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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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DELAYED COMPLICATIONS FOLLOWING LONG-TERM CENTRAL VENOUS CATHETER PLACEMENT IN PEDIATRIC ONCOLOGY CASES
(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024)
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Litajkovska, Slavica
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Aleksovski, Zlatko
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Introduction: Modern chemotherapy protocols in pediatric oncology necessitate the deployment of central venous catheters. The duration of catheter usage ranges from several months to a year. Typically, long-term central venous catheters (LCVC), including external tunneling (ETLCVC) and totally implanted (TILCVC) variations, are employed for this purpose. Aim: This study aims to assess the superiority of ETLCVC over TILCVC and to evaluate the occurrence of delayed complications, specifically focusing on catheter occlusion, dislocation of the catheter and catheter – related thrombosis, following the placement of central venous catheters. Material and Methods: This prospective interventional clinical study encompassed 120 pediatric patients, aged 2-14 years, diagnosed with leukemia, lymphomas and solid tumors. The participants were stratified into two groups (n=60). Group 1 received ETLCVC, whereas Group 2 underwent TILCVC placement. An informative interview was conducted with the eligible patients' parents, and written consent for study participation was obtained. Results: In the group of patients with an implanted ETLCVC, four patients had a dislocation of the catheter, three patients had a catheter occlusion, two patients had a catheter – related thrombosis. In the group of patients in whom a TILCVC was implanted, one patient had an dislocation of the catheter, one patient had catheter occlusion, and there wasn’t any patient with catheter – related thrombosis. Conclusion: Incidence of delayed complications (catheter occlusion, dislocation of the catheter, and catheter –related thrombosis) in our study were more frequent in patients in whom ETLCVC was applied, but this difference did not have statistical significance.
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Scar cosmetics after laparoscopic (PIRS) and open repair of inguinal hernia in female children
(Hrvatsko drustvo za djecju kirurgiju; Hrvatski ljiecnicki zbor, 2022-09)
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Stepanovski, Aleksandar
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Litajkovska, Slavica

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