Modern surgical treatment of malignant skin melanoma: A brief literature overview

BackgroundMalignant melanoma (MM) of the skin is a rare, highly malignant tumour, affecting younger age. Its incidence rate has been rising as compared to all malignant neoplasms – 5 per cent of all newly diagnosed cancers in men, and 6 per cent of those in women.AimsThe aim of the literature review is the present the contemporary tendencies in the surgical treatment and monitoring of patients with malignant melanoma of the skin.Methods Systematic Literature Review Made By Google and Science Direct.com Search Engines. Publications and guidelines in English, including the newest aspects in the overall care of patients with malignant melanoma of the skin. Information for the indications and contraindications of performing a sentinel biopsy.Results The study established that the most modern surgical treatment of a malignant melanoma of the skin includes: primary tumour biopsy, sentinel biopsy of the regional lymph nodes with wide re-excision of the affected area, usually with a radius of 2cm, and the removal of local recurrences, lymph and distant organ metastases. When it comes to monitoring, it has to be done according to the contemporary worldwide guidelines.ConclusionSuccessful treatment of skin MM is in direct correlation to keeping up with the most modern tendencies

A rare clinical case of synchronous colorectal cancer, affecting the transverse colon

Synchronous colorectal cancer is a rare condition, which presents with the simultaneous development of more than one primary carcinoma and affects different segments of the colon and rectum. The incidence of this disease is about 3.5 per cent of all carcinomas of the colon and rectum and more often affected men. Adenocarcinoma is the most common histological type for synchronous colorectal cancer.We present a rare clinical case of a 62-year-old woman with synchronous colorectal carcinoma, located in the transverse and sigmoid colon and verified histologically by colonoscopy

A quartz crystal microbalance-assisted method for the assessment of iodine content in organoiodines

Introduction: A new experimental quantitative approach for evaluating iodine content in organoiodine compounds has been proposed, based on the quartz crystal microbalance (QCM) method. This approach relies on following the time behavior of the resonance frequency of the quartz plate under temperature activation of iodine-containing analyte deposited on its surface.Materials and Methods: We have applied the QCM method and the pharmacopoeial titrimetric method.Results and Conclusion: From the mass variations observed, the quantity of emitted iodine is precisely obtained, which readily delivers its initial content in the studied sample. The obtained value corresponds exactly to the theoretical prediction, in contrast to the value obtained by applying the conventional pharmacopoeial metrics

Diltiazem-loaded Eudragit RS 100 microparticles for drug delivery: the challenge of viscosity

Strongly shape-dependent viscosity has been found in drug loaded and `empty` polymeric microspheres (drug delivery systems) made of pharmacopoeial Eudragit RS 100 representative. The dramatically increased viscosity of a layer of spherical particles deposited on the gold electrode surface of quartz resonators from water suspension leads to a large dynamic resistance and inability to sustain stable oscillations in a frequency measuring circuit. The viscosity is also affected by loading the polymer matrix with Diltiazem. Its adverse impact is removed by exposing the deposed layer to acetone vapor leading to `dissolving` the investigated spheres and changing their shape to a thin layered one

Primary, nodal, marginal zone lymphoma of a woman’s left breast imitated fibroadenoma

BackgroundPrimary breast lymphoma is a rare malignant neoplastic disease, accounting for around 0.5 per cent of all malignant diseases of that organ, and also 2.2 per cent of extranodal lymphomas. The most common histopathological types are: diffuse large B-cell lymphoma, extranodal B-cell marginal zone lymphoma and MALT lymphoma. The primary affected group is with median age between 55 and 62 years. The clinical manifestation is usually of a tumour process in the affected breast.Case presentationHere we present an extremely rare case of a 68 years old woman with primary, nodal, B-cell, marginal zone lymphoma of the left breast, presenting itself under the mask of a benign tumour process, found accidentally following a histopathological examination of excisional samples.ConclusionsPrimary, nodal, marginal zone, B-cell lymphoma of the breast is extremely rare. Its clinical and mammographic presentation completely overlaps with those of fibroadenoma, which makes diagnosing it preoperatively practically impossible. Main treatment method here is not surgical, but radiological and chemotherapeutic

Diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography over conventional imaging studies to detect malignant lesions in staging and restaging after radically treated primary and recurrent locoregional cutaneous melanoma

Introduction. Cutaneous melanoma (CM) has a high metastasizing potential and requires many imaging tests for accurate staging and restaging. As a hybrid imaging method, 18F-FDG PET/CT has the power to diagnose clinically undetected regional and distant metastatic disease with a better detection rate than conventional imaging. The aim of our study was to assess the value of 18F-FDG PET/CT in detecting different types of malignant lesions – local recurrences, regional lymph nodes (RLN), in-transit (ITM) and distant metastases (DM) after radical excision of the primary lesion or regional recurrence.  Materials and methods. A retrospective analysis was performed of all patients with CM referred for 18F-FDG PET/CT for staging or after resection of locoregional recurrent disease. All patients had a combination of pre-PET/CT conventional imaging studies (CIS), including a whole body computed tomography (CT) and ultrasonography (US) of the RLN basin/s. The results from 18F-FDG PET/CT were compared with the CIS results.  Results. 246 consecutive patients, aged 10-87 years were included with identification of 71 malignant lymph nodes, 4 local recurrences, 28 ITM, and 65 DM in total. The detection rate of 18F-FDG PET/CT for RLN was 84.5%, and in the diagnosis of ITM and DM, it reached a sensitivity of 100.0% with 0.7% of false positive results.  Conclusions. 18F-FDG PET/CT has an invaluable role in the detection of small, clinically silent ITM and DM and has a smaller value in RLN detection. It may guide the process of selection of suspicious lesions, suitable for biopsy or further ultrasound follow-up

