Mutacije kod melanoma u progresiji

In this review, we present the findings from the literature on several new molecules that can be targeted in the melanoma treatment process, especially metastatic melanoma, since five-year survival rates are below 20%. Recently, melanoma has been defined by mutations that occur in oncogenes and lead to melanomagenesis. A mutation in BRAF gene selects the patients for targeting therapy with BRAF inhibitors. Although BRAF inhibitor therapy is associated with clinical benefit, the majority of patients with the BRAFV600-mutated metastatic melanoma develop resistance, usually within the first year. Clinically significant discrepancy in BRAF status, between primary melanoma and its metastasis were detected in about 15% of cases. There are no specific recommendations on BRAF re-testing, but might be clinically relevant to repeat testing on recent metastatic sites in cases of previous BRAF wild type results.U ovom preglednom radu, predstavljena su saznanja iz literature o nekoliko novih molekula na koje može biti usmjeren razvoj ciljane terapije u procesu liječenja melanoma, osobito metastatskog, gdje je petogodišnje preživljenje manje od 20%. Melanomi su sve češće definirani mutacijama u onkogenima koje dovode do maligne trasnformacije. Mutacije BRAF gena određuju bolesnike za ciljanu terapiju BRAF inhibitorima. Iako bolesnici imaju kliničku korist od terapije, većina bolesnika s BRAFV600 mutiranim metastatskim melanomom postanu rezistentni unutar godinu dana. Klinički značajne razlike u BRAF statusu između primarnog melanoma i metastaza, javljaju se u oko 15% slučajeva. Nema specifičnih preporuka za ponovno BRAF testiranje, ali može biti klinički značajno ponoviti testiranje na novonastalim metastazama, u slučajevima prethodnih BRAF rezultata divljeg tipa

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

Histopatološke karakteristike raka dojke od 2005 do 2019 u jednom centru u Hrvatskoj: pregled promjena nakon uvođenja mammografskog probira

INTRODUCTION: Croatia launched the National program for the early detection of breast cancer (BC) in 2006. The program targets women between the age of 50 and 69 to take a mammogram every two years. About 60% of women performed mammography through the program. The study aimed to determine the difference in breast cancer’s pathohistologic features before and after the introduction of screening. MATERIALS AND METHODS: Data was collected retrospectively in a single high volume center for women diagnosed with invasive BC in the period before the introduction of mammography screening (2005-2007; N=1833), and from newly diagnosed (2017-2019; N=2676). Statistical significance of the findings was evaluated using Chi square test. RESULTS: We recorded a 31.5% increase in the number of patients referred to our hospital in the post-screening period. However, no statistically significant reduction in tumor size, histological grade or the number of positive axillary lymph nodes was detected in newly diagnosed BC compared to those diagnosed over ten years ago. The mean age of BC incidence was 61 years, with the mean tumor size of 22 mm (median 18 mm), in both periods. The significant difference occurred in the distribution of the intrinsic subtypes of BC (P<.001). About 45% of patients were diagnosed with pT1N0 stage, in both periods. CONCLUSION: In the post-screening period, we treated 32% more newly diagnosed breast cancers. However, pathohistological features of BC, along with the average tumor size, did not change.UVOD: Nacionalni program za mamografski probir raka dojke u Hrvatskoj započeo je 2006, s ciljem otkrivanja raka u ranijem stadiju bolesti. Program uključuje mamografski pregled žena u dobi od 50 do 69. Cilj našeg istraživanja je utvrditi razlike u patohistološkim karakteristikama raka dojke prije uvođenja probira s novodijagnosticiranim. MATERIJALI I METODE: Retrospektivno smo u jednom centru prikupili podatke o patohistološkim karakteristikama raka dojke bolesnica oboljelih na početku mamografskog probira (2005-2007; N=1833) i podatke o novooboljelima iz razdoblja više od deset godina nakon uvedenog probira (2017-2019; N=2676). Dobivene podatke analizirali smo upotrebom χ2 testa. REZULTATI: Zbrinuli smo 31.5% više novodijagnosticiranih bolesnica s karcinomom dojke. Naši rezultati nisu pokazali statistički značajne razlike u veličini tumora, histološkom gradusu ili pozitivnom status limfnih čvorova u podpazušnoj jami u skupini novodijagnosticiranih bolesnica s karcinomom dojke u usporedbi s onima iz razdoblja prije mamografskog probira. Prosječna dob oboljevanja je 61 godina s prosječnom veličinom tumora od 22 mm (medijan 18 mm), u oba razdoblja. Oko 45 % bolesnica je dijagnosticirano s pT1N0, u oba razdoblja. ZAKLJUČAK: U razdoblju nakon uvođenja probira zbrinuli smo 32% više oboljelih od raka dojke u našoj instituciji. Nismo zabilježili razlike u patohistološkim karakteristikama tumora, niti u prosječnoj veličini tumora između ova dva perioda

