Faculty of Medicine

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    COMPARATIVE ANALYSIS OF PREOPERATIVE AND POSTOPERATIVE DIAGNOSIS IN SKIN MELANOMA
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2021-12)
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    Gruev, Vladislav
    Introduction: Taking into account the increase in incidence and high mortality in advanced stages, early diagnosis is a prerequisite for successful treatment of melanoma. The aim of this study was to determine the concordance between dermatological (withdermoscopy), surgical and pathohistological diagnosis in patients with a suspicious finding of skin melanoma. Material and methods: A comparison between the clinical and pathohistological diagnosisof patients of both sexes, of all ages, with a referral diagnosis of skin melanoma was made. Results: Out of a total of 535 analyzed cases, 469 (87.5%) had preoperative dermato logical findings. In 329 of these patients the referral diagnosis was in favor of melanoma. In 140 cases with a dermatological finding other than melanoma, a pathohistological finding of melanoma was obtained, 30% with a dermatological finding.In addition to melanoma, in 289 cases out of 329 cases with dermatological findings a pathohistological finding for melanoma was obtained, and in 40 cases a pathohistological finding other than melanoma was obtained. Of 66 cases without dermatological findings, 27 patients with a surgical diagnosis other than melanoma were operated on, with a pathohistological finding for melanoma - 41%. With a diagnosis of melanoma without prior dermatological examination, 39 cases were operated on, of which in 12 cases the pathohistological finding was in support of melanoma. Of 58 patients who underwent dermoscopy, 78% had a matching dermoscopic and pa thohistological diagnosis. Conclusion: The results of this study showed a high percentage of erroneous preope rative diagnoses
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    Solitary lung metastasis of malignant melanoma - Case report
    (Turkish Respiratory Society; Respiratory Society of Serbia, 2017-04)
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    Kochovska Kamchevska Nade
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    Bushev Jane
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    Smileska Snezana
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    Baloski Marjan
    Malignant melanoma is increasing last thirty years, one of the most common cancers in young adults (especially women). Primary localization on skin, mouth, intestines, eye. Survival in malignant melanoma stage IV is 10-15%, better prognosis have patients with normal lactate dehydrogenase (LDH). Lung metastases are usually asymptomatic, multiple, nodular. Desmoplastic (neurotropic, spindle cell) melanoma is rare form of infiltrating carcinoma, with diificult diagnosis due to similarity to un-melanocytic lesion as scar, fibroma, cyst. Female patient, 69 years of age, hospitalized for changes seen on chest X-ray. Symptoms: intermittent pain in left shoulder, dyspnea. Profession: housewife, non-smoker, comorbidity: arterial hypertension. Normal lung auscultatory finding. Laboratory: sedimentation 20, hemoglobin 11,9, LDH and tumor markers (CA19-9, CEA, CA 125, CA 15-3) normal. Chest X-ray: left apical, oval, soft-tissue shadowing. Bronchoscopy – without pathological findings. A computed tomographic chest scan showed: in left apicoposterior segment, solid formation with dimensions 18x13,6mm, close to the pleura, that accumulated contrast, two mediastinal lymph nodes 5,7mm and 8,5mm. CT guided transthoracic lung core biopsy was performed. Histopathological diagnosis - Metastatic process of Spindle cell melanoma malignum. Microscopic examination with accumulation of large, pleomorphic cells with deposits of melanin irregularly arranged. The origin and systemic dissemination of the melanoma was investigated. Abdominal ultrasound without abnormalities. Dermatological, ophthalomological, gastroenterohepatological examinationas were performed, but the primary lesion remained unknown. The patient denied to receive proposed oncological and surgical therapy. Two years after, control CT scan, the tumor was 47x43mm, in right lung secondary deposite 11x8mm, increased mediastinal lymph nodes to 18mm.
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    Survival and prognosis of patients with cutaneous melanoma on extremities
    (Macedonian Association of Anatomists, 2018)
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