Retroperitoneal sarcomas are mesodermic origin and include less than 1% of all malignant tumors. The most frequent histological type of sarcoma are liposarcomas. Most commonly they are located in lower extremitetes while intraabdominal findigs are rare. Early diagnosis is quite challenging because the first symptoms occur only in advanced stages of disease. The gold standard for diagnosing is MSCT. The therapeutic approach is surgical by combining radiation therapy in case of recurrence and excision was not comletly. The chemotherapy is still controversial, and most authors consider that it is not adequate way of treatment. Seventy years old woman was admitted to the department of surgery because of the pain located in theleft half of the abdomen. It lasts for 3 monthsand in recent times became stronger and accompanied by nausea. Stooll and urin were regular . Physical examination revealed painfully formation. Velaues of blood examples were within normal range. US and MSCT of the abdomen were made before operation. MSCT showed retroperitoneal TU formation size 52x35cm. The findings were confirmed during the operation. Tumor weight was 9250g. Histopathological examination showed that it was a low-grade myxoid liposarcoma. One year after surgery, there was a recurrence. The first symptoms of abdominal liposarcoma manifests only in advanced stages of the disease. Radical surgical excision first choice in treatment. If the excsion lines could not be clear radiotherapy should be added.

Tumors of the gallbladder are rare. Adenomas of the gallbladder is mostly occur as papillary or tubular. Tubular adenomas of the gallbladder occur in middleaged and old people, and it is extremely rare in children. We present 61 year old woman in whom during an ultrasound examination of the abdomen for pain that lasts a long time discovered a chronic inflammation of the gallbladder and slightly polypoid tumor of the gallbladder. Cholecystectomy was performed based on ultrasonographic findings of polyps in the gallbladder. Macroscopic and microscopic established that it is a tubular adenoma type with intestinal epithelial dysplasia, which clearly indicates that it is adenoma with reliable signs of precancer Finding intraoperative cholangiography was normal, and the postoperative course was uneventful.

The aim of this paper is to present the incidence of placental abruption and placenta previa at GAO General Hospital N. Pazar like to stress the importance of bleeding in the second trimestreu pregnancy. A retrospective study was conducted at the department of gynecology and obstetrics, ZC Novi Pazar January 2008 December 2012th As the basis of the data, the history and the findings from the protocol konzervtaivno treated surgically and we pacijenata. Analizirali incidence of bleeding compared to the total number of births, maternal age, parity and gestation. During the period of 2008-2012, there were 186 abruption (1.72 %) and 34 placenta previa (0.31%). Within a given period, there were 10778 delivery of which 220 bleeding or 2.03 %. The incidence of placenta previa and ab.placente compared to 84.5% abruption and placenta previa 15.5%. The age of pregnant women who develop bleeding: the highest percentage of bleeding at the age of 26- 31god (43.6%) than in the group of 19-25 years. 82.63 % and the lowest in the group under 18 (3.18) and above 35 years of age (11.3%). Maternal parity. primipara i 92 (41.88%), second child 49 (22.27 %) , third child i 46 (20.91%), fourth child 28 (12.72%). Gestational age at which it contacted the bleeding; 8 to 27 ng (3,645), 28-34 ng 30 (13.63 %) 0.35 to 37 ng 41 (18.64 %), and 37 ng 141 (64%). Method of delivery; caesarean 117 abruption (62%) vaginal delivery 69 (38%). Placenta previa; cesarean section 28 (82.3 %) and 6 vaginal (17.6 %). Any bleeding in the second half of pregnancy should be taken seriously. Prolong pregnancy as possible. You need to pay attention to risk factors: hypertension, gestational diabetes, smoking, previous cesarean section, and in this sense preventive effect on pregnant women.

Colorectal cancer (CRC) is an important social and medical problem. Complete recovery can be achieved only if the disease is diagnosed in the early stages, most common by screening methods. Studies have shown that screening methods reduce the incidence and mortality of colorectal cancer. The methods for colorectal screening can be divided into tests that allow the detection of cancer (fecal occult blood test and fecal DNA test) and morphological tests that allow diagnosis of cancer or adenomatous polyps (flexible sigmoidoscopy, colonoscopy, double contrast barium enema, CT colography ). In people with average risk of disease, screening begins at 50 years and performed on one of the following: fecal occult blood test (every year), flexible sigmoidoscopy (every 5 years), colonoscopy (every 10 years), double contrast barium enema (every 5 years) or CT colography (every 5 years). Colonoscopy is the preferred method, and is used as a confirmatory method, if the any other methods was positive.

