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Case Reports 2014; 35(8): 673-675 PubMed PMID: 25702294 Citation  Keywords:  Adenocarcinoma:diagnostic imaging, Colonic Polyps:diagnostic imaging, Colonoscopy:instrumentation, Female, Humans, Middle Aged, Sigmoid Neoplasms:diagnostic imaging, Ultrasonography:instrumentation, Vagina:diagnostic imaging,.   

: Adenocarcinoma of the colon represents the third most frequent cause of death from cancer, being surpassed only by lung and stomach cancer. Early screening and diagnosis of polyps are important for a good prognosis. Based on a clinical case, a novel approach is presented for screening of sigmoidal polyps and neoplasia using transvaginal 2D, 3D mode in women. This novel and simple technique can be used to visualize the sigmoid diverticula during routine gynecological examination via 3D transvaginal ultrasound probe....

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Case Reports 2014; 35(Suppl 2): 211-213 PubMed PMID: 25638389 Citation  Keywords:  Choristoma:congenital, Glioma:congenital, Humans, Infant, Newborn, Male, Neuroglia:pathology, Nose Neoplasms:congenital,.   

: Neuroglial heterotopia is a rare developmental abnormality. Most frequently the diagnosis is established at birth or in early childhood by a typical clinical presentation. Neuroglial heterotopia can be intracranial or extracranial. A typical example of extracranial heterotopia is nasal glioma, which can be isolated or can communicate directly with the intracranium. The most sensitive investigation for the confirmation of its site is magnetic resonance imaging. Histological investigation is crucial in establishing the diagnosis. The authors present the case of postnatally assessed nasal glioma. They emphasize the importance of detailed prenatal investigation as most important in preventing birth trauma and consequent complications.

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Journal Article 2014; 35(7): 613-618 PubMed PMID: 25617885 Citation  Keywords:  Adult, Aged, Aged, 80 and over, Biopsy:adverse effects, Brain Neoplasms:mortality, Female, Humans, Lymphoma:mortality, Magnetic Resonance Imaging:methods, Male, Middle Aged, Morbidity, Retrospective Studies, Risk Factors, Stereotaxic Techniques:adverse ef.   

OBJECTIVES: Stereotactic biopsy is a suitable method for sampling intrinsic brain lesions. Although this method is considered to be a safe procedure, some risk of complications still exists. The aim of the study was to retrospectively assess the morbidity and mortality of MRI-guided stereotactic biopsy of lesions which were histologically proven to be brain lymphoma.

METHODS: We retrospectively studied all accessible medical records for patients who had undergone MRI-guided stereotactic biopsy of brain lesions with histologically proven brain lymphoma from January 2007 to December 2012. Our cohort included 45 patients, 27 males and 18 females, aged 23-84 (63±14) years.

RESULTS: Forty-nine biopsies were carried out on 45 patients; the average number of tissue specimens was 3±1. The diagnostic yield of the stereotactic biopsy was 92%. Overall major morbidity directly related to stereotactic biopsy of brain lymphoma was 6.1% (3 cases) including 4.1% mortality (2 cases). Both deaths after the stereotactic procedure were due to intracranial hemorrhage and subsequent complications and both these patients had a history of treatment of systemic lymphomas. In one patient the stereotactic biopsy was complicated by a brain abscess which was successfully treated.

CONCLUSION: Stereotactic biopsy is still a mandatory diagnostic procedure for primary brain lymphomas, with an acceptable risk of complications. However, according to our results, the risk of complications can be higher in patients who have previously been treated for secondary lymphomas....

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Journal Article 2014; 35(7): 602-607 PubMed PMID: 25617883 Citation  Keywords:  Adult, Aged, Breast Neoplasms:metabolism, Carcinoma, Ductal, Breast:metabolism, Carcinoma, Lobular:metabolism, Female, Fibroadenoma:metabolism, Humans, Membrane Lipids:metabolism, Middle Aged, Neoplasm Staging, Oxidative Stress:physiology, Postoperative P.   

OBJECTIVES: To evaluate the level of oxidative damage to membrane lipids due to the breast cancer surgery in the early postoperative period.

PATIENTS AND METHODS: Blood samples were collected on the preoperative day and 24 hours postoperatively in 71 women operated for breast cancer, and preoperatively in 38 female patients with benign breast tumour. Lipid peroxidation (LPO) in the blood samples was estimated by measuring the concentrations of malondialdehyde+4-hydroxyalkenals (MDA+4-HDA) with spectrophotometry.

CLINICAL DATA INCLUDED: tumour site, tumour histological findings, cancer stage, grade, tumour volume, state of lymph nodes, type of surgery for breast, type of surgery for axilla.

RESULTS: Blood LPO level was similar in breast cancer patients and benign tumour patients (2.01±0.46 nmol/ml vs. 1.92±0.39 nmol/ml, respectively; p>0.05). In cancer patients, MDA+4-HDA increased on the first postoperative day, i.e. from 2.01±0.46 nmol/ml to 2.58±0.98 nmol/ml (p=0.0001). In women with benign breast tumour, LPO did not relate to the histological finding (p=0.8915). In the breast cancer group, preoperative LPO did not correlate with age, tumour volume and number of metastatic lymph nodes. Level of MDA+4-HDA was similar in stages I/II (2.03±0.46 nmol/ml) compared to stages III/IV (1.69±0.26 nmol/ml, p=0.1521). Consequently, levels of MDA+4-HDA did not relate to disease stage (p=0.1364).

