Faculty of Medicine
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Item type:Publication, Gastric metastasis from high-grade soft tissue sarcoma: a rare occurrence with literature review(Oxford University Press and JSCR Publishing Ltd, 2025-03-15); ; Todorova, TeodoraMetastasis of high-grade soft tissue sarcoma to the stomach is an extremely rare occurrence. While sarcomas can spread to distant organs,they most commonly metastasize to the lungs,liver,and bones.We report a unique case of gastric metastasis from a high-grade soft tissue sarcoma,occurring 4 years after the initial diagnosis of fibrosarcoma in the right femoral region.The patient did not undergo adjuvant chemotherapy and developed a large soft tissue metastasis in the left gluteal region 2 years later. After 4 years, he presented with a second soft tissue metastasis and suspected metastatic lung nodules. Symptoms of melena and severe anemia prompted a gastroscopic examination, which revealed gastric metastasis from a high-grade soft tissue sarcoma. Due to severe anemia, a palliative gastric resection was performed.A review of the literature indicates that metastatic leiomyosarcomas are the most frequently reported sarcoma subtype metastasizing to the stomach. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Effects of age and gender on concentration of lipid parameters and glucose in elderly patients(Македонско лекарско друштво = Macedonian medical association, 2024-12); ; Objective: Lipids have significant biochemical functions, but their excess can also be a high-risk factor for cardiovascular disease (CVD). Glucose levels, diabetes and as well aging seriously contribute in increasing the prevalence of CVD. The main aim of the study is to analyze the correlation between age and gender with the concentration of lipid parameters and glucose in elderly patients. Material and methods: A total of 50 patients selected from the Medical Biochemistry Laboratory in Bitola were included in the study. Triglycerides (TG), total cholesterol (TC), and fasting blood glucose levels were measured quantitatively using standard methods. Results were evaluated to identify a potential association between age, gender and blood glucose as well as lipid parameters. Results: The selected group consisted in 50 patients, of whom 24 (48%) males and 26 (52%) females. The age ranged between 55 and 83 years old, with a median age of 72. The median value of each was as follows: triglycerides 1,614 mmol/l (ranging 0.5-5.9 mmol/l), cholesterol 5.464 mmol/l (ranging 3.3-7.7 mmol/l) and glucose 6.85 mmol/l (ranging 4.8-13.4 mmol/l). We compared the parameters regarding gender and age. No correlation was found when comparing the age and value of triglycerides or cholesterol, while regarding the glucose status, Pearson`s correlation was not statistically significant (p=0.06). Chi-squared test regarding the gender and the normal or results above the reference value showed a statistical significance regarding the triglycerides status and gender (p=0.011). There was no statistical significance regarding gender and results of cholesterol and glucose levels. Conclusion: Our results show a plausible correlation between these parameters and the gender of the patients. Considering the increasing age, decreasing levels of hormones especially estrogen in women, factors such as lifestyle and habits, regular checkups are required. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Conoccurence of extraskeletal osteosarcoma and undiagnosed Paget disease in a 49-year-old female(Oxford University Press (OUP), 2025-01); ; Angelovska, TamaraExtraskeletal osteosarcoma (ESOS) represents a rare soft tissue entity, accounting for ⁓1% of all soft tissue malignancies. It is generally considered to have an even worse prognosis than bone osteosarcoma, therefore detailed investigations and proper treatment are required. ESOSs arising in the subcutaneous tissue are even rarer than the ones positioned in deep tissues, and they are considered to have far better outcomes. We present a case of a 49-year-old patient diagnosed with subcutaneous ESOS and Paget disease of the bone, which is not typical for the patient's age, considering that Paget disease of the bone tends to affect a population above 50 years. The coexistence of these two entities in a single patient and all their features make this case unique, and to the best of our knowledge, this is the first case reported. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Autologous vascular proximal fibular graft in the treatment of giant cell tumor of the distal radius-a case report(Oxford University Press and JSCR Publishing Ltd., 2024-08); ; Giant cell tumor of bone (GCTB) represents an intermediate, locally aggressive tumor, with a peak of incidence in the third decade of life with female predominance (2:1). The distal radius is the third most common localization and especially challenging in the treatment is saving the wrist joint function. In this report, we present a case of a 32-year-old patient diagnosed with a giant cell tumor of the distal radius, primarily treated with curettage of the bone. Due to aggressive tumor recurrence, considering local control of the tumor, we decided to perform a resection of the distal radius and reconstruction with an autologous proximal vascular fibular graft. We performed a SPECT/CT scan to confirm the functionality of the graft. We find this procedure a safe technique for local control of tumor recurrence and an ideal substitute for a limb salvage procedure. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, A clinicopathological study of invasive apocrine carcinoma of the breast: a single centre experience(Springer, 2024-09); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Immunohistochemical expression of ER, PR and AR in papillary thyroid carcinoma(Springer, 2024-09); ; Background & objectives: From all types of thyroid carcinomas, papillary thyroid carcinoma (PTC) is the most common type. The present study aimed at evaluating the immunohistochemical expression of estrogen receptors (ERs), progesterone receptors (PRs) and androgen receptors (ARs) in PTC compared to goiter. Methods: The retrospective study included 12 cases of PTC and 6 cases of goiter. The cases were diagnosed in the period between December 2020 and March 2021. All of them were retrieved from our database and immunohistochemical staining of formalin fixed paraffin embedded tissues was performed, for ERs, PRs and ARs. Results: From twelve cases of PTC, three were male and nine were female with age range from 19 to 72. All of the goiter cases were female patients, with age range from 34 to 64. Six out of twelve PTC cases were positive for ER in comparison to two out of six goiter cases with a statistically significant difference (p < 0,05). Regarding PR, eight out of twelve PTC cases were focaly positive, and all of the goiter cases were negative. Ten out of twelve cases of PTC were positive for AR, in comparison to one out of six goiter cases with a statistically significant difference (p < 0,05). Conclusion: The results of the present study indicate that malignant cells in PTC express ER, PR and especially AR, in comparison to goiter. That is suggesting that these hormonal receptors may play a role in thyroid cancer tumorigenesis, and that these patients may benefit from hormonal therapy, which should be verified in further studies. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Serrated lesions and polyps of colon(Macedonian Society of Gastroenterohepatology, 2023-05); ; Introduction: Serrated lesions and polyps are characterized by the unique architectural pattern of epithelial infoldings into the gland lumen creating a sawtooth (“serrated”) type appearance. Most serrated polyps are asymptomatic and therefore are incidental endoscopic finding. There are 4 main histologic types: hyperplastic polyps, sessile serrated lesion, sessile serrated lesion with dysplasia and traditional serrated adenoma. As many as 30% of colorectal carcinomas arise from serrated neoplasia pathway. Material and methods: Our study analyzed serrated lesions in a one-year period (2022) diagnosed at Institute of pathology, Faculty of medicine in Skopje. Polypectomies were performed at the University Clinic of Gastroenterohepatology in Skopje. All polyps were formalin fixed, paraffin embedded and the sections were routinely stained with HE. Results: We had 99 cases of serrated polyps of colon of which 49 cases were hyperplastic polyps and 50 were sessile serrated lesions. Twenty-seven cases of hyperplastic polyps were males and 22 were females. Thirty-one males had sessile serrated lesions and 19 were females. There were 26 cases of serrated lesions with dysplasia and 24 without dysplasia. Sixteen patients had associated another type of lesion, the most common was conventional tubulovillous adenoma. Conclusion: Serrated lesions in our study were more common in males. Small hyperplastic polyps in distal colon have no malignant potential. Dysplasia was found in almost half of the cases with serrated lesions. Although most of the serrated lesions contain no dysplasia, missing serrated polyp with dysplasia on endoscopy may increase the risk for postcolonoscopy cancer. Follow up intervals are recommended especially in large serrated polyps (>1cm) because of the risk for colorectal carcinoma. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Ectopic Prostatic Tissue in Uterine Cervix: A Case Report(2022-04); ; ; Tanturovski, DraganSpeaking about prostate in the context of a female patient would sound rather odd to the vast majority of interlocutors. We describe a case of ectopic prostatic tissue in the uterine cervix in a 30 years old patient. The microscopic analysis of the cervical cone biopsy showed H-SIL in the lower-left quadrant, diffuse foci of L-SIL, as well as a focus of low-grade cervical glandular intraepithelial neoplasia in the lower-left quadrant. Tubulo-alveolar glands were incorporated deeply in the cervical stroma were identified in the lower right quadrant, lined with two-layered,cuboidal to columnar, secretory epithelium, resting on a basal cell layer. The immunohis- tochemical analysis showed strong and diffuse PSA positivity in the superficial secretory cells, while the basal cells were CKHMW positive, as well as a partial positivity of Smooth muscle actin. Diagnosis of H-SIL accompanied by LCGIN and aberrant prostat- ic glands in the cervical stroma was made. In almost all reported cases, ectopic prostatic tissue in the female genital tract is a benign condition, although a further follow-up of the patients is required. Possible theories of histogenesis include a developmental anoma- ly, metaplasia of pre-existing endocervical glands, and derivation from mesonephric remnants. It is important that pathologists be aware of this condition and to take it into account in the differential diagnosis. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Expression of Major Vault Protein in ovarian carcinoma(Macedonian Association of Anatomists and Morphologists (MAAM), 2021-09); ; ; Introduction: The major vault protein (MVP) is a component of large ribonucleoprotein complexes called Vaults. Vaults are organelles in eukaryotic cells, three times bigger than the ribosomes, associated with the nuclear pores. Their function has not been fully elucidated. Vaults are probably involved in RNA trafficking and cell signaling by regulating the selective permeability of the nuclear pores. Since Scheffer et al. showed that MVP is identical to the LRP (Lung Resistance Protein), a new role for the vaults emerged - a multi-drug resistance in malignant tumors. Objective: To evaluate the expression of MVP in advanced high-grade ovarian carcinoma and analyze possible correlations to the disease course and chemotherapy response. Material and methods: We tested the expression of MVP in 31 cases with ovarian cancer treated with the same postoperative chemotherapeutic protocol, 17 of which had a satisfactory response to the therapy (group I) and 14 had a poor response (group II). MVP expression was tested with immunostaining using the LRP-56 primary antibody and En-Vision Flex (DAKO) visualization kit and in two of the positive samples, electron microscopy was performed to confirm the localization of vaults at the nuclear pores and correlate the immunostaining pattern. Results: We found MVP over-expression in 50-100% of the tumor cell population in the second group, compared to cases with negative staining and cases with MVP staining in less than 30% of tumor cells in samples from the first group (p<0,01). Anti-MVP staining prior to chemotherapy could be a beneficial prognostic marker in cases with ovarian carcinoma, especially having in mind that its visualization (detection) exploits routine methodology. Conclusion: We found MVP expression in more than 50% of tumor cells in advanced highgrade ovarian carcinoma in 38.7% of cases. This overexpression is correlated to worse chemotherapy (platinum-based and taxanes) response and shorter event-free time.