Gordana Djordjevic

Ectopic mammary tissue in vulva.

BACKGROUND Ectopic mammary gland tissue is a residual tissue that persists during the embryologic development along ectodermal primitive milk streaks. Incomplete involution anywhere along the primitive milk streak can result in accessory or ectopic mammary tissue. CASE REPORT A woman, 27-year old, admitted to Obstetrics and Gynecology Clinic Kragujevac for surgery, of goose-egg size, vulva tumor, of elastic consistency. Menarche started in 12 years of age, with the regular menstrual cycle, without previous gyneocological diseases. The woman had one pregnancy terminated by cesarean section because of the multiple (twin) pregnancy. Excision of the tumor was completely done in the total endotracheal anesthesia. Pathohistologic (PH) findings was: Dysplasia fibrosa cystica simplex mammae, with focuses of sclerosing adenosis. Expression of estrogen (ER) and progesterone receptors (PR) were positive. CONCLUSION Ectopic mammary tissue in vulva in adult period is very rarely seen, and can be changed pathologically as well as normally positioned breast tissue into benign cystic changes, benign tumors, adenomas and fibroadenomas and tumors. Cells with low ER/PR receptor level grow independently of estrogene stimulation and they could be resistant to hormonal therapy effects.

Radical resection of giant chondrosarcoma of the anterior chest wall.

BACKGROUND Chondrosarcomas represent approximately 30% of primary malignant bone tumors, the most frequent of which is on anterior thoracic wall. CASE REPORT We presented a case of 50-year-old man suffering from a slow-growing, painless giant chondrosarcoma of the anterior chest wall. A wide resection was performed to excise the tumor including attached skin, right breast, ribs, sternum, soft tissues and parietal pleura. Mediastinum was not affected by the tumor. After resecting a 26 x 20 x 22 cm segment, the chest wall defect was reconstructed with a Marlex mesh and extensive latissimus dorsi myocutaneous flap pedicled on the right thoracodorsal vessels. Histopathology diagnosis was chondrosarcoma G 2-3. The mechanics of ventilation was not altered and respiratory function was normal from the immediate postoperative period. Three years after the operation postoperative results showed no local recurrence and excellent functional and aesthetic results were evident. Respiratory function remained unaltered. CONCLUSION According to the results it can be concluded that the use of Marlex mash and myocutaneous flap is good method for stabilization of the chest wall and enough to avoid paradoxical respiratory movements in managing giant chondrosarcoma of the anterior chest wall.

Principles of reanimation in managing thoracic injuries

Bez obzira na težinu povreda grudnog kosa vecini povređenih može se pomoci ako se povrede prepoznaju na vreme i ako se, pre svega, na vreme preduzmu reanimacijske mere i pruži odgovarajuca prva pomoc. Primenom reanimacijskih mera stvaraju se uslovi za ocuvanje vitalnih funkcija povređenih i primenu ostalih vidova lecenja. Tako shvacen koncept zbrinjavanja povreda grudnog kosa predstavlja kontinuiran i dinamican proces u toku koga se stalno preplicu inicijalni pregled, procena stanja povređenog, primena reanimacijskih mera i hirursko lecenje, uz stalnu procenu efekta reanimacije i preduzetog lecenja.