Papillary thyroid carcinoma (PTC) represents ~80% of all thyroid cancers, most frequently presenting in women in the third and fourth decade of life. The first clinical manifestation of PTC commonly includes a palpable mass in the thyroid area or cervical lymphadenopathy in cases of metastatic disease. Hematogenous distant metastases are a sign of an advanced stage of the tumour. The present study reported an extremely rare occurrence of solitary metastasis of a PTC in the left breast of a 63-year-old male patient, mimicking primary male breast cancer (MBC). The presence of a male breast lesion that did not follow the typical imaging criteria for MBC aroused suspicion of a different primary origin. The combination of imaging methods, laboratory findings and fine-needle aspiration techniques enabling cytological and histopathological examination, with the use of a wide panel of immunohistochemical markers, is crucial to establishing a definitive and correct diagnosis.

• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

miRNA expression in triple-negative breast cancers (TNBC) has mainly been studied from a methodological viewpoint. However, it has not been considered that miRNA expression profile may be associated with a specific morphological entity inside every tumor. The verification of this hypothesis on a set of 25 TNBCs was the subject of our previous work, where we confirmed specific expression of the studied miRNAs in 82 samples of different morphologies including inflammatory infiltrate, spindle cell, clear cell, and metastases after RNA extraction and purification as well as microchip and biostatistical analysis. In the current work, we demonstrate a low suitability of in situ hybridization method for miRNA detection compared to RT-qPCR, and in detail discuss the biological role of 8 miRNAs with the most significant changes of expression.

• MeSH
• lidé MeSH
• mikro RNA * genetika   metabolismus   MeSH
• triple-negativní karcinom prsu * genetika   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

The authors present the effect of preoperative oral nutritional supplements (ONS) in the form of sipping on the postoperative morbidity and mortality of patients suffering from carcinoma of esophagus and gastroesophageal junction who underwent esophagectomy and who do not in the high risk of malnutrition. The main goal was to assess whether preoperative ONS results in a decrease in 30-day postoperative morbidity and mortality who do not qualify to the high risk of malnutrition strategy. 29 patients who underwent surgery were included, 14 patients (48.3%) without sipping, 15 patients (51.7%) with sipping. In the sipping group, there were significantly more patients who had adenocarcinoma (p = 0.035) and the tumor localized in the distal part of the esophagus (p = 0.006), showed significantly higher values of albumin (p = 0.007) and prealbumin (p = 0.005) when compared to patients without sipping. No statistically significant difference in 30-day postoperative morbidity (p = 0.700) and in 30-day postoperative mortality (p = 1.000).

• MeSH
• dospělí MeSH
• ezofagektomie metody   škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory jícnu * chirurgie   komplikace   mortalita   terapie   MeSH
• nutriční podpora metody   MeSH
• pooperační komplikace mortalita   prevence a kontrola   MeSH
• předoperační péče * metody   MeSH
• riziko MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

• MeSH
• biopsie sentinelové lymfatické uzliny metody   MeSH
• lidé MeSH
• lymfadenektomie metody   MeSH
• mamoplastika metody   MeSH
• mastektomie metody   MeSH
• triple-negativní karcinom prsu * chirurgie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH

Publikace se zaměřuje na různé aspekty triple-negativního karcinomu prsu u žen. Určeno odborné veřejnosti.

• MeSH
• triple-negativní karcinom prsu MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• onkologie
• gynekologie a porodnictví
• NLK Publikační typ
• kolektivní monografie

Okultní primární karcinom prsu je velice vzácný typ nádoru, který se projevuje axilární lymfadenopatií bez průkazu ložiska v prsu. S vývojem zobrazovacích metod (magnetická rezonance, PET/CT, PET/MRI apod.) se daří detekovat velkou část nádorů, které jsou na základních vyšetřovacích metodách mamografii a ultrasonografii, neviditelné. V současné době není shoda v názorech na optimální léčebný postup tohoto onemocnění. Obecně se doporučuje léčba stejná jako u primárního karcinomu prsu s metastázou do axilárních lymfatických uzlin, tzn. neoadjuvantní onkologická léčba, disekce axily s adjuvantní radioterapií a mastektomie nebo ozáření prsu. Nicméně několik současných studií tento postup vyvrací a poukazuje na méně radikální postupy se srovnatelnými výsledky. Práce popisuje případ 62leté pacientky s okultním karcinomem prsu, postup a výsledek zobrazovacích vyšetření a následně management léčby. Dále uvádí a diskutuje léčebné postupy a jejich výsledky, které jsou publikovány v současné literatuře.

