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Author: search.filters.author.Dalipi, Adelina

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    Lymphepithelioma Like Invasive Cervical Cancer
    (Elsevier Inc., 2025-02)
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    Stojchevski, Sasho
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    Jovanovska, Vangelica
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    Introduction/Background Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix is a rare variant of squamous cell carcinoma of the uterine cervix, composing 0.7% of primary cervical tumors. It is usually composed of nests of poorly differentiated epithelial cells encircled by a noticeable lymphocytic infiltrate, which is the hallmark of this tumor. Even though is poorly differentiated, it appears to have a better outcome than the usual squamous cell carcinoma of the uterine cervix due to lack of lymph metastases. It may be linked with HPV virus infection, or Epstein Bar virus. Methodology We present a case of a 61-year-old patient, with a main complaint of post-coital bleeding. Speculum examination revealed exophytic papillary growth on the ectocervix, biopsy was done. Histology resulted to be LELC of the uterine cervix. MRI was stage IB2. Radical surgery was done type C1 according to Querleu–Morrow classification picture 1. Results PCR for HPV and Epstein Bar virus from paraffin-embedded tissues which was positive for HPV45 but not for Epstein Bar virus. Histology from the biopsy resulted to be positive for hematoxylin and eosin stain, there were aggregates of atypical epithelial cells and numerous small lymphocytes. Tumor cells are polygonal and display poorly defined eosinophilic cytoplasm, vesicular nuclei with prominent nucleoli and increased mitotic activity, including atypical mitotic figures (picture 100x, other 400x) picture 1, there was also a positive stain for p63, CD3 and CD20. Final staging is pTIIB pN0 pMX L1 V1 R0 G3 FIGO stage IIB NG3 Conclusion It is a rare subtype of cervical cancer, there is a lot unknown due to its rarity, there are published data which confirm its association with HPV and Epstein Bar virus. Commonly it is believed that it is less aggressive due to its less lymph node involvement but data are conflicting it may be more aggressive due to this aggressive treatment is preferred. Larger studies are needed.
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    Adnexal masses in pregnancy
    (Македонското Лекарско Друштво во соработка со Медицинскиот Факултет - Скопје, 2023)
    Dalipi, Adelina
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    Objectives: The objective of this case is to present a rare case of maternal ovarian mucinous cystadenocarcinoma during pregnancy and its outcome. Only 0.05-2.4% of pregnancies are complicated by an adnexal mass, and approximately 1-6% of these masses are malignant. The majority of ovarian masses are diagnosed by a routine ultrasound examination or cesarean delivery. Adnexal masses less than 5cm usually are benign and in 70% of cases spontaneously resolve by the second trimester while the adnexal masses 5 cm or greater are dermoids and 10% found in pregnancy are malignant. One-half of all ovarian malignancies in pregnant women are epithelial ovarian tumors. Material and Methods: We present a case of 27-year-old pregnant women who was incidentally diagnosed by ultrasound examination with a large multilocular cystic adnexal mass in right ovarium at the first trimester (ml III) with diameter 88x85mm which enlarged to 88x140mm at third trimester (ml X). In week 40 of pregnancy, the patient gave birth to a healthy baby through cesarean section, during that was performed and right salpingo-oophorectomy, Results: The pregnancy was terminated at term with good pregnancy outcome. The histopathology report of right salpingo-oophorectomy describe mucinous cystadenocarcinoma of the right ovarium Stage IA according to FIGO classification. Conclusion: Surgical intervention and histological examination of persisting adnexal lesion are often necessary, even during pregnancy.
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    OUR EXPERIENCY WITH USING THE OMENTAL FLAP FOR THE TREATMENT OF GYNECOLOGIC JATROGENIC VESICOVAGINAL FISTULAS
    (SHMSHM - AAMD, 2018)
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    Ismaili, Bashkim
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    Dalipi, Adelina
    Objective: To report our experience with using the omental flap for the treatment of gynecologic jatrogenic vesicovaginal fistulas (VVF). Material and methods: The study evaluated 14 patients who underwent VVS repair with transabdominal approach with omental flap between January 2010 and December 2013. The main causes of VVF in this study cohort were 9 (64.2%) for benign and 5 (35.8%) for malignant conditions. In all cases were used omental flap with sufficient length in delayed surgical repair (after 3 month of gynecologic surgery). Preoperatively the cystoscopi with colposcopy was done to identify the size, site, number of fistulas and relationship with ureteral orifices and sites of vagina. In addition CT urography or intravenous pyelograms were performed to exclude the ureterovaginal fistulas. The dorsal lithotomy position, with infraumbilical laparothomy approach and transvesical O’Connor technique in general anesthesia were used. Before resection of fistulous canal up to fresh and healthy tissue the intubation of ureteral orifices were performed. Further multilayer defect closure beginning from vagina, omental flap interposition, followed by bladder serosa and mucosa. Next 7 days bladder was drained with urinary catheter, cystostoma and ureter stents, which were pulled out one by one next 2 days. At 10th day, before catheter removal was performed cystogram. Results: Operative method is successful in 13 (93%) of patients. After one year follow up it’s no recurrence. The bladder capacity is sufficient. Conclusion: O’conore’s technique for repairing subtrigonal and supratrigonious vesicovaginal fistulas over 10 mm in wide, with the omentum interposition, is a method that promise a high percentage of success in the first repair.
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    #1024 Low-grade malignant peripheral nerve sheath tumor of the uterine cervix
    (BMJ Publishing Group Ltd, 2023-09)
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    Stojchevski, Saso
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    ROBSON CLASSIFICATION OF CESAREAN SECTION IN NORTH MACEDONIA - CURRENT TRENDS
    (Македонско лекарско друштво = Macedonian medical association, 2021)
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    Dalipi, Adelina
    Abstract Introduction. Over the last few decades, the global cesarean section rate has significantly increased and reached an unprecedented level. The World Health Organization (WHO) has advised that cesarean section (CS) rates should not rise above 15%. Several classify¬cation systems have been proposed to tackle the increased cesarean section epidemic. Most of the countries have adopted and started using the Robson (10 groups) classification as the best and the one that is the easiest internationally applicable CS classification. Aim. To present the Robson classification as a way to start better classification of cesarean section and hence to reduce the number of unnecessary cesarean section deliveries. Methods: This study was realized at the University Clinic for Gynecology and Obstetrics in Skopje, North Macedonia. It is a retrospective study where two years were compared. Results. The rate of cesarean sections for 2017 was 38.5% and for 2019 42.6%. Categorization of deliveries according to Robson criteria showed a different rate of cesarean section for each subgroup. Discussion. The implementation of the Robson classi-fication in most countries has shown a reduction in the number of cesarean deliveries and thus a reduction in overall maternal and neonatal morbidity and mortality. The analysis has shown that group 5 had the largest number of cesarean section deliveries in both years, 2017 and 2019; these were patients with previous cesarean sections. They were followed by group 1 and 2, or pri¬mi¬para with spontaneous onset and induced delivery. Conclusion. The goal of Robson clasification is to identify the target groups that contribute most in the percentage of cesarean sections and to act on these tar-get groups through appropriate education and training.