Bone morphogenetic proteins regulate differentiation of human promyelocytic leukemia cells.

We investigated the role of bone morphogenetic proteins (BMPs) in suppression of all-trans retinoic acid (ATRA)-mediated differentiation of leukemic promyelocytes. In NB4 and HL60 cell lines, BMPs reduced the percentage of differentiated cells, and suppressed PU.1 and C/EBPε gene expression induced by ATRA. BMP and ATRA synergized in the induction of ID genes, causing suppression of differentiation. In primary acute promyelocytic leukemia bone-marrow samples, positive correlation of PML/RARα and negative of RARα with the expression of BMP-4, BMP-6 and ID genes were found. We concluded that BMPs may have oncogenic properties and mediate ATRA resistance by a mechanism that involves ID genes.

Unrecognized hemangiopericytoma of posterior cervical region with intracranial extension.

Hemangiopericytoma of the posterior cervical space and occipital bone is an uncommon lesion which should be considered in the differential diagnosis of a lumpy and highly vascular lesion of the posterior cervical space. We report the case of a 47-year-old woman who experienced sudden and painful occipital and posterior cervical swelling. She underwent a blind biopsy which was complicated by profuse bleeding. The palpable lesion was not properly diagnosed preoperatively, and the endocranial extension of the lesion was overlooked by her surgeon who performed a blind biopsy without adequate diagnostic imaging who inadvertently invaded the posterior cranial fossa during biopsy. We would like to emphasize the need for appropriate non-invasive diagnostic investigations before any biopsy of head and neck lesions that may extend deeply.

[Locally invasive papillary thyroid cancer--our experience]. / Lokalno invazivni papilarni karcinom stitnjace--nasa iskustva.

Differentiated thyroid carcinomas, particularly papillary carcinoma, are the tumors with good prognosis, but sometimes have a tendency to spread into the surrounding tissue. The spread of these tumors usually involves muscle, cartilage and upper aerodigestive tract. During two years (2008-2009) at the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Center Zagreb, 233 patients with differentiated thyroid carcinoma were treated. Among them there were 23 cases of locally invasive papillary thyroid carcinoma. In this paper we present our experience in treating 23 patients with locally invasive papillary thyroid carcinoma with special reference to extrathyroid spread, surgery and postoperative treatment. Our recommendations for the treatment of such patients are total thyroidectomy and selective neck dissection, removal of macroscopically visible tumors, radical surgery for tumors with intraluminal expansion in the upper aerodigestive tract and postoperative adjuvant therapy.

Extracranial propagation of glioblastoma with extension to pterygomaxillar fossa.

BACKGROUND: Glioblastoma multiforme is a highly malignant primary brain tumor that shows marked local aggressiveness, but extracranial spread is not a common occurrence. We present an unusual case of recurrent glioblastoma in 54-year old male that spread through the scull base to the ethmoid and sphenoid sinuses, to the orbita, pterygomaxillar fossa, and to the neck. METHODS: A 54-year old male underwent left temporal resection because of brain tumor of his left temporal lobe. Operation was followed by external beam radiation combined with temozolomide. The tumor recurred eight months after first surgery. The patient developed swelling of left temporal region, difficult swallowing and headache. MRI of head showed recurrent tumor, which invaded orbita, ethmoid and sphenoid sinuses, nasal cavity, pterygomaxillar fossa. RESULTS: The patient died ten months after initial diagnosis of glioblastoma multiforme, and two months after his second operation. CONCLUSIONS: The aggressive surgical operation helped to downsize the tumor mass as much as possible, but did not prolonged significantly the life or improved the life quality of the patient. The current literature is reviewed, and the diagnostic approaches as well as therapeutic options are discussed.

[Nonepidermoid carcinomas of the larynx--15 years experience in the single institution]. / Neepidermoidni tumori larinksa--15-godisnje iskustvo u nasoj ustanovi.

Nonsquamous carcinomas of the larynx are very rare and present a diverse group of diseases. Timely recognition of these tumors is extremely important for their different origin, appearance, and approach in the treatment and prognosis. Polypoid and submucosal lesions of the larynx are characteristic findings in these tumors, and probably the reason for late diagnosis even in the presence of symptoms. According to cell origin, nonsquamous carcinomas are classified into secretory, connective tissue, lymphoreticular, melanoma, or metastatic carcinoma. In this study, 771 laryngeal carcinomas treated during a 15-year (1990-2005) period at the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Zagreb, were reviewed to yield 11 cases of nonsquamous carcinoma, including one case of neuroendocrine carcinoma, leiomyosarcoma, fibrosarcoma, rhabdomyosarcoma, adenoid cystic carcinoma, and plasmacytoma, 2 cases of chondrosarcoma, and 3 cases of high-grade mucoepidermoid carcinoma. Our experience and treatment results for these tumors are presented.

Chronic unreduced anterior shoulder dislocation: application of anatomy to forensic identification.

The uniqueness of anatomic structures and their variations provide the basis for forensic identification. During the identification process of 1991-1995 Croatian war victims, forensic pathologists and forensic anthropologists were faced with the problem of incomplete skeletal remains and insufficient premortem medical data. Here we present a case of anterior shoulder dislocation, which was a key confirmation in the identification of a war victim. In our case, anterior shoulder dislocation was not medically treated for 15 years, and the changes in the glenoid cavity and coracoid process indicated morphologic adaptation of anatomic structures to the new mechanical and physiological demands.

Bilateral arterial and nervous variations in the human upper limb: a case report.

During routine dissection, we found bilateral arterial and nervous anomalies in a female cadaver. On the left side the axillary artery divided into a medial brachial artery and lateral profunda brachii artery, and the musculocutaneous nerve arose from the upper trunk of the brachial plexus, before the formation of the lateral cord. On the right side a common trunk that divided into the circumflex scapular artery, thoracodorsal artery and posterior circumflex humeral artery was observed, while the musculocutaneous nerve fused with the median nerve.