Occult breast cancer is a very rare type of cancer which presents with axillary lymphadenopathy with no visible mass in the breast. Advances in imaging methods (MRI, PET/CT, PET/MRI, etc.) have enabled the detection of a large number of lesions which are not visible using basic imaging methods, such as mammography and ultrasound. To date, optimal management of this type of cancer is lacking. Generally, treatment of occult breast cancer is that of primary breast cancer with axillary lymph node involvement. This includes neoadjuvant oncological therapy, axillary dissection with adjuvant radiation therapy and either mastectomy or radiation to the breast. However, several recent studies have shown that similar results may be achieved with less radical treatment. The paper describes the case of a 62-year-old patient with occult breast cancer, the procedure and results of imaging assessments, and subsequently the treatment management. Furthermore, the paper reports on current treatment trends published in the literature.

• Klíčová slova
• okultní karcinom prsu,
• MeSH
• axila chirurgie   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfadenektomie metody   MeSH
• lymfatické metastázy MeSH
• mamografie MeSH
• mastektomie metody   MeSH
• nádory prsu * chirurgie   diagnostické zobrazování   patologie   MeSH
• PET/CT metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Introduction: The authors report long-term outcomes in patients who received neoadjuvant chemoradiotherapy and consequently underwent hybrid oesophagectomy for oesophageal cancer (OC). Aim: To evaluate long-term outcomes in patients suffering from OC, who underwent hybrid oesophagectomy. Material and methods: Our cohort consisted of patients suffering from OC, who received neoadjuvant chemoradiotherapy. Hybrid esophagectomy was performed 8-10 weeks after oncological treatment. Results: Ninety-four patients underwent surgery for OC from 2011 to 2015. Histology revealed adenocarcinoma in 60.6%, squamous cell carcinoma (SCC) in 36.2%, and other type of cancer in 3.2%. Seventy-three (77.7%) patients with advanced stage (T3-4, N0-2, M0) were indicated to receive neoadjuvant chemoradiotherapy (nCRT). Trans-hiatal hybrid oesophagectomy was performed in 83 (88.3%) patients. Transthoracic hybrid oesophagectomy was performed in 11 (11.7%) patients. Histology of the resected specimens of 18 (24.7%) patients did not reveal OC, i.e. pathological complete response (pCR). In our cohort, we proved an association between occurrence of pCR and age as well as disease-free survival (DFS). The patients who presented with pCR were significantly younger - below 60 years of age (p = 0.017). They also showed significantly higher mean DFS (p = 0.004). Conclusions: Combined oesophagectomy with neoadjuvant chemoradiotherapy results in a better long-term outcome in patients suffering from oesophageal cancer. In our set of patients who underwent hybrid esophagectomy, satisfactory short-term and especially long-term results of surgical treatment for oesophageal cancer were observed.

• Publikační typ
• časopisecké články MeSH

Defecation problems affect up to 30% of the adult population. Women are affected 3x more often than men. Diagnosis is complex, and is performed in cooperation with other medical specialties, such as urology, gynecology and neurology. Nonetheless, a proctologist is the first specialist, which patients with defecation problems most often seek out. Treatment includes dietary measures, rehabilitation techniques, and surgical procedures. The most common causes include ventral rectocele, anorectal prolapse, and rectorectal intussusception. In the majority of cases, III. and IV. degree hemorrhoids also present. A number of surgical techniques have been developed to treat static and dynamic disorders of the small pelvis. The new resection technique using the TST high-capacity stapler seems promising. This method is based on segmental resection of the rectal wall. Between January 2016 and October 2017, 34 patients were operated on using the TST stapler. Surgery using the TST stapler led to treatment of the underlying disease in all patients. Stapler failure did not occur in any of the cases. The introduction of high-capacity circular staplers (TST 36) creates new possibilities for treating anorectal prolapse and rectocele. Based on our experience, this method is able to treat rectal prolapse protruding 3cm past the anus. The surgery is always performed using only one stapler.