CONCLUSIONS: Surgery for breast cancer causes peripheral increase in oxidative damage to macromolecules in the early postoperative period. Therefore, perioperative antioxidant supplementation should be considered....

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Case Reports 2014; 35(5): 355-358 PubMed PMID: 25275255 Citation  Keywords:  Adrenal Gland Neoplasms:complications, Female, Humans, Hypertension:diagnosis, Middle Aged, Neoplasms, Multiple Primary:complications, Paraganglioma:complications, Pheochromocytoma:complications, Stroke:diagnosis, Syndrome, Teratoma:complications,.   

OBJECTIVES: Adrenal pheochromocytomas are rare neuroendocrine tumours, however their prevalence is probably underestimated - in some series 50% were diagnosed at autopsy. The clinical presentation varies among patients, that is why diagnosis might be difficult to establish. Pheochromocytoma may coexist with paraganglioma and when paraganglioma is diagnosed, the patient should be screened for pheochromocytoma too, especially in people with hypertension. We present a case of woman with pheochromocytoma, but diagnosed after incidence of stroke, who had also paraganglioma in the past. Additionally, a teratoma was diagnosed simultaneously.

CASE REPORT: 49-year old woman with hypertension was referred to the Department of Endocrinology, Diabetology and Isotope Therapy in Wrocław with suspected pheochromocytoma. She was operated twice because of paraganglioma of the right and left carotid artery, second operation was complicated with stroke. After administration of anticoagulants a bleeding from gastrointestinal tract occurred. During diagnostic process CT of the abdomen showed tumour in the right adrenal gland and a tumour in pelvis. Significantly elevated catecholamines and their metabolites in blood and urine confirmed the diagnosis of pheochromocytoma. Both tumours were removed surgically, the second was teratoma maturum. Genetic screening for hereditary pheochromocytoma was proceeded. A mutation in SDHD gene was revealed in patient's DNA and subsequently in blood samples of her sister and daughter.

CONCLUSIONS: Occurrence of paraganglioma with hypertension suggest need of screening for pheochromocytoma-paraganglioma syndrome, especially in case of paragangliomas in family history. Early treatment is crucial to avoid life-threatening cardiovascular complications. The association between pheochromocytoma and teratoma is unclear....

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Case Reports 2014; 35(4): 249-251 PubMed PMID: 25038605 Citation  Keywords:  Aged, Blindness:etiology, Breast Neoplasms:pathology, Choroid Neoplasms:complications, Fatal Outcome, Female, Humans, Multiple Organ Failure:etiology, Neoplasm Metastasis:pathology,.   

: Intraocular choroidal metastasis is a very rare cause of blindness. Carcinoma of breast is the most common primary malignancy the accounts for choroidal metastasis in females. Other primary neoplasms which can uncommonly metastasize to the choroid are gastrointestinal tract, thyroid, pancreas, prostate and testis. Metastatic neoplasm to the eye outnumbers the primary tumors such as retinoblastoma and malignant melanoma. We present a case of sudden loss of vision due to breast cancer metastasis to the eyeball. The interval between the diagnosis of the primary tumor and the choroidal metastasis was 4 years.

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Case Reports 2014; 35(4): 262-264 PubMed PMID: 25038597 Citation  Keywords:  Adult, Female, Humans, Laparoscopy, Magnetic Resonance Imaging, Myoma:pathology, Pregnancy, Pregnancy Complications:etiology, Treatment Outcome, Uterine Neoplasms:pathology,.   

: Patients with infertility commonly undergo various diagnostic and therapeutic procedures that may affect the future course of the pregnancy. In this presented case a female patient with infertility has been subjected to laparoscopic myomectomy and chromoscopy of the fallopian tubes, as it turned out later, 4 days after spontaneous conception. Due to severe pain in the 19th week of pregnancy the uterus area with the scar resulted from the removed myoma was visualised by magnetic resonance imaging (MRI). The MRI showed an active red degeneration in one of the myomas. At the same time the thickness of the uterus wall in previous myomectomy area was normal. The control MRI performed in the 36th week of pregnancy showed a hyaline degeneration of the myoma, underlying its dynamic refraction. The MRI approach enabled a non-invasive treatment and delivery in term....

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Case Reports 2014; 35(3): 179-182 PubMed PMID: 24977964 Citation  Keywords:  Adult, Anti-Inflammatory Agents, Non-Steroidal:therapeutic use, Bromocriptine:therapeutic use, Female, Humans, Pituitary Neoplasms:drug therapy, Polyendocrinopathies, Autoimmune:drug therapy, Prolactinoma:drug therapy,.   

: Excessive prolactin release and/or receptor action may be implicated in the pathogenesis of many autoimmune disorders. We report here a case of a woman who developed Graves' disease and subclinical autoimmune adrenal failure, and was diagnosed as having autoimmune polyglandular syndrome type 2. Because of coexisting microprolactinoma she was treated with bromocriptine for 24 months. This treatment resulted in a normalization of thyroid and adrenal function tests (with the exception of 21-hydroxylase antibodies) and reduced monocyte cytokine release. Our study indicates that bromocriptine and probably also the remaining prolactin-lowering agents produce anti-inflammatory effects and may prevent or delay the progression of autoimmune disorders of endocrine glands....

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