INTRODUCTION: Triple negative breast carcinomas (TNBC) account for approximately 15-20% of all breast carcinomas. This subtype is characterised by an unfavourable prognosis with early locoregional recurrence a metastases. Only few studies have focused on the impact of local surgery on the overall therapeutic outcome. However, decisions are difficult to make in the case of TNBC, and no particular molecular subtype or marker exists that would make the decision-making process easier. The aim of our retrospective study was to analyse the TNBC surgical management outcomes at EUC Clinic in Zlin. METHODS: 440 women with breast carcinoma were operated on at EUC Clinic from 2014 to 2016, including 29 patients with TNBC; bilateral carcinoma was present in one case. Neoadjuvant chemotherapy (NAC) was indicated in 6 cases. The tumour centre was marked with a clip. The extent of surgery depended on the residual size of the tumour. Sentinel lymph node biopsy was indicated in clinically negative lymph nodes; further management followed the Z0011 study if the biopsy was positive. Axillary lymph node dissection was performed after NAC. In all cases, surgery was followed by systemic chemotherapy, and by radiotherapy in the case of breast-conserving procedures. RESULTS: The group included 29 women and one patient with bilateral carcinoma, i.e. 30 cases of TNBC. Mean age was 57 years and median age was 55.5 years. Mean follow-up was 62.9 months, with the median of 69.9 month. NAC was indicated in 6 patients; complete pathological response was achieved in one case. NAC was followed by mastectomy in 5 cases including a bilateral procedure in one case, and by breast-conserving surgery in one case. Axillary dissection was performed in all cases. Breast-conserving surgery and sentinel node biopsy predominated in the group (16 cases). Local recurrence was observed in 4 cases, 2 times as an isolated local recurrence after one year and 2 times as part of generalization, always after mastectomy. Six patients died of generalized disease. No regional recurrence was observed. CONCLUSION: TNBC is characterised by a worse prognosis and a higher rate of local recurrence. As confirmed by our study, the results of breast-conserving surgery can be comparable to those of radical procedures, and thus radical surgery should be indicated prudently.

• Klíčová slova
• breast-conserving surgery, local recurrence, triple negative carcinoma,
• MeSH
• axila patologie   MeSH
• biopsie sentinelové lymfatické uzliny metody   MeSH
• karcinom * chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfadenektomie MeSH
• lymfatické uzliny patologie   MeSH
• mastektomie MeSH
• nádory prsu * chirurgie   MeSH
• neoadjuvantní terapie MeSH
• retrospektivní studie MeSH
• triple-negativní karcinom prsu * chirurgie   patologie   radioterapie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Although syringoma is a common benign tumour of the sudoriferous gland, there is also an extremely rare malignant form known as syringoid eccrine carcinoma (SEC). SEC usually exhibits slow growth with deep invasion and a frequent tendency to relapse. The treatment of choice is radical wide resection, which poses a difficult reconstructive problem, especially when the tumour is located in the centre of the face. CASE PRESENTATION: In this case, a 70-year-old man was diagnosed with an SEC at the same location as a benign syringoma of the upper lip and nasal base that had undergone primary excision 7 years prior. Primary radical resection was performed with immediate Abbé flap reconstruction. Nevertheless, histology revealed positive margins, and 3 additional re-excisions were needed to achieve clear margins. Four months after the initial resection, the patient had undergone an innovative reconstruction technique including not only the Abbé flap but also a turbinate flap harvested with functional endonasal surgery and a three-stage forehead flap. CONCLUSION: To the best of our knowledge, this is the first case report of a suspect malignant transformation of a benign syringoma after 7 years. In addition, from oncoplastic and reconstructive points of view, the bilateral use of the turbinate flap for reconstructing the intranasal lining of the alar base is unusual, and the use of functional endonasal surgery in nasal reconstruction for reducing the risk of damaging the vascular supply of the flap is innovative.

• Klíčová slova
• Functional endonasal surgery, Head and neck malignancy, Nasal reconstruction, Syringoid eccrine carcinoma, Turbinate flap,
• MeSH
• čelo chirurgie   MeSH
• karcinom * chirurgie   MeSH
• lidé MeSH
• lokální recidiva nádoru chirurgie   MeSH
• nádory kožních adnex MeSH
• nádory kůže MeSH
• nádory potních žláz * chirurgie   MeSH
• nosní skořepy chirurgie   MeSH
• ret chirurgie   MeSH
• senioři MeSH
• syringom * chirurgie   MeSH
• zákroky plastické chirurgie * metody   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

