Ljiljana Vuckovic

Prognostic relevance of CD105-assessed microvessel density in laryngeal carcinoma

OBJECTIVE: To examine immunohistochemical expression of CD105 among patients with laryngeal cancer and investigate the prognostic significance of CD105-assessed microvessel density (MVD). STUDY DESIGN: Cross-sectional study. SETTING: University hospital. SUBJECTS AND METHODS: The study comprised 80 patients with laryngeal squamous cell carcinoma who underwent complete excision. Clinicopathological data were collected retrospectively. Immunohistochemical analysis was performed with CD105 (endoglin) antibody. Positive-stained microvessels for CD105 were counted on hot spots of tumors at ×200 magnification. RESULTS: Average CD105-assessed MVD in considered laryngeal squamous cell carcinomas (SCCs) was 12.9 (SD 3.84). High expression of CD105 correlated significantly with advanced T (tumor) classification (P = 0.008), advanced TNM (tumor, node, metastasis) stage (P = 0.001), tumor recurrence (P = 0.001), and age ≥65 years (P = 0.026). The multivariate logistic regression showed that a high CD105+ MVD (odds ratio [OR] 4.27; P = 0.019) and advanced TNM stage (OR 3.72; P = 0.047) were independent markers of tumor recurrence. High MVD, advanced clinical stage, the presence of lymph node metastasis at the time of diagnosis, and age <66 years were associated with worse disease-free survival. Cox regression analysis revealed that expression of CD105 (P = 0.016) and advanced clinical stage (P = 0.05) were the independent factors for disease-free survival. CONCLUSION: The present results suggest that MVD evaluation with CD105 is a promising prognostic factor for the outcome of patients with laryngeal SCC. CD105-assessed MVD could help to identify patients with more aggressive disease and increased risk of developing malignancy recurrence after treatment.

Nonsteroidal Anti-inflammatory Drug Colopathy in a Colorectal Cancer Screening Program

Objective: To present a case of colopathy related to the use of diclofenac in a patient with a positive immunochemical faecal occult blood test (iFOBT) and to discuss the influence of nonsteroidal anti-inflammatory drugs (NSAIDs) on iFOBT specificity. Clinical Presentation and Intervention: A colonoscopy in a 56-year-old female presenting with a positive iFOBT revealed diaphragm-like strictures and ulcers in the right colon. While carrying out a detailed retrospective interview, she reported a chronic backache requiring long-term NSAID treatment. Conclusion: No association has been established between chronic use of NSAID and a false-positive iFOBT. There is no need to stop NSAIDs before performing an iFOBT in a colorectal cancer screening program.

Clinical significance of understanding lateral and medial circumflex femoral artery origin variability

The common femoral artery (CFA) divides into the superficial femoral artery (SFA) and deep femoral artery (DFA). The lateral circumflex femoral artery (LCFA) and medial circumflex femoral artery (MCFA) are most often branches of the DFA, although a large number of different variations in their origin has been described. We performed microdissection on both lower limbs of 30 fetuses, gestational age from 7 to 10 lunar months. Our results show that the LCFA and MCFA usually arise from the DFA. In 78.3% of cases, the MCFA originated from the DFA. In 11.7% of cases, the MCFA originated from the CFA, and in 5% of cases from the SFA. One case showed a common trunk with the DFA. Also, the MCFA was missing in one case, and it had a common trunk with the LCFA in one case. In 83.3% of cases, the LCFA arose from the DFA and in 6.7% of cases from the CFA. In one case, it had a common trunk with the DFA, and in one case with the MCFA. In 3.3% of cases, the LCFA was missing. In 66.7% of cases, both arteries originated from the DFA, in 15% of cases one originated from the DFA and the other from the CFA or SFA. Our results are in accordance with some published studies but also differ from the outcomes of other studies. Comprehensive knowledge of different variation types is imperative in order to prevent complications during surgical and orthopedic interventions.

Preoperative misdiagnosed gastrointestinal stromal tumor surgical “transferred” into gastric duplication cyst

Introduction. Gastrointestinal duplications are rare congenital anomalies, especially in the adult population which can occur along the entire gastrointestinal tract. The rarest among them are gastric duplications, making up 2–8% of all gastrointestinal duplications. Unusual embryonic malformations can be found even in the adult population and should always be considered in the differential diagnosis of thoraco-abdominal tumors. Unclear findings during preoperative diagnostic procedures are the reason for presenting the case. Case report. We present a 33 years old female, with tumorous lesion in the stomach wall, which had the endoscopic ultrasound features of gastrointestinal stromal tumor. During surgery, it was determined that the lesion was actually a cystic formation with gelatin content and histological examination confirmed the diagnosis of gastric duplication cyst. Conclusion. Preoperative diagnosis of gastric duplication cyst has always been a challenge for clinicians, since its morphological appearance may vary. That is the reason why these anomalies are often misdiagnosed as solid tumorous lesions by imaging methods and even by the most superior ones, and set up the surgery as a part of diagnostic algorithm.