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Author: search.filters.author.Jovcheski, Lazo

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    Appendiceal neuroendocrine tumor in a pediatric patient – A case report
    (Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2026-02)
    Jovcheski, Lazo
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    Andonovska Dokovska, Biljana
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    Stepanovski, Aleksandar
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    Gjorik, Sanja
    Appendiceal neuroendocrine tumors (NETs) are the most common appendiceal neoplasms but remain rare in the pediatric population. They often present with clinical features mimicking acute appendicitis and are therefore usually diagnosed incidentally on histopathological examination after appendectomy. Prompt identification is crucial, as tumor characteristics determine management and prognosis. We report a case of a 13-year-old girl presenting with clinical and radiological signs of acute appendicitis due to fecalith obstruction and a right ovary cyst. Laparoscopic appendectomy and ovarian cystectomy were performed without intraoperative suspicion of malignancy. Histopathological analysis revealed a well-differentiated neuroendocrine tumor measuring 1.5 cm localized near the tip of the appendix. The lesion infiltrated all the layers of the appendix wall and penetrated the serosa, without lymphovascular invasion or mesoappendiceal extension. Immunohistochemical staining confirmed the diagnosis. Multidisciplinary tumor board decision guided further management and the patient remains disease-free at twelve-month follow-up. Outcome was promising with no recurrence, metastasis, complications, or need for additional therapy observed during follow-up. The discussion section emphasizes the critical role of histopathological analysis of appendectomy specimens and gives further recommendations for efficient management of appendiceal NETs in children, depending on tumor size and histological risk features. Appendectomy alone is usually sufficient for tumors less than 2 cm without invasion. This case underscores the critical role of histopathological vigilance and multidisciplinary care in pediatric surgical oncology.
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    CILIATED VULVAR CYST IN A 13-YEAR-OLD GIRL- CASE REPORT
    (Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2024)
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    Naunova, Vesna
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    Jovcheski, Lazo
    Vulvar cysts are rare, mostly benign lesions in childhood, originating from Miller's embryonic tissue and associated with progesterone action. The interior of the cysts is lined with columnar epithelium with cilia. They can be asymptomatic until they reach a size that causes heaviness and pressure on the surrounding tissue and aesthetic deformity of the vulva. Case report: A 13-year-old girl presented with a large elongated cystic structure originating from the right labia majora of the vulva, with a length of about 20 cm, without significant symptoms, except for discomfort in the external genitalia. The cyst was surgically removed and the histopathological findings confirmed the existence of a ciliary vulvar cyst, originating from Miller's structures. After the operation, the cosmetic result was excellent and the young patient felt relieved. Conclusion: Vulvar cysts are a rare finding in childhood and puberty, but they can also reach large sizes. The treatment is surgical excision, which provides a cure, correction of the normal anatomy of the vulva, and histological confirmation of the diagnosis.