Reliable preoperative staging of cervical cancer is important to evaluate and compare the results of different therapeutic modalities, including, surgical treatment, chemotherapy and radiation therapy. The diagnostic reliability of preoperative staging of cervical cancer by cervical biopsy and endocervical curettage was evaluated by a retrospective diagnostic study. The results of this preoperative staging were compared with the stage of cancer set on the basis of histopathological examination of the samples. Only patients who were clinically staged as early (operable) to the disease stage were included in the study. Postoperative diagnosis in 98 patients was exocervical cancer, in 12 endocervical cancer in 5 it was H-SIL (CIN III), and in 4 patients it was chronic cervicitis. The diagnostic reliability of preoperative staging of cervical cancer by cervical biopsy and endocervical curettage was 76.9%. In order to reduce errors in the staging of cervical cancer, it is advised that it be performed in specialized cancer centers by an experienced oncology gynecologist.

Congenital simple hepatic cysts are extremely rare, and are usually asymptomatic. The therapeutic approach for simple liver cysts is still subject of debate. We present a case of a giant liver cyst removed with minimally invasive laparoscopic approach in a 68 years old women presented with rapid weight loss.

We are the witnesses of a significant increase in chronic kidney diseases (CKD) occurrence. There is scarce literature evidence about functional integrity and natural adaptation of endocrine system axes in patients with different stages of always progressive CKD. Such a problem is growing with the beginning of renal replacement treatments (peritoneal and hemodialysis) or even with renal transplantation. The close monitoring of CKD patients by nephrologist and endocrinologist is mandatory because the natural adaptation of the endocrine system in CKD patients must be differed out of endocrine dysfunction, which has to be treated. Endocrine dysfunction management principles are mostly the same as for the patients with no CKD, except for close drug dose monitoring, especially in the circumstances with concomitant renal replacement treatment.

Breast cysts are the most common benign changes at women aged 35 to 50 years old. Usually there isn’t highest risk for breast cancer in women with cystic changes, but in the rare cases cancer can be found in association with a cyst. We reported two patients aged 33 and 45 years old. Both of them had breast cystic changes. We performed Fine Needle Aspiration (FNA) with cytological examination of the aspirated content, the breast ultrasound examination and mammography for second patient. Cysts were surgically removed and sent to the final histopathological verification. Patient 33 years old was diagnosed medullary breast cancer and undergone axillary dissection and breast sentinel node biopsy (SNB) with histopathological (HP) and immunohistochemical (IHC) findings, after that patient was treated with adjuvant chemotherapy. In patient 44 years old was diagnosed mucinous breast cancer, performed partial breast resection with axillary dissection and applied adjuvant hormonal therapy. Radiotherapy was conducted on both patients and they were followed for 3 years by a regional oncologic dispensary. Although malignant cells wasn’t find by cytological examination we have to be careful because in the wall of the cyst may be malignant cells, so histopathological (HP) and immunohistochemical (IHC) findings are the most relevant diagnostic procedures. Primary treatment of breast cancer is surgery, but important role in management have postoperative radiotherapy, chemotrerapy and hormonal therapy. Survival depends on the size, type of tumor and affected lymph nodes. Prognostic parameters which should be considered are: menopausal status, tumor size, tumor location, lymph node status, tumor type, nuclear grade, histological grade,
hormone receptors and tumor markers.

Pregnancy-associated breast cancer is defined as breast cancer diagnosed during pregnancy or in the first postpartum year. High hormons level (estrogen, progesteron and prolactin) during this specific period make structural changes, increase breast volume and density and make the diagnosis often very difficult. We present the case of 38 old women, who noted a painless breast mass during first month of breastfeeding.

This study aimed to evaluate the degree of involvement and infiltration of the pelvic lymph glands in endometrial cancer. The retrospective study included patients who were diagnosed with endometrial cancer after exploratory curettage, and who were then referred for surgical treatment with partial or total pelvic lymphadenectomy. We analyzed 99 patients who met the inclusion criteria. Pelvic lymphadenectomy is the treatment of choice in patients with medium and high risk endometrial cancer for disease recurrence. Given the importance of the evaluated issue, it is necessary to perform randomized studies to examine the therapeutic effect of pelvic and paraaortic lymphadenectomy, especially in patients at medium and high risk for recurrence of endometrial cancer.