BACKGROUND: To evaluate the safety, feasibility and outcomes of patients treated for colorectal liver metastases (CLM) with an innovative combined approach - hepatic resection and Stereotactic body radiotherapy (SBRT) using CyberKnife® system. METHODS: This was a retrospective cohort study conducted in a single institution. Patients with CLM and no evidence of extrahepatic disease were included during a 6-year study period. RESULTS: In total, 19 patients with 63 liver lesions underwent liver resection combined with SBRT of unresectable lesions. Major hepatectomy was performed in 42.1% patients; postoperative complications were noted in 31.6% patients. 27 unresectable lesions were treated by SBRT with a total dose of 50-60 Gy in five fractions. The median follow-up of study patients was 29.7 ± 20.58 months. Local control of CLM at 1 and 2 years was achieved in 89.5% of patients. Out-of-field hepatic recurrence was diagnosed in 63.1% patients. The 1-year disease-free survival (DFS) was 52.6%; 2-year DFS was 31.6%. The overall actuarial survival rates at 1 and 2 years were 88.2% and 50.4%. CONCLUSION: Liver resection combined with SBRT presents a promising therapeutic option for patients with CLM which traditionally are unresectable. The additional use of SBRT allows for the effective clearance of the disease for thoroughly selected patients.

• Klíčová slova
• Colorectal liver metastases, Combined strategy, CyberKnife, Liver resection, Oligometastases, Stereotactic body radiotherapy, Survival,
• MeSH
• hepatektomie metody   MeSH
• karcinom mortalita   sekundární   chirurgie   MeSH
• kohortové studie MeSH
• kolorektální nádory patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití MeSH
• nádory jater mortalita   sekundární   chirurgie   MeSH
• pooperační komplikace epidemiologie   MeSH
• radiochirurgie metody   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• studie proveditelnosti MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Secretory carcinoma of the skin is a rare adnexal carcinoma, which is morphologically and immunohistochemically identical to secretory carcinoma of the breast and is associated with the presence of t (12;15) translocation, resulting in the ETV6-NTRK3 gene fusion. Nineteen cases of primary cutaneous secretory carcinoma have been previously published in the literature. In this study, we describe 6 new cases of secretory carcinoma of the skin. The study group consisted of 5 female patients and 1 male patient, ranging in age from 57 to 98 years (mean: 74.2, median: 74). Locations included the axilla (2), neck, eyelid, thigh, and nipple base, each one. Microscopically, all but 1 tumor were well circumscribed and nonencapsulated and exhibited characteristic abundant secretions within the microcystic and tubular spaces comprised by bland oval, round to cuboidal neoplastic cells. In addition, solid areas and focal pseudopapillae were seen, and, in 1 case, a focal mucinous component with small lakes of mucin containing small tumor nests or tubules of the neoplastic cells was present. The remaining neoplasm was mostly solid and papillary, with only few characteristic lumina containing secretions. Immunohistochemically, all cases expressed S-100 protein, mammaglobin, STAT5, GATA3, and NTRK. ETV6-NTRK3 gene fusion was detected in 5 cases, whereas, in the remaining tumor, a novel NFIX-PKN1 gene fusion was found.

• MeSH
• databáze faktografické MeSH
• fenotyp MeSH
• fúze genů * MeSH
• genetická predispozice k nemoci MeSH
• hybridizace in situ fluorescenční MeSH
• imunohistochemie MeSH
• karcinom chemie   genetika   patologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádorové biomarkery analýza   genetika   MeSH
• nádory kůže chemie   genetika   patologie   chirurgie   MeSH
• polymerázová řetězová reakce s reverzní transkripcí MeSH
• prospektivní studie MeSH
• proteinkinasa C genetika   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• transkripční faktory NFI genetika   MeSH
• translokace genetická * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• nádorové biomarkery MeSH
• NFIX protein, human MeSH Prohlížeč
• protein kinase N MeSH Prohlížeč
• proteinkinasa C MeSH
• transkripční faktory NFI MeSH

Parathyroid cancer is a rare endocrine malignancy, representing less than 1 % of all cases of primary hyperparathyroidism. The exact etiology of the disease remains unknown. Known risk factors include neck irradiation, end stage renal failure, genetic factors, particularly the the HPRT2/CDCT73 gene mutation. The clinical picture is often indolent, yet progressive with a trend of local invasion and metastasis formation in advanced disease. The clinical picture includes symptoms of severe and resistant hypercalcemia, requiring intensive therapy often with the need of dialysis. Radical surgery is the mainstay of the parathyroid cancer treatment. Chemotherapy and radiotherapy are generally ineffective. An early and correct diagnosis of parathyroid carcinoma significantly influences both morbidity and mortality.Key words: diagnosis - hyperparathyroidism - parathyroid cancer - treatment.

