Faculty of Medicine

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    Multiseptate gallbladder accompanied by an incomplete annular pancreas in a 19-year male patient: A case report
    (Elsevier BV, 2025-10)
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    Misimi, Shqipe
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    Trpeski, Stanko
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    Atanasov, Zvonko
    Multiseptate gallbladder (MG) is a rare congenital malformation that may occur as an isolated anomaly or in conjunction with other abnormalities of the pancreaticobiliary, urinary, and gastrointestinal systems. The coexistence of MG with an annular pancreas is an exceedingly rare phenomenon. The diagnosis is typically established using abdominal ultrasound; however, further imaging modalities are often required to delineate the detailed anatomy and to identify any associated anomalies within the pancreaticobiliary system. We present a case of a symptomatic MG associated with an incomplete annular pancreas. This case underscores the importance of considering additional congenital anomalies in patients diagnosed with MG, as such associations may influence clinical management and outcomes.
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    Primary Renal Squamous Cell Carcinoma in Native Polycystic Kidney and Ureter 16 Years After Living Donor Kidney Transplant
    (2021-07-16)
    Popov, Zivko
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    Ivkovski, Ljube
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    Atanasov, Zvonko
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    Jovic, Goran
    We describe a case of a 55-year-old woman with polycystic kidney disease who received a living donor kidney transplant 16 years earlier and was on immunosuppressive therapy with satisfactory renal function. The donor was her mother. The patient presented with flank pain on the right side and macrohematuria, and noncontrast computed tomography and magnetic resonance imaging led to the diagnosis of tumors in the remaining right native polycystic kidney and ureter, as well as secondary retroperitoneal dissemination. We performed right radical nephrectomy and ureterectomy with extirpation of 2 metastases; the left native kidney remained intact. Histology showed squamous metaplastic changes and invasive epithelial neoplasm in the lumen of the renal pelvis and ureter with extensive squamous differentiation positive for nuclear p63 as squamous cell immunohistochemical marker. After surgery, an immunosuppressive therapy with methylprednisolone was administered, without calcineurin inhibitors and mycophenolate mofetil. Twelve months later the patient was still alive, with a glomerular filtration rate of 29 mL/min. Needs remain for further treatment modalities in patients with primary squamous cell carcinoma in nonfunctioning kidneys and improvements in imaging technique accuracy.