Rectal Metastasis from Lobular Carcinoma of the Breast: A Case Report

Rectal metastases from breast carcinomas are very rare. They often occur in lobular invasive breast carcinoma (ILC), usually after a long disease-free period. It is important to be aware of these unusual metastatic patterns of ILC of the breast because of the possibility of systemic therapy. We present a case of 83-year old woman with rectal metastesis from ILC seven years after surgery of primary tumor

Primary Ewing’s Sarcoma of the Kidney: A Case Report

Primary adult Ewing’s sarcoma is a rare entity. They most commonly occur in children and young adults. 6% of them are localized extraosseously. We present a case of a 51 year old patient with primary renal Ewing’s sarcoma and multiple metastases in liver and iliac bone. Patients with metastatic disease are usually treated with aggressive chemotherapy and have a poor outcome. Our patient underwent complete surgical excision of tumour, and was treated with aggressive chemotherapy, respectively. Two and half years after presentation he is well, without any symptoms

Primary Extragastrointestinal Stromal Tumor of the Sigmoid Mesocolon with Metastatic Spread to Greater Omentum: Case Report

A 71-year-old female complained of abdominal pain, weight loss and abdominal distension. Gynecologic examination revealed a hardly movable, palpable mass in the lower abdomen, reaching the umbilicus. An abdominal ultrasound and computed tomography (CT) scan suggested a large abdominal mass with the possible origin in the left ovary and without significant lymph node enlargements. The patient subsequently underwent complete evacuation of tumor tissue, omentectomy and total abdominal hysterectomy and bilateral salpingo-ovariectomy. Immunohistochemical examination revealed strongly positive staining of tumor cells for CD117. The final pathologic diagnosis was a primary extragastrointestinal stromal tumor (EGIST) of the sigmoid mesocolon with omental metstasis. The differential diagnosis of the tumor presented in the lower abdomen should consider the EGIST as well

Abdominalni parakordom – prikaz slučaja

We report a very rare case of abdominal parachordoma. Parachordoma is indolent in nature, grows slowly and it has occasional recurrence after 3 months to 12 years and rare metastases. A 70-year-old female presented to our Department complaining of abdominal pain. Clinical examination showed a tumor mass in the pelvis and abdomen. Surgery was indicated. Histopathological and immunohistochemical analysis of resected tumor tissue confirmed the diagnosis of parachordoma with metastases in the sigma and omentum.Prikazujemo vrlo rijedak slučaj abdominalnog parakordoma. Parakordom raste sporo, rijetko metastazira, a recidiv se može pojaviti nakon 3 mjeseca do 12 godina. Sedamdesetogodišnja pacijentica primljena je na Odjel za ginekološko-onkološku kirurgiju Klinike za tumore KBC „Sestre milosrdnice“ zbog bolova u donjem dijelu trbuha. Kliničkom obradom dijagnosticirana je tumorska masa u zdjelici i trbuhu. Učinjen je kirurški zahvat. Histološka i imunohistokemijska analiza potvrdila je dijagnozu parakordoma s metastazama u sigmi i omentumu