolescent males with predilection for involvement of the peritoneum. It is an aggressive neoplasm with a poor prognosis. Herein we present a case of a 23 year old man with DSRCT which, at the beginning, has been a diagnostic and clinical problem.Dezmoplastični okrugli malostanični tumor ( DSRCT) je rijedak maligni tumor koji se pojavljuje u mla|ih muškaraca i najčešće zahvaća peritonej. To je agresivan tumor s lošom prognozom. Ovdje ćemo prikazati slučaj 23-godišnjeg muškarca s dijagnosticiranim DSRCT, koji je u početku predstavljao dijagnostički i klinički problem

CLINICAL RECOMMENDATIONS FOR TREATING AND MONITORING PATIENTS WITH RENAL CANCER

Svjetlostanični tip karcinoma bubrežnih stanica najčešći je oblik raka bubrega. Klinički je uglavnom asimptomatski, a samo se kod manjeg postotka bolesnika očituje hematurijom, tupom boli i palpabilnom masom u trbuhu. Najčešće se otkrije slučajno tijekom radioloških pregleda. Dijagnoza raka bubrega potvrđuje se patohistološkim nalazom nakon provedene dijagnostičke obrade. Odluka o liječenju donosi se temeljem kliničke procjene stadija bolesti i drugih čimbenika rizika. Ovisno o tome, mogućnosti liječenja uključuju kirurški zahvat te s obzirom na visoku rezistenciju raka bubrega na kemoterapiju i hormonsku terapiju, primjenu ciljane terapije (imunoterapija, inhibicija aktivnosti receptora tirozin kinaze) te palijativnu radioterapiju. U tekstu koji slijedi predstavljene su kliničke upute s ciljem standardizacije postupaka i kriterija postavljanja dijagnoze, upravljanja i liječenja te praćenja bolesnika s rakom bubrega u Republici Hrvatskoj.Clear cell renal carcinoma is the most common kidney cancer. It is generally asymptomatic. A small percentage of patients present with hematuria, flank pain and abdominal mass. It is usually detected accidentally during radiologic examination. The diagnosis of kidney cancer is confirmed by pathohistological findings after completion of the diagnostic process. The decision about treatment is made based on clinical assessment of disease stage and other risk factors. Depending on that, treatment options include surgery, and considering high resistance of kidney cancer on chemotherapy and hormone therapy, use of targeted therapies (immunotherapy, tyrosine kinase inhibitors) and palliative radiotherapy. The following text presents the clinical guidelines in order to standardize procedures and criteria for the diagnosis, management, treatment and monitoring of patients with kidney cancer in the Republic of Croatia

CLINICAL GUIDELINES FOR DIAGNOSING, TREATMENT AND MONITORING PATIENTS WITH TESTICULAR CANCER – CROATIAN ONCOLOGY SOCIETY AND CROATIAN UROLOGY SOCIETY, CROATIAN MEDICAL ASSOCIATION

Tumori testisa najčešći su solidni tumori u muškaraca u dobi od 15. do 34. godine. Njihova je incidencija u svijetu podvostručena u posljednjih 40 godina. Tumori zametnih stanica obuhvaćaju 95% svih tumora testisa, a podijeljeni su u dva osnovna histološka tipa: seminomi i neseminomi. Osobito značenje daje im visok postotak izlječivosti i u diseminiranoj fazi bolesti. Ovom uspjehu najviše je pridonijela kemoterapija, ali i dalje je kirurgija neizostavni dio uspješnog liječenja. Kod znatnog dijela ovih bolesnika danas se nastoji odrediti terapijski minimum kojim se izbjegava niz nuspojava, a koji dovodi do jednakog uspjeha kao i donedavno agresivniji terapijski pristup. U tekstu koji slijedi iznesene su kliničke upute radi standardizacije dijagnostike, terapije i kontrole bolesnika s tumorima zametnih stanica testisa u Republici Hrvatskoj.Testicular tumors are the most common solid tumors in men between 15 and 34 years of age. The worldwide incidence of these tumors has doubled in the past 40 years. Germ cell tumors comprise 95% of malignant tumors arising in the testes and they are classified either as seminoma or nonseminoma. Testicular cancers have a high cure rates even in disseminated stage of the disease. The chemotherapy mostly contributed to these results but surgery is an inevitable part of successful treatment. In a significant number of these patients treatment algorithms with minimum side effects are designed with the intention to maintain same cure rates as previously used, more aggressive therapy. The following text presents the clinical guidelines in order to standardize the procedures and criteria for diagnosis, management, treatment and follow-up of patients with testicular cancer in Republic of Croatia