Mnogi autori odnedavno dovode uvezu postojanje elemenata metaboličkog sindroma(MetSy) kod bolesnika sa subkliničkim hipotiredizmom(SH).Cilj:U ovoj studiji preseka smo prikazali elemente MetSy kod novodijagnosktikovanih bolesnica sa SH ipokušali da utvrdimo njihovu povezanost. Istraživanje je obuhvatilo 70 ispitanica, 50 ispitanica sa novootrkivenim SH, i 20 eutiroidnih kontrola. Grupa bolesnica je prema vrednostima glikemije i posle OGTT testa podeljena na dve grupe, bolesnice koje imaju SH , a bez Diabetes mellitusa tip2 (DMT2), i bolesnice koje imaju i SH i DMT2. Kalkulacije su urađene pomoću EXCEL i Med Calc (verzija 9.3.8.0) programa,i pomoću programa SPSS-verzija 17. Dobili smo sledeće rezultate: Bolesnice su značajno starije u odnosu na kontrolnu grupu, imaju više vrednosti za obim struka(OS) i BMI (Index telesne mase ), značajnoveći procenat osoba sa hipertenzijom (62%) i DMT2 (36%),od toga 14% novootkrivenih sa DMT2, dok u kontrolnoj grupi nije bilo DM. Vrednosti glukoze i HbA1c su više u grupi bolesnica u odnosu na kontrolnu grupu, a nema razlike u insulinemiji i HOMA. Očekivano su vrednosti TSH i Anti TPO-At više, a koncentracije FT4 značajno niže kod ispitanica sa SH u odnosu na kontrolnu grupu.Utvrđeno je da postoji korelacija između koncentracije glukoze i TSH u grupi bolesnica,ali ne i u kontrolnoj grupi.Prevalenca MetSy je 25 % kod kontrola i 62 % kod bolesnica. S obzirom na rezultat naše studije preporučuje se odredjivanje glikemije kod svakog bolesnika kod koga je utvrđen SH,i obrnuto,određivanje tiroidnog statusa kod osoba sa DMT2. Takođe se preporučuje lečenje SH po utvrđenim kriterijumima, jer zajedno sa MetSy imaju veći rizik za razvoj kardiovaskularnog događaja.

Renocelularni karcinom (RCC) je najčešći maligni tumor bubrega kod odraslih. Čini oko 3% adultnih maligniteta i 90-95% neoplazmi bubrežnog porekla. Renocelularni karcinom može biti asimtomatski tokom najvećeg dela svoje evolucije a klasična trijada koja obuhvata lumbalni bol, hematuriju i lumbalnu masu je neuobičajena. RCC se karakteriše čestom pojavom paraneoplastičnog sindroma. Muškarac starosti 46 godina se žalio na uporan kašalj koji je trajao oko godinu dana. Negirao je druge tegobe i nije uzimao blokatore angiotenzin konvertujućeg enzima. Fizikalni nalaz po sistemima je bio u granicama normale. Rezultati laboratorijskih analiza su ukazali na ubrzanu sedimentaciju (SE 92 mm/1.h), leukocitozu i sideropenijsku anemiju (hemoglobin 103 g/L, serumsko gvožđe 4.3 μmol/l). Radiografija srca i pluća i spirometrija su bili uredni. Test na okultno krvarenje u stolici je bio negativan a vrednosti tumor markera su bile u referentnim granicama. Ultrazvuk abdomena je pokazao postojanje tumorske mase duž desnog bubrega. Kompjuterizovana tomografija abdomena je potvrdila postojanje tumorske mase veličine 93x72 mm duž celog desnog bubrega bez znakova invazije okolnih organa. Postavljena je radna dijagnoza renocelularnog karcinoma i izvršena je otvorena desna radikalna nefrektomija. Postoperativni tok je protekao uredno uporni kašalj je nestao 2 dana nakon operacije sa brzim poboljšanjem anemije i normalizacijom SE a uporni kašalj je nestao 2 dana nakon operacije. Tri meseca nakon operacije pacijent nije imao nikakve tegobe niti je bilo znakova rekurencije tumora. Veoma je važno imati u vidu čitav spektar simptoma i znakova kojima se renocelularni karcinom može prezentovati.

Mucinous aenocarcinoma is one of the least common variant of prostate cancer. The prognosis of this variant of prostate cancer remains controversial. We report the case of 67-year old men with severe lower urinary tract symptoms (LUTS), bladder outlet obstruction (BOO), and sense of urinary retention. The serum level of prostate specific antigen (PSA) was 10.4ng/mL. Prostate was large (56mL), hard, lobulated, with extraprostatic extension and infiltration of surrounding structures, unsuitable for radical operative treatment. The patient demonstrated poor response to complete androgen blockade (CAB) (bilateral orchiectomy, steroidal antiandrogen) after 6 months of treatment with minimal decline of PSA (7.1ng/mL) and progressive growth of the primary tumor (110mL). The patient is submitted to antiandrogen withdrawal consisted of simultaneous addition of ketoconazole with hydrocortison substitution, resulting in normalisation of PSA (<1.0ng/mL) and diminution of prostate volume (PV) (63 mL) after 2 months, followed by adjunctive radiotherapy. Ketoconazole in reduced doses was stopped 6 months after completion of radiotherapy with PSA level < 0.002ng/mL and PV 16mL. The patient is alive with no evidence of disease more than 9 years after diagnosis of primary tumor. This case demonstrated modest hormonal sensitivity of mucinous adenocarcinoma of the prostate, whereas ketoconazole combined with radiotherapy, resulted in long term survival.

Razlike u polu su pronađene u mnogim oboljenjima srca, kod moždanog udara i tumora.Razlike u poluu depresiji kod pacijenata satumorommozga su retko istraživane. Cilj rada Cilj ovog rada je bio da se utvrdi odnos između ispoljene depresivne epizode i pola kod pacijenata sa tumorom mozga. Metode rada Podaci se sastoje od 115 pacijenata sa primarnim tumorommozga, 61 muškaraca i 54 žena. Depresija pacijenata je procenjena Hamiltonov skalom depresivnosti (HADS). Nivo depresije kod žena je bila veća u odnosu namuškarce. Nije bilo statistički značajne razlike između muške i ženske grupe, iako je depresija češća kod žena. Naši podaci su slični kao i većina rezultata iz epidemioloških studija koje pokazuju da je depresija češća kod žena.Dalje studije su potrebne da pronađu konekciju između biološkog uzroka tumora mozga i depresije. Razlike u polu pomažu nam da razumemo prirodu neuropsihijatrijskih poremećaja, koje će nam pomoći da pronađemo specifične tretmane i strategije prevencije.

Spinalna mišićna atrofija (SMA) je autozomno recesivna neuromišćna bolest koju odlikuje progresivna denervacija skeletnih mišića usled propadanja alfa-motoneurona i sledstvena pojava hipotonije, mišićne slabosti, atrofije. Cilj rada je da se pokaže potencijalni uticaj broja kopija SMN2 na razvoj jednog od tri tipa SMA. Ispitivanjem je obuhvaćeno 74 pacijenta oba pola sa kliničkom dijagnozom SMA i to 44 (59.4%) ženskog pola i 30 (40.5%) muškog pola. Pacijenti su klasifikovani u određenu kategoriju SMA (tip 1, 2 ili 3). Glavni kriterijum za klasifikaciju bio je mogućnost samostalnog sedenja/hodanja. Dijagnozu SMA tip 1 imalo je 8 (11.3%) pacijenata, SMA tip 2 27 (38%), dok je SMA tip 3 imalo 36 (50.7%). Homozigotna delecije gena SMN1 bila je zastupljena kod 72/74 (97.2%) pacijenta, dok je kod preostalih detektovana jedna kopija ezgona 7 i 8 SMN1 gena (heterozigotni status), u kombinaciji sa tačkastom mutacijom na drugom alelu. Broj kopija SMN2 gena je bio statistički značajno niži kod SMA tip 1 pacijenta nego kod SMA tip 2 i tip 3 pacijenata (p<0.001). Broj kopija gena SMN2 je u korelaciji sa težinom kliničke slike SMA, što se može koristiti kao jedan od prognostičkih parametara kod ovog obolenja.

Schwannomas are benign sheat tumors composed of Schwann cells, which are covering peripheral nervs. Althought schwannomas can be found in any localisation, retroperitoneal scheannomas are extremly rare. Multiple schwannomas (neurilemomas) can be part of neurofibromatosis type II, as well as schwannomatosis. Depending on tumor localization, disease symptoms differ. We present a patient with multiple spinal as well as peripheral schwannomas as a part of schwannomatosis. Patient was successfully operated in cooperation between general surgeon and neurosurgeon.