Clear-cell sarcoma of tendons and aponeuroses in the right genitofemoral line - a case report.

INTRODUCTION: Our case report presents a rare occurrence of clear cell sarcoma in the genitofemoral line region that has not been described to date. CASE REPORT: A 57-year-old male patient with clear-cell sarcoma of tendons and aponeuroses is presented. The patient underwent a radical operation and adjuvant radiotherapy. CONCLUSION: The patient is still alive, in a good health condition, without local recurrence or generalised disease. Key words: clear-cell sarcoma of tendons and aponeuroses - genitofemoral line.

[Significance of the sentinel lymph node biopsy in early breast carcinomas]. / Význam biopsie sentinelovej uzliny pri vcasnom karcinóme prsníka.

We present our experience regarding sentinel lymph node biopsy (SLNB) at St. Elizabeth Institute of Oncology during 48 months. From January 1st, 2006 until December 31st, 2009, we had performed SLNB in 269 patients. Primary tumour size was 0.3-3.5cm including non-invasive breast carcinoma (i.e. TIS, T1 and T2 of TNM classification). Invasive carcinoma accounted for 255 (94.8%) cases, while non-invasive carcinoma for 14 (5.2%) cases. From total of 269 patients with invasive carcinoma, we used validation method in 157 (72.7%). In 255 patients with invasive carcinoma, sentinel node was not identified in 4 (1.6%) cases--in 1 patient with T1 invasive carcinoma and in 3 patients with T2 tumours. False negativity of sentinel node in T1 tumours was 4.3%. The incidence of macrometastases in sentinel nodes was confirmed using standard histopathologic examination with hematoxylin-eosin stain. In negative instances, the examination was then completed with serial sections and immunohistochemistry using cytoskeletal antibodies for confirmation of presence of micrometastases. In 6 (2.4%) cases, we found micrometastase in originally negative sentinel lymph node. Subsequent axillary dissection has not confirmed non-sentinel nodes involvement.

Radionavigated detection of sentinel nodes in breast carcinoma--first experiences of our department.

INTRODUCTION: Biopsy and histological evaluation of sentinel lymphatic node limits the axillary node dissection only in cases of positive histological finding and decreases the occurrence of postoperative complications related to the axillary node dissection. METHODS: We used radiotracer SentiScint, Medi-Radiopharma Ltd, Hungary and preoperatively administered blue dye--Blue Patenté V, Guebert, Aulnay-Sous-Bios, France. 11 (18%) patients were subdued to deep peritimorous application of radiotracer, 10 (16.4%) to sub/intradermal application over the lesions and n 40 (65.6%) patients the application was sub/intradermal and periareolar. The patients underwent an operation protocol of corresponding quadrantectomy, radionavigated blue-dye sentinel node biopsy and axillary dissection. RESULTS AND CONCLUSIONS: From May 2006 to June 2008, we examined 61 patients with breast carcinoma. They underwent radionavigated and blue-dye sentinel node biopsy. We detected 57 (93.4%) sentinel nodes with preoperative scintigraphy, of which only 51 (83.6%) were detected peroperatively and underwent histological evaluation. In six (9.8%) cases, the "frozen cut" histology of the primary lesion had shown a benign lesion; hence no sentinel node biopsy or axillary disection was performed. 12 (19.7%) of 51 histologically evaluated sentinel nodes had metastatic invasion. We retrospectively compared the histological fund in sentinel and axillary nodes in patients with metastatic sentinel nodes. In 6 (16.6%) cases, the sentinel node was positive of metastatic invasion but axillary nodes were histologically negative, in 6 (16.6%) cases the sentinel node and axillary nodes were positive for metastatic invasion. We observed falsely negative findings in 3 (8.3%) patients with negative histological fund in the sentinel node, but positive axillary nodes (Tab. 3, Fig. 2, Ref. 11). Full Text (Free, PDF) www.bmj.sk.

[Central cervical dissection of lymph nodes in the management of differentiated thyroid carcinoma--our experience]. / Centrálna krcná disekcia lymfatických uzlín v liecbe diferencovaného karcinómu stítnej zl'azy--na e skúsenosti.

