[Neglected case of uterine leiomyoma--case report].

INTRODUCTION: Uterine leimyomas are the most common gynaecologacal tumors and represent 30% of all benign gynecological tumors. The vast majority of leiomyomas are asymptomatic and do not need to be treated. Pelvic pain and abnormal uterine bleeding should be considered as the most important reasons for surgical treatment of uterine fibroids. CASE REPORT: A female patient, age 69, was treated at the Institute of Oncology in Sremska Kamenica because of a huge abdominal tumor. Major symptoms were increased body temperature, abnormal uterine bleeding and extensive abdominal enlargement. After the clinical, laboratory and imaging evaluation, the offered hysterectomy was performed. The evacuated tumor was 18 kg heavy and 40 cm in length. The pathohystological diagnosis was leiomyoma per magnum. The patient was released after 11 days of hospitalization without any postoperative complications and in good general condition. DISCUSSION: Uterine fibroids can be managed medically and surgically. Hysterectomy should be performed in every case with dominant symptoms like abnormal uterine bleeding, tumor growth and increasing abdominal pain (when other causes are excluded) in postmenopausal women. This particular case is an example of low general and health culture of the reported patient and maybe caused by fear from medical and surgical treatment. Sometimes, making a diagnosis of the nature of pelvic tumor is very hard, but by respecting diagnostic procedure an adequate treatment of those patients can be ensured.

[The influence of aging on pathologic and immunobiologic parameters of invasive ductal breast carcinoma].

BACKGROUND/AIM: Most human cancers, including breast one, increase in frequency with aging. The aim of this study was to explore the hypothesis that aging also alters breast cancer biology. METHODS: The study included 120 women with primary invasive ductal carcinoma of the breast. We correlated the patients age and diagnosis with the commonly used clinical, pathological factors and newer tumor biomarkers. Immunohistochemical staining was conducted for p53, c-erbB-2, Ki-67, estrogen (ER), progesterone (PR) receptors, and angiogenesis. RESULTS: In our study, the patients with axillary lymph node metastases and negative steroid hormone receptors (ER and PR) were significantly younger than the patients with nodal involvement and positive hormone receptors. There was also a significant association between the patients age, diagnosis and angiogenesis. No association was found between the patients age and tumour size, histological grade, p53, c-erbB-2, and Ki-67. CONCLUSION: The results of our study supported only partially the hypothesis that the breast cancer biology is significantly affected by a patient's age.

[Psychophysiologic disturbances in early postmenopause in women after physiological and surgical menopause].

BACKGROUND/AIM: The most common secondary manifestations of menopause are clinical manifestations of estrogen deficiency. They could be early and late. The aim of this study was to compare manifestations of somatic disturbances in early postmenopause in women after physiological and surgical menopause. METHODS: This prospective study included 60 women, age 41-55 years, divided into two groups: physiological (30 of them) and surgically induced menopause. For every subject a special evidence list, consisting of the disease history questions, physical and gynecology examination as well as dates about physiological variables (arterial tension, height, weight, and body-mass index) and laboratory examination was formed. The values of arteriol blood pressure, body height, body mass, body mass index (BMI), and lipid status were determined and gynecological examinations were performed in each patient. RESULTS: The most frequent symptoms in both groups were vasomotor ones. Headache was the more intensive sign in the group after induced menopause. Extrasistolyc heart excursion was a common symptom in both study groups. Arterial tension, regardless of the type of menopause, was in the physiological range. The frequent organic signs of menopause, more intensive in the group after induced menopause, were genitourinary and skin atrophy. An analysis of the BMI showed that the women in both groups were obese (BMI > 25). The lipids analysis confirmed the predomination of hyperlipoproteinemia type IIa in the group with physiologic menopause and type IIb after induced menopause. CONCLUSION: The dominant signs of menopausal syndrome were vasomotor and bone-joint symptoms, more frequent in the group after induced menopause. There were no statistically significant differences between the study groups according to the genitourinary atrophy and other signs of aging. Menopausal hormonal changes, regardless of the way of menopause developing, increase the risk for hyperlipoproteinemia. The frequency of somatic signs in early post menopause is typically higher after induced menopause. More intensive follow-up in patients after surgical removing of the ovaria is necessary in order to improve the quality of life in these patients.

[Immunohistochemical analysis of angiogenesis in invasive ductal breast carcinoma with correlations to clinicopathological factor].

BACKGROUND/AIM: Angiogenesis is the formation of new vessels from preexisting ones. The aim of our study was to determine the relevance of tumor-induced angiogenesis, its correlation with some of the commonly used clinical, pathological factors and the recent biological indicators, and metastatic potential of the tumor in a series of 120 patients with invasive ductal carcinoma of the breast. METHODS: The identification of microvessels was performed immunohistochemically with factor VIII-related antigen. The microvessel count (MVC) was assessed at the invasive front of each carcinoma. The cases were divided into high-and low-microvessel density groups according to an average number of microvessels found in the multiple fields of the most vessel-dense part of each tumor. The nuclear immunohistochemical staining for hormone receptors, and the p53, and the membranous staining for c-erbB-2 were evalueted. RESULTS: There were significant correlations between a high MVC and a large tumor size, high histological grade, and c-erbB-2 protein overexpression. There was no association between tumor angiogenesis, as assessed by the MVC, and the hormone receptors status, and the p53 protein expression. In the cases with a high MVC, there was a significant number of tumors with lymph node metastases. CONCLUSION: Our findings showed that a high MVC might point out an aggressive tumor phenotype. This might help to stratify patients for an appropriate therapy on an individual basis and, thus, offer the possibility of a more effectively tailored treatment program.