Simultaneous bilateral breast carcinoma: Histopathological characteristics and CD44/catenin-cadherin profile.

AIMS: Family history of breast carcinoma, multicentric tumor foci in one breast, and in situ lobular carcinoma increase the risk of bilateral breast cancer (BBC), synchronous or metachronous. Synchronous tumors are designated as simultaneous breast carcinoma if they appear at the same time. The CD44 family and cadherin/catenin immunophenotype of this group of BBCs has not yet been evaluated. The aim of this study was to compare clinicopathological characteristics and immunohistochemical profiles of simultaneous BBC and corresponding lymph node metastases in eight patients. METHODS AND RESULTS: In toto 15 primary and 9 metastatic tumors were evaluated. The expression of CD44 variant isoforms, beta-catenin, E, P and N-cadherin were evaluated by immunohistochemistry. Rare types of breast carcinoma were frequent in this group of patients. There were 6 pleomorphic lobular, 5 invasive ductal of usual type, 3 atypical medullary carcinomas, 2 mucinous and one invasive micropapillary carcinoma. The expression CD44v6 was most frequent, followed by CD44v3-10, CD44v5, and CD44v3. CD44v4 was generally not expressed. E-cadherin was expressed in 80% primary tumors, 40% expressed N-cadherin, and 66% expressed P-cadherin. CONCLUSIONS: Generally, simultaneous carcinomas had different morphology and different immunophenotype. Each primary tumor was more similar to its corresponding metastatic tumor than to the contralateral primary tumor.

[Laparoscopic excision of non-parasitic splenic cyst--case report and literature review].

INTRODUCTION: Non-parasitic splenic cysts are rare condition and are mostly asymptomatic. They are usually found on abdominal US or CT investigation. The indications for operative treatement are exesive size and complications. MATERIALS AND METHODS: 18-years old women was admitted with a history of pain in the left upper abdominal quadrant. US and CT revealed 70/40 mm multilocular splenic cyst, negative serologic tests for E. granulosus. We performed spleen-sparing laparoscopic excision of the cyst in typical supine position using Harmonic scalpel. No intra- and postoperative complications were observed. DISCUSSION: Symptomatic and complicated spleen cysts are surgically treated. Total splenectomy, which traditionally was the procedure of choice, recently has been changed to more conservative approaches. Several spleen-concerving surgical methods have been proposed - deroofing, partial splenectomy, fenestration, excision, etc.

[Micrometastases in patients with colorectal cancer: markers for metastatic potential or proofs for residual disease]. / Mikrometastazi pri patsienti s kolorektalen kartsinom: markeri za matastatichen potentsial ili dokazatelstvo za rezidualna bolest.

It is know that bone marrow micrometastases are an indicator of poor prognosis in patients with epithelial tumors. At the same time little is known if they reflect minimal residual disease or cells distribution and marked metastatic potential. We aimed to perform a clinical study, which though with little gathered clinical material has a direction--investigation of bone marrow in patients with colorectal cancer by the time of surgery, carefully rendering an account of staging and performing curative resection. In intraoperatively done bone marrow biopsy with following investigation for cytoceratin 19 positive cells we found ol presence of metastatic cells in some the studied patients. Finding micrometastases in patients with colorectal cancer is a marker for more agressive course of the disease and for the need to change some of recent methods of treatment.

[A new approach for discovering minimal residual disease in patients with operable breast cancer]. / Nov podkhod za otkrivane na minimalna ostatuchna bolest pri patsienti s operabilen rak na gurdata.

The striving of surgeon for achieving better long-term results of surgical treatment of patients with breast cancer put the searching of new independent prognostic factors for the exit of the treatment. This has become possible in the last decade of XX century when new diagnostic methods as immunochistochemistry, polimerase chain reaction (PCR), cytomorphology etc. entered the clinical practice. With bone marrow biopsy in patients with breast cancer earlier diagnosis of minimal residual disease is achieved, the approach to those patients is changed and a possibility for discovering women at higher risk is given. By immunochistochemistry method in the diagnostics of minimal residual disease in patients with breast cancer, more precise staging is achieved. This will change the therapeutic approach to these patients.

[A case of dermatofibrosarcoma in 27 year old patient]. / Sluchai na dermatofibrosarkoma pri 27-godishna patsientka.

A case of dermatofibrosarcoma protuberans of the trunk involving the underlying soft tissue and muscle fascia, in early stage of development in 27 year old patient, operated by taking safety margin of 3 cm and the underlying muscle fascia, is being reported. Modality of treatment has been discussed.

Generalized uncertainty relations and coherent and squeezed states.

Characteristic uncertainty relations and their related squeezed states are briefly reviewed and compared in accordance with the generalizations of three equivalent definitions of canonical coherent states. The standard SU(1, 1) coherent states are shown to be the unique states that minimize the Schrödinger uncertainty relation for every pair of the three generators and the Robertson relation for the three generators. The characteristic uncertainty inequalities are naturally extended to the case of several states. It is shown that these inequalities can be written in the equivalent complementary form.

[Diagnosis and surgical treatment of adrenocortical carcinoma. A review of the literature and report of two cases]. / Diagnoza i khirurgichno lechenie na adrenokortikalen kartsinom. Pregled na literaturata i predstaviane na dva klinichni sluchaia.

Adrenocortical carcinomas (ACC) are rare and represent only 0.05 to 0.2% of all cancers. They can be hormonally active, appearing clinically by one or more endocrine syndromes, or can be hormonally non-active. Commonly most of the cases with AC are diagnosed when the neoplastic process have spread out of the suprarenal gland (stage III or IV). Computed tomography and magnetic resonance imaging are the most useful diagnostic methods of ACC but the latter is more accurate, especially in estimation of the local invasion of the tumor. Surgery is the main and the most effective method for treatment of both primary and recurrent ACC, and in selective cases--of metastasis. The chemotherapy with mitotane has a limited role and is indicated in cases of inoperable ACC (primary or recurrent) and/or presence of metastasis. Two cases of ACC treated in our department are reported. Case I: a 26-years-old female with ACC in stage II, which was diagnosed incidentally by ultrasound investigation for other consideration. Although the urine levels of free cortisol were elevated, the woman had no endocrine symptoms. Case II: a 50-years-old female with a second recurrence ACC appeared 5 years after a resection of the first recurrence tumor and 6 years after an operation for the primary tumor. Problems in diagnose and surgical treatment of these cases are discussed.

[Phyllodes tumors of the breast]. / Filoidni tumori na mlechnata zhleza.

Phyllodes tumors are mixed tumors of the mammary gland. They account for 0.3 to 0.5 per cent of all breast tumors. This is a report on nineteen cases presenting phyllodes tumors. Depending on the number of mitoses, growth pattern and atypism degree, the neoplasms are classified as benign (12 cases), borderline (2) and malignant (5). Fourteen of them (9 with benign and 5 with malignant phyllodes tumors) undergo clinical follow-up study. A case with bilateral location of the neoplasm exhibiting strongly expressed susceptibility to relapse is described. The basic methods of preoperative diagnosis and the operative treatment procedures used are outlined.

[One-step breast reconstruction]. / Ednomomentna mamarna rekonstruktsiia.

The mental trauma induced by removal of the mammary gland for cancer may be overcome by reconstruction of the breast. One-step reconstruction applied on 4 patients showed considerable advantages over a postponed reconstruction: technically it is easier to perform; a single stay of the patient in hospital makes it cheaper. It is no obstacle to perform pre- and postoperative radio- and chemotherapy. According to available data in the literature, implanted prosthesis or transposed flap do not veil a local relapse.