The debate of proponents of laparoscopic and classical colorectal surgery is still ongoing, especially on the oncological principles of colorectal malignancy treatment. For now, there are promising results in terms of the adequacy of laparoscopic surgery in the treatment of this disease. The study involved 60 patients with acceptable generalized operability and a diagnostically verified malignant neoplasm of colorectum. Patients were divided into two groups of 30 patients: patients who were operated with open and laparoscopically assisted colorectal surgery. Two groups of factors were collected and analyzed for all patients. The first group of factors was known preoperatively and the second group of factors was known postoperatively. There was no significant differences between the two groups concerning the age, sex, ASA score, preoperative hemoglobin values, blood type. Both groups were the most represented in the rectum cancer. The largest number of patients was G2 grade 49.1%. Surgical margins were negative for cancer in all examined patients. There was a statistically significant difference, in terms of a larger number of removed lymph glands in open surgery treated patients. The average number of lymph nodes removed laparoscopically was 14 (range 5-40), while in the classic-open group number was 20 (range 8-44). Laparoscopic group were able to retrieve >12 LNs in 70% of the cases while in classic-open group were able to retrieve >12 LNs in 93% of the cases. The third stage of the disease was significantly more prevalent in the classical group of patients than in laparoscopic group of patients (17: 7 patients). The average volume of the removed tumor in the laparoscopic group is 73 cm3, while in the classical group the average volume is 99 cm3. Our results show that classic-open and laparoscopic approaches in colorectal cancer surgery are associated with the retrieval of greater than 12 LNs, therefore both are adeqate for safe oncological treatment of this disease. With classic-open colorectal surgery, we are still able to retrive more matching LNs, compared to laparoscopic surgery.

The aim of this study is to show the correlation between histopathological findings of preoperative exploratory uterine curettage with the result of postoperative histopathological findings in endometrial cancer. Our retrospective study included 386 patients who underwent exploratory curettage and were diagnosed with endometrial cancer, and who were then subjected to surgical treatment for endometrial cancer. The patients were operated on in the period from 2016-2020. at the Gynecology and Obstetrics Clinic “Narodni Front”. Retrospectively, 388 patients who underwent exploratory curettage and were diagnosed with endometrial cancer were included, who were then operated on. The mean age of the patients was 62.7 years and the coincidence of the findings of the histopathological type of endometrial cancer obtained by exploratory curettage and postoperatively was determined in 71.6%, and the coincidence of the histological grade of the cancer in 61.6% of cases. Exploratory uterine cirrhosis is a diagnostic procedure for endometrial cancer. Our results showed that in 4% of cases of endometrial cancers diagnosed by exploratory curettage, they were not found in the postoperative histopathological finding

Fat embolism syndrome represents a life-threatening condition in which blood vessels become clogged by fat droplets coming from fractured parts of the bones seldomly seen in patients with orthopedic trauma. Absence of specific diagnostic criteria and varying degree of presentation symptoms makes it hard to be diagnosed. We present a 20-years-old male injured in road traffic accident as a pedestrian, diagnosed with polytrauma and lethal outcome on the second day of admission. Autopsy and pathohistological findings confirmed death due to damage of important brain centers, as well as signs of massive fat embolism with fat particles found in lungs blood vessels as well as in systemic circulation, suggesting paradoxical embolism throughout exceedingly uncommon pulmonary right to left shunt capillaries, since completely closed heart foramen ovale was also found.

Hyponatremia is an electrolyte disorder frequently encountered in clinical practice. The first step in the diagnostic evaluation of hyponatremia is the volume assessment (clinical estimation of hypo/hypervolemia presence). In the cases of euvolemic hyponatremia, followed by decreased plasma osmolality (<275mOsm/kg) with urine osmolality >100mOsm/kg, urine sodium >30mmol/L along with normal intake of salt and water, preserved pituitary, adrenal, thyroid, adrenal function as well as no recent use of diuretics, syndrome of inappropriate diuresis (SIAD) is diagnosed. In symptomatic, especially acute hyponatremia, careful and gradual substitution by 3 (10) % sodium-chloride infusion is advised with liquid intake restriction, the administration of demeclocycline, urea, or vaptans, as well as causal treatment of SIAD. SIAD is often transient and etiologically clear. In this paper, we present two cases with idiopathic, chronic SIAD with poor outcomes. During the diagnostic follow-up, the cause of SIAD was not found. The autopsy finding was also adverse. In most cases, euvolemic hyponatremia in patients with chronic, idiopathic SIAD is an ominous sign.