INTRODUCTION: Total thyroidectomy (TTE) with central compartment lymphonodes (LU) dissection remains a standard procedure in the treatment of differentiated thyroid carcinomas. METHODOLOGY: The retrospective study assessed a group of patients undergoing primary or secondary procedures in our clinic. PATIENT GROUP: From 01.01. 2005 to 31. 07. 2007, a total of 50 patients underwent primary procedures, TTE with dissection of central compartment lymphonodes was performed in 18 patients, 58 patients were reoperated for relapses of the disorder. In the primary procedures, the central compartment lymphonodes were affected with increased rate, proportionally to a T-stage of the disorder 28% (T1), 52 (T2), 58% (T3). Multifocal carcinoma was associated with a high risk, where metastatic lymphadenopathy occured in 53% of the cases. In the reoperated subjects, relapses of the disorder were recorded in 78% of the patients in their central compartment lymphonodes and their thyreoglobulin levels decreased. Out of 126 patients, paresis of the nervus laryngeus reccurens was recorded in 4 subjects (3.1%) and postoperative hypoparathyreosis in 14 subjects (11%). CONCLUSION: Dissection of lymphonodes is a standard part of the surgical management of differentiated carcinomas, providing local control of the disease. 78% of the relapses were located within the central compartment. Risk and complication rates correspond to those reported in total thyroidectomy.

[Completion of total thyroidectomy for a differentiated thyroid carcinoma]. / Dokoncenie totálnej tyreoidektómie pre diferencovaný karcinóm stítnej zl'azy.

Total thyroidectomy with dissection of the central compartment (CK) lymphatic nodes is a standard surgical procedure in differentiated thyroid carcinomas. A minority of the patients are diagnosed postoperatively. Our study reports on surgical tactics in these patients. During 2003-2006, 47 patients were operated, to have total thyoidectomy performed. The patients' data were assessed retrospectively.

[Diagnosis of the Zollinger-Ellison syndrome. I: Significance of anamnestic, clinical and laboratory examinations]. / Diagnostika Zollingerovho-Ellisonovho syndrómu I.: význam anamnestických, klinických a laboratórnych vysetrení.

The authors describe the diagnostic algorithm of Zollinger-Ellison's syndrome which proved useful in the diagnosis of 73 patients with a confirmed diagnosis. They evaluate the diagnostic validity of anamnestic and clinical data, of different examination methods and compare them with experience assembled abroad. For the diagnosis of sporadic gastrinomas the onset of the disease after the age of 40 years is important, the development of serious peptic complications (haemorrhage F-70%, M-59%, perforation M-54%, F-47%) and the presence of watery diarrhoea (41%). As to laboratory parameters they rely on high BAO values (96% > 15 mmol H+/hour and 100% > 5 mmol H+ after gastric resection. Less important is the examination of basal serum gastrin (almost 30% patients have normal or liminal values of BSG--empirically set at 100-150 pg. ml-1). The authors draw attention to the fact that patients with ZES after gastric resections may have BSG values lower than 100 pg/ml (12%). A positive secretin test has a higher validity (rise of SG by 150-200 pg. ml-1 above basal values) positive in 82.2% patients, liminally positive in 11% and negative in 6.3% patients. An even higher diagnostic value was possessed by a BAO/MAO index higher than 0.6 which was positive in 93.4% patients. At present it is not used as pentagastrin is not available. Every year they diagnose 4-6 new cases of ZES which with regard to the number of inhabitants (5 million) places Slovakia along with Denmark and Sweden among the countries with the highest detection rate (0.8-1.2 ZES cases/1 million per year).

[Cholelithiasis and acute pancreatitis]. / Cholelitiáza a akútna pankreatitída.

The authors evaluate the results of treatment of acute pancreatitis at the surgical clinic in 1972-1988. In 64% biliary pancreatitis was involved. The group with a more severe, complicated course is formed by 22.1% patients. In that group the mortality rate was 21.6%. In 57% it was accounted for by patients with biliary pancreatitis. In the group with a mild course of pancreatitis (77.9% of patients) the mortality was 0.9%. The approach to treatment of cholelithiasis in the acute stage of pancreatitis must be considered on an individual basis. In the majority of patients disease of the biliary pathways can be treated after control of acute pancreatitis during the primary hospitalization. In some patients surgery of the biliary pathways during acute pancreatitis is indicated. The risk of operation is high. Therefore in some patients endoscopic papillosphincterotomy is indicated.