Stoilovska, Bojana
Preferred name
Stoilovska, Bojana
Official Name
Stoilovska, Bojana
Main Affiliation
Email
b.stoilovska@medf.ukim.edu.mk
6 results
Now showing 1 - 6 of 6
- Some of the metrics are blocked by yourconsent settings
Item type:Publication, PRIMARY HYPERPARATHYROIDISM INDUCED BY AN ECTOPIC ADENOMA, INITIALLY PRESENTED AS BROWN TUMOR OF THE TIBIA(Department of Anaesthesia and reanimation, Faculty of Medicine, Ss Cyril and Methodious University Skopje, Macedonia, 2020-10); ; ; The classic manifestation of unchecked, advanced hyperparathyroidism is the brown tumor, a non-neoplastic giant cell osteomedullary lesion. We report a case of, these days rarely seen manifestation of advanced hyperparathyroidism, brown tumor due to an ectopic mediastinal parathyroid adenoma. A 63-years-old woman presented with an expansile osteolytic lesion of the right tibia on the radiographic images. Because of the suspicion of primary or secondary bone tumor, bone scintigraphy was performed. The bone scan was indicative of metabolic bone disease. Furthermore, laboratory investigations were obtained that revealed hypercalcemia, hypophosphatemia, increased level of alkaline phosphatase, and parathyroid hormone. Subsequently, ultrasound of the neck was performed, but no enlarged parathyroid glands were detected, so the patient underwent dual-phase 99mTc-methoxy-isobu- tyl-isonitrile (MIBI) parathyroid scintigraphy using a hybrid SPECT/CT gamma camera. The MIBI scan showed ectopic hypermetabolic parathyroid tissue in the anterior mediastinum, as well as an additional appearance of focal radiotracer uptake in the sternal end of the right clav- icle, suggesting the presence of a brown tumor. After thorough clinical workup, the diagnosis was in favor of primary hyperparathyroidism and the patient underwent surgical resection of the ectopic parathyroid gland with gamma-probe guidance, later histopathologically confirmed it to be a parathyroid adenoma. Postoperatively her PTH level dropped and the electrolyte status normalized within 6 months. Osteolytic brown tumors can easily imitate bone malignancy and should be evaluated with caution. The use of intraoperative gamma-probe guidance could support the complete removal of the parathyroid adenoma tissue ensuring the surgical and therapeutic success for the patient. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Thyroid cancer detection rate and associated risk factors in patients with thyroid nodules classified as Bethesda category III(Walter de Gruyter GmbH, 2018); ; ; ; Background Ultrasound guided fine-needle aspiration (FNA) is a standard procedure for thyroid nodules management and selecting patients for surgical treatment. Atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS), as stated by The Bethesda System for Reporting Thyroid Cytopathology, is a diagnostic category with an implied malignancy risk of 5-15%. The aim of our study was to review cytology and histopathology reports, as well as clinical and ultrasound data, for thyroid nodules reported as AUS/FLUS, in order to evaluate the malignancy rate and to assess factors associated with malignant outcome. Patients and methods A total of 112 AUS/FLUS thyroid nodules in 105 patients were evaluated, of which 85 (75.9%) were referred to surgery, 21 (18.8%) were followed-up by repeat FNA and 6 nodules (5.3%) were clinically observed. Each was categorized in two final diagnostic groups - benign or malignant, which were further compared to clinical data of patients and ultrasonographic features of the nodules. Results Final diagnosis of malignancy was reached in 35 cases (31.2%) and 77 (68.8%) had benign lesions. The most frequent type of cancer was papillary thyroid carcinoma (PTC) - 58.1% PTC and 25.8% had follicular variant of PTC. Patients' younger age, smaller nodule size, hypoechoic nodule and presence of calcifications were shown to be statistically significant risk factors for malignancy. Conclusions The rate of malignancy for the AUS/FLUS diagnostic category in our study was higher than estimated by the Bethesda System. Clinical and ultrasound factors should be considered when decision for patient treatment is being made. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, HYPERPARATHYROIDISM DUE TO INTRATHYROIDAL PARATHYROID ADENOMA(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2025-07-18); ; ; The intrathyroidal parathyroid adenoma (IPA) represents a rare anatomical variant where parathyroid tissue is located within the thyroid gland instead of its usual extrathyroidal position. This condition arises due to aberrant embryologic migration of the parathyroid glands and is identified in approximately 1.3% to 6.7% of all parathyroid lesions. Case report: We present the case of a 56-year-old female diagnosed with a thyroid nodule, incidentally found on neck ultrasound. Fine-needle aspiration biopsy reported only microfollicular and macrofollicular arrangement of benign thyrocytes and lymphocytes. Due to continuous fatigue, loss of appetite, pain in bones, osteoporotic changes and constipation, hyperparathyroidism was suspected and laboratory revealed hyperparathyroidism with increased parathormone (1587 pg/mL), ionized calcium (2.25 mmol/L) and low phosphates. 99mTc-MIBI scintigraphy revealed a focal accumulation in the lower quadrant of the right thyroid lobe, indicative of intrathyroidal parathyroid adenoma, which was confirmed by histopathology report. After surgery, continuous decrease in PTH levels were reported, and after 7 months PTH levels were 66.73 pg/mL, ionized calcium 1.12 mmol/L and inorganic phosphate 1.15 (0.8-1.4 mmol/L). Follow-up of the patient revealed variations in the PTH levels, above the upper reference limit, along with hypoechogenic nodule in the posterior parts of the contralateral thyroid lobe. Further close follow-up is recommended due to the possibility of recurrence. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Absent 99mTc-MIBI Uptake in the Thyroid Gland during Early Phase of Parathyroid Scintigraphy in Patients with Primary and Secondary Hyperparathyroidism(ID Design 2012/DOOEL Skopje, 2018-05-20); ; ; ; Thyroid uptake of technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) during parathyroid scintigraphy can be affected by various conditions. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, 99mTc-MIBI SPECT/CT imaging contribution in the diagnosis of patients with hyperparathyroidism(Research Center for Nuclear Medicine (Tehran University of Medical Sciences), 2019-01); ; ; Introduction: Hyperparathyroidism is presented with increased parathyroid hormone (PTH) secretion due to hyperfunctioning of one or more of the four parathyroid glands. Primary hyperparathyroidism (p-HPT) can be due to parathyroid adenoma, hyperplasia or carcinoma of the parathyroid gland. Secondary hyperparathyroidism (s-HPT) is usually a response to hypocalcaemia and consecutive hyperplasia of the glands. Our aim was to compare the efficacy of 99mTc-methoxyisobutylisonitrile (MIBI) SPECT/CT in identification of the location of the lesion(s) in cases of HPT by comparing these results with the findings of ultrasound (US) and planar scintigraphy. Methods: Forty one consecutive patients (54±17 age, 12 males and 29 females) with primary or secondary hyperparathyroidism were included. All patients were examined by US and afterwards patients underwent conventional double-phase 99mTc-MIBI scintigraphy combined with neck SPECT/CT procedure. Planar images (early and delayed), US and SPECT/CT image sets were evaluated for adenoma localization at the neck and thorax. Regions of interest (ROIs), equal sized, were selected and compared, over the hyperfunctioning parathyroid tissue (accumulated impulses-counts value) and over the contralateral lobe of the thyroid gland (control counts value). Results:The ultrasonography detected 24 positive findings. The late phase of planar scan detected 26 positive findings. SPECT/CT presented with bigger detection rate than late planar phase or US (75.6%, 63.4%, 61.5%) and with higher sensitivity (100%, 83.8%, 77.4%), respectively. Conclusion: The SPECT/CT study seems reliable, sensitive and with added value in diagnosing hyperparathyroidism as a complementary method to planar scintigraphy. US as compatible method, should be performed prior the scintigraphy protocols. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, GENDER DIFFERENCES AND PREDICTORS OF INCRASED CORONARY CALCIUM SCORE AND MYOCARDIAL ISCHEMIA IN DIABETES TYPE 2 PATIENTS(Macedonian Association of Anatomists, 2021); ; ; ;