Amelanotic melanoma of the skin – detailed review of the problem

BackgroundMalignant melanoma (MM) of the skin accounts for about one per cent of all malignancies in humans. Amelanotic melanoma is a rare tumour, diagnosed in eight per cent of all melanomas.AimsThe study aimed to analyse our clinical experience with amelanotic MM of the skin and the statistical data from a retrospective five year analysis of pigmented and amelanotic types of skin melanoma. Furthermore, we compare our results to those from other teams' studies. To reach the corresponding in-depth conclusions.MethodsThe study included 151 patients with malignant melanoma of the skin, diagnosed and treated at Dr. Georgi Stranski University in Pleven, Bulgaria, between 2012 and 2016. All the patients signed informed consent forms.ResultsOf the 151 patients we studied, 14 (9.3 per cent) were diagnosed with amelanotic melanoma. The average Breslow thickness in patients with amelanotic MM was 4.2mm, while in pigmented MM patients it 2.1mm. Local recurrence rates (35.7 per cent) were higher in patients with amelanotic melanoma. Distant metastases were found in 39 of all tested patients with melanoma. Of the 14 patients with amelanotic MM, eight had such metastases.ConclusionAmelanotic melanoma was diagnosed too late. Local recurrences were six times as many as the ones diagnosed in pigment melanoma. Distant metastases were twice as many, and mortality rates were three times higher

Lymph node involvement and the role of lymphadenectomy in patients with advanced ovarian cancer

BackgroundOvarian carcinoma (OC) is one of the most common types of cancer diagnosed in women and its clinical significance is reflected in the leading place it holds in the morbidity and mortality rates among women diagnosed with cancer. The evaluation of lymph node involvement by the oncosurgeons is a pivotal step towards proper disease staging and adjuvant therapeutic choices, towards optimal treatment outcomes.AimsThe aim of this study was to investigate the lymph node metastases and patient characteristics in women with advanced OC (FIGO II-IV).MethodsThe study includes 58 patients with advanced OC (FIGO II-IV) operate in our clinic for the period 2004-2012. The patients were analysed with respect to age, FIGO stage, histological type and tumour grading, type of surgical verification of lymph nodes (biopsy, pelvic and/or para- aortic lymphadenectomy), results from histopathological reports describing the extent of lymphatic involvement, localization of lymph node metastases, and presence of ascites.ResultsLymph node metastases were found in 56.7 per cent of the patients. 24.1 per cent of the patients had micrometastases in lymph nodes that were not initially detected on both pre- operative diagnostic imaging and intraoperative inspection. ConclusionThe only reliable method for initial/early detection of lymphatic metastases in patients with OC is the surgical, through lymphadenectomy, with subsequent histological evaluation

Robotic gastrointestinal stromal tumors surgery - initial results

Introduction: Gastrointestinal stromal tumors (GISTs) usually present as an exophytic mass localized in stomach. Years ago, conventional surgery was the only option. Laparoscopic and robotic procedures have risen to prominence in recent decades as technology and surgical techniques have advanced.Aim: The aim of this study was to evaluate the safety and feasibility of robotic surgery of GIST.Materials and methods: All patients who underwent robotic surgery for a GIST in the University Hospital Kaspela-Plovdiv between November 2021 and April 2022 were included. Post-operative course and short oncological outcomes were analyzed.Results: Four patients with gastric GIST, median size 50 mm [40–70 mm], underwent robotic surgery. Conversion to open surgery not occurred. We have two cases with localization in corpus, one in antrum and one in the fundus. We have registered one complicationsanastomotic leakage after proximal resection treated conservatively. In others, the post-operative period was uneventful. The average hospital stay was 8.2 (4-11) days. The median operating time was 255 min (220–320 min).Conclusions: On basis of this initial results, we can conclude that robotic gastrointestinal tumors surgery is safe, feasible, and oncological sustained. Of course, one of the weakest sides of this surgery is prolonged operative time and increased expenses

Vaginal myoma – A rare type of vaginal tumor

Vaginal myoma is an extremely rare benign tumour. Its clinical picture is multiform, core being the presence of pain symptom. This diagnosis is not that easy and malignant tumour should always be considered. We present three clinical cases, where the formations differ in their dimensions, localizations and clinical pictures. We used one and the same method in their surgery and there was no recurrence during the follow up period. We cannot rely on clinical symptoms or gynaecological examination to diagnose vaginal leiomyoma. The ultrasonography is only of orientational character. Therefore, each formation originating vaginally should be treated as malignant – it should be removed intact, without disrupting its entirety