<it>Campylobacter fetus</it> infection presenting with bacteremia and cellulitis in a 72-year-old man with an implanted pacemaker: a case report

Abstract Introduction Campylobacter is an important causative agent of intestinal infections in humans. Bacteremia is detected in less than 1% of patients, mainly in immunocompromised patients and in extreme age groups. Cellulitis is a relatively common manifestation of Campylobacter infection, but concomitant bacteremia is a rare event. Infections of the pacemaker area are caused primarily by staphylococci, followed by fungi, streptococci and Gram-negative rods. To the best of our knowledge, this is the first case report of pacemaker pocket infection and bacteremia caused by Campylobacter fetus. Case presentation A 72-year-old Croatian Caucasian man with myelodysplasia, impaired fasting glucose levels and a recently implanted permanent pacemaker was admitted to hospital after six days of fever, development of red swelling of the pacemaker pocket area and worsening of his general condition. No antibiotic therapy was introduced in the outpatient setting. He denied any recent gastrointestinal disturbances. With the exception of an elevated leukocyte count, erythrocyte sedimentation rate, and C-reactive protein and blood glucose levels, other laboratory findings were normal. Treatment with vancomycin plus netilmicin was introduced, and a surgical incision with drainage of the pacemaker pocket was performed. The entire pacemaker system was removed and a new one re-implanted after 14 days of antibiotic therapy. Transesophageal echocardiography showed no pathological findings. Three subsequent blood cultures obtained on admission as well as swab culture of the incised pacemaker area revealed Campylobacter fetus; stool and pacemaker lead cultures were negative. According to the microbiological results, antibiotic therapy was changed to ciprofloxacin plus netilmicin. A clinical examination and the results of a laboratory analysis performed after two weeks of therapy were within normal limits. Conclusion Myelodysplasia, impaired fasting glucose levels and older age could be contributing factors for the development of bacteremic Campylobacter fetus cellulitis. Emergent surgical and antibiotic treatment are mandatory and provide the optimal outcome for such types of pacemaker pocket infection.</p

Clinicopathological Characteristics of BRAF V600E Mutated Melanomas in the Dalmatian Region of Croatia

A high proportion of cutaneous melanomas harbor activating mutations of the BRAF or NRAS genes, which are components of mitogen-activated protein kinase (MAPK) signal transduction pathway. The importance of BRAF V600E mutation in melanoma is not only related to the possibility of the administration of the targeted therapy, but also to the fact that BRAF V600E mutated melanomas have distinct clinicopathological features. We investigated the clini-copathological features of 80 primary skin melanomas with known BRAF V600E mutation status excised in the Dalmatian region of Croatia, with comparison of these features between the mutated and wild-type group. The frequency of BRAF V600E mutation was 47.5%. In comparison with wild-type melanomas, BRAF V600E mutated melanomas were significantly associated with younger age and female sex (P=0.014 and P=0.011, respectively). The mutated melanomas were more often located on the extremities, of a nodular type, ulcerated, and with higher median of mitotic index but without significant difference in comparison with wild-type tumors. There were no differences in the depth of invasion and the presence of lymphovascular invasion, tumor infiltrating lymphocytes, and regression between the investigated groups. The frequency of BRAF V600E mutation in our cohort of primary skin melanomas and the clinicopathological features of mutated tumors were similar to those reported in the literature, except for the higher proportion of women observed in our group with mutation

Desmoplastični tumor malih okruglih stanica – DSRCT – prikaz slučaja

Desmoplastic small round cell tumor (DSRCT) is a rare malignant neoplasm of adolescent males with predilection for involvement of the peritoneum. It is an aggressive neoplasm with a poor prognosis. Herein we present a case of a 23 year old man with DSRCT which, at the beginning, has been a diagnostic and clinical problem.Dezmoplastični okrugli malostanični tumor ( DSRCT) je rijedak maligni tumor koji se pojavljuje u mla|ih muškaraca i najčešće zahvaća peritonej. To je agresivan tumor s lošom prognozom. Ovdje ćemo prikazati slučaj 23-godišnjeg muškarca s dijagnosticiranim DSRCT, koji je u početku predstavljao dijagnostički i klinički problem