BACKGROUND: One of the prerequisites for proper healing of the anastomosis after a colorectal resection is adequate blood supply to the connected intestinal segments. It has been proposed that adequate visualization of the blood flow using indocyanine green (ICG) could lead to the reduction in the incidence of anastomotic leakage (AL). The aim of this study was to assess the effectiveness of intraoperative fluorescence angiography (FA) in decreasing the incidence of AL after minimally invasive low anterior resection (LAR) with total mesorectal excision (TME) in rectal cancer patients and to determine predictors of anastomotic leak. METHODS: From August 2015 to January 2019, data from 100 patients who underwent mini-invasive TME for rectal cancer using FA with indocyanine green (ICG) were prospectively collected and analyzed. They were compared with retrospectively analyzed data from a historical control group operated by one team of surgeons before the introduction of FA from November 2012 to August 2015 (100 patients). All patients from both groups were operated sequentially in one oncological center in Nový Jičín. RESULTS: The incidence of AL was significantly lower in the ICG group (19% vs. 9%, p = 0.042, χ2 test). In fifteen patients in the ICG group (15%), the resection line was moved due to insufficient perfusion. Using Pearson's χ2 test, diabetes (p = 0.036) and application of a transanal drain (NoCoil) (p = 0.032) were identified as other risk factors (RFs) for AL. CONCLUSION: The use of ICG to visualize tissue perfusion in low rectal resections for cancer can lead to a reduction of AL.

• MeSH
• anastomóza chirurgická škodlivé účinky   MeSH
• fluoresceinová angiografie MeSH
• indokyanová zeleň MeSH
• lidé MeSH
• nádory rekta * chirurgie   MeSH
• netěsnost anastomózy epidemiologie   etiologie   MeSH
• proktektomie * MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Úvod: Neoadjuvantní terapie (NT) je jedna z možných strategií onkologické léčby u malignit prsní žlázy. Cílem je downstaging nádorového postižení prsu a axily a tím možnost konverze mastektomie na záchovný výkon prsu a provedení šetrnější cílené operace axilárních uzlin. Úlohou radiologa je provést pomocí zobrazovacích metod přesný lokální staging malignity před podáním NT, hodnotit efekt léčby v jejím průběhu a po ukončení léčby provést restaging nádorového postižení prsu a axily. Kazuistiky: Autoři prezentují ve třech kazuistikách pacientek s neoadjuvantní chemoterapií (NCHT) diagnostický postup a zobrazování při stanovení lokálního stagingu malignity před léčbou, při sledování v průběhu podávání a při provedení restagingu malignity po ukončení NCHT. Radiologická odpověď po ukončení NCHT je korelována s patologickou odpovědí. Závěr: Správné stanovení rozsahu nádorového postižení prsu a axily radiologem před léčbou a přesné histologické posouzení nádoru patologem jsou zásadní pro rozhodnutí o následné terapii u pacientů v mamárním týmu.

Introduction: Neoadjuvant therapy (NT) is one of the possible oncological treatment strategies for breast cancer. Its aim is to achieve down-staging of the tumour in the breast and axilla and thus the possibility of converting mastectomy to a breast-conserving procedure, and also to allow for a less burdensome and more targeted operation of the axillary lymph nodes. The role of the radiologist is to utilise imaging procedures for precise local staging of the malignancy prior to NT, to evaluate the effect of treatment during its course and upon its completion, and to perform restaging of the cancer in the breast and axilla. Case reports: The authors present three case reports of female patients with breast cancer who underwent neoadjuvant chemotherapy (NCT). They describe the diagnostic procedure and imaging methods used to establish local staging of the cancer prior to treatment, to monitor the disease during the course of treatment, and to perform restaging of the cancer after completing NCT. The radiological response after NCT completion was correlated with the pathological response. Conclusion: Correct determination of the extent of the cancer in the breast and axilla by the radiologist before NT and precise histological analysis of the tumour by the pathologist are fundamental for selecting the appropriate treatment for patients at the multidisciplinary breast tumour board.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• mamografie metody   MeSH
• nádory prsu chirurgie   diagnostické zobrazování   farmakoterapie   MeSH
• neoadjuvantní terapie metody   MeSH
• segmentální mastektomie metody   MeSH
• senioři MeSH
• staging nádorů MeSH
• ultrasonografie metody   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH