EPIDEMIOLOGICAL REGISTRY OF NEUROENDOCRINE TUMORS IN BULGARIA--A PILOT SURVEY.

The National registry of patients with neuroendocrine tumors (NET) in Bulgaria was established in 2013 as a joint initiative of the Bulgarian Surgical Society and the Institute for Rare Diseases. The register aims to explore the epidemiology of NET in Bulgaria, as well as the different diagnostic and treatment approaches for the disease throughout the country. This the first of its kind retrospective study of NET in the country is covering the period January 2012 - January 2013. A total of 127 patients with NET were identified. At the time of the survey the average age of patients with NET was 58.61 ± 15.59 years. The data show almost equal distribution between the genders with a slight predominance of women. The largest relative part of NET is those of NET located in the gastrointestinal tract (54.10 ± 4.51%), followed by those located in the pancreas (12.30 ± 2.97%) and in the lungs (10.66 ± 2.79%). In 72.44 ± 3.96% of the patients a immunohistochemical diagnosis was performed. The study confirmed the leading role of the surgery method of the NET management. In 65.83 ± 4.33% of the patients a radical removal of the tumor was conducted, while the relative part of the undertaken partial resection was 7.50 ± 2.40%. A statistically significant association between the type of surgical treatment and during the follow-up of patients was found. An update of the information in the register will allow a more precise determining of the distribution and management of NET in Bulgaria.

Radioisotopic detection of sentinel lymph nodes in clinically localized high-risk prostate cancer.

PURPOSE: To explore the efficacy of a radioisotopic (RI) method in detecting sentinel lymph nodes (SLNs), known as sites of harboring metastases, in localized high-risk prostate cancer (HRPC). METHODS: The RI method was applied to 26 males with clinically localized HRPC, subjected to radical prostatectomy in 2006-2008. All had poor pathological characteristics: initial PSA > 15 ng/ml, Gleason score > 7, clinically suspected extracapsular extension, seminal vesicle invasion, and/or positive pelvic lymph nodes (LNs). The radiopharmaceutical (Tc-99m) was injected preoperatively at 4 zones of the periphery of the prostate. Tc-99m-nanocolloid particles were

Subdermal laterocranial mapping of sentinel lymph nodes in breast cancer as an alternative to the peritumoral mapping.

PURPOSE: Peritumoral injection of blue dye is standard method of sentinel lymph nodes (SLN) biopsy in breast cancer. Applying the marker to different locations will be of great benefit in cases in which the peritumoral mapping is difficult to implement. The aim of this study was to demonstrate that the subdermal laterocranial (SLC) mapping with a dye has similar diagnostic reliability to the peritumoral mapping and is applicable for clinical use. PATIENTS AND METHODS: 254 patients with operable breast cancer (cT

Perioperative locoregional application of mitoxantrone in patients with early breast carcinoma.

The aim of this study was to investigate the clinical and morphological aspects of drug diffusion and efficacy after perioperative locoregional application of mitoxantrone in patients with early breast cancer. Mitoxantrone was injected at a dose of 0.5 ml (1.0 mg) in two sites around the tumor in 37 patients. Intraoperative inspection of mitoxantrone diffusion in breast and axillary tissues was carried out by blue color of the chemotherapeutic drug. Investigations of reactive morphological changes in axillary nodes were determined intraoperatively by blue stained lymph capillaries identified 2-4 cm laterally from the application sites and in 30 patients a mean of 1.5 stained axillary nodes was found. The light microscopy in the metastatic blue lymph nodes showed circulatory changes, dilatation of marginal sinus and inflammatory alterations. It was concluded that lymphotropic locoregional application of mitoxantrone results in diffusion of the drug in the regional lymph drainage and in cytotoxic effects on axillary nodes.

[Breast carcinoma - a challenge faced by surgeons]. / Rak't mlezhnata zhleza i khirurg't - predizvikatelstva spriamo niakoi standarti.

We are representing results of some projects of Oncology Centre in Pleven about some problems in breast cancer, like: local screening program for early diagnostic of the disease and how to choose axillary dissection and axillary staging by sentinel lymphadenectomy and reconstructive surgery after mastectomy.

A case of intraduodenal diverticulum imitating choledochocele.

An intraduodenal diverticulum in 54 year old woman which caused alcalculous cholecystitis and pancreatitis is described. The diverticulum was missed at the first operation, performed for acute cholecystitis. Before the second it was interpreted as a pancreatic cyst. At the second intervention, the cyst wall was excised through a duodenotomy. Histological examination of the wall of the diverticulum is crucial for correct diagnosis.