• MeSH
• chronické selhání ledvin epidemiologie   MeSH
• hyperkalcemie etiologie   MeSH
• hyperparatyreóza etiologie   MeSH
• hypoxanthinfosforibosyltransferasa genetika   MeSH
• karcinom komplikace   epidemiologie   genetika   chirurgie   MeSH
• krk MeSH
• lidé MeSH
• mutace MeSH
• nádory příštítného tělíska komplikace   epidemiologie   genetika   chirurgie   MeSH
• radioterapie statistika a číselné údaje   MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• hypoxanthinfosforibosyltransferasa MeSH

OBJECTIVES: Access to the pterygopalatine fossa is very difficult due to its complex anatomy. Therefore, an open approach is traditionally used, but morbidity is unavoidable. To overcome this problem, an endoscopic endonasal approach was developed as a minimally invasive procedure. The surgical aim of the present study was to evaluate the utility of the endoscopic endonasal approach for the management of both benign and malignant tumors of the pterygopalatine fossa. METHOD: We report our experience with the endoscopic endonasal approach for the management of both benign and malignant tumors and summarize recent recommendations. A total of 13 patients underwent surgery via the endoscopic endonasal approach for pterygopalatine fossa masses from 2014 to 2016. This case group consisted of 12 benign tumors (10 juvenile nasopharyngeal angiofibromas and two schwannomas) and one malignant tumor. RESULTS: No recurrent tumor developed during the follow-up period. One residual tumor (juvenile nasopharyngeal angiofibroma) that remained in the cavernous sinus was stable. There were no significant complications. Typical sequelae included hypesthesia of the maxillary nerve, trismus, and dry eye syndrome. CONCLUSION: The low frequency of complications together with the high efficacy of resection support the use of the endoscopic endonasal approach as a feasible, safe, and beneficial technique for the management of masses in the pterygopalatine fossa.

• MeSH
• angiofibrom * diagnostické zobrazování   patologie   chirurgie   MeSH
• dospělí MeSH
• fossa pterygopalatina * diagnostické zobrazování   patologie   chirurgie   MeSH
• karcinom diagnostické zobrazování   patologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nádory nosohltanu * diagnostické zobrazování   patologie   chirurgie   MeSH
• nádory nosu diagnostické zobrazování   patologie   chirurgie   MeSH
• následné studie MeSH
• neurilemom * diagnostické zobrazování   patologie   chirurgie   MeSH
• počítačová rentgenová tomografie metody   MeSH
• reprodukovatelnost výsledků MeSH
• retrospektivní studie MeSH
• stupeň nádoru MeSH
• terapeutická embolizace metody   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

CONTEXT: Multifocality is often treated as a risk factor for papillary thyroid cancer (PTC), prompting aggressive treatments, but its prognostic value remains unestablished. OBJECTIVE: To investigate the role of tumor multifocality in clinical outcomes of PTC. METHODS: Multicenter study of the relationship between multifocality and clinical outcomes of PTC in 2638 patients (623 men and 2015 women) with median [interquartile range (IQR)] age of 46 (35 to 58) years and median (IQR) follow-up time of 58 (26 to 107) months at 11 medical centers in six countries. Surveillance, Epidemiology and End Results (SEER) data were used for validation. RESULTS: Disease recurrence in multifocal and unifocal PTC was 198 of 1000 (19.8%) and 221 of 1624 (13.6%) (P < 0.001), with a hazard ratio of 1.55 [95% confidence interval (CI), 1.28 to 1.88], which became insignificant at 1.13 (95% CI, 0.93 to 1.37) on multivariate adjustment. Similar results were obtained in PTC variants: conventional PTC, follicular-variant PTC, tall-cell PTC, and papillary thyroid microcarcinoma. There was no association between multifocality and mortality in any of these PTC settings, whereas there was a strong association between classic risk factors and cancer recurrence or mortality, which remained significant after multivariate adjustment. In 1423 patients with intrathyroidal PTC, disease recurrence was 20 of 455 (4.4%) and 41 of 967 (4.2%) (P = 0.892) and mortality was 0 of 455 (0.0%) and 3 of 967 (0.3%) (P = 0.556) in multifocal and unifocal PTC, respectively. The results were reproduced in 89,680 patients with PTC in the SEER database. CONCLUSIONS: Tumor multifocality has no independent risk prognostic value in clinical outcomes of PTC; its indiscriminate use as an independent risk factor, prompting overtreatments of patients, should be avoided.

• MeSH
• dospělí MeSH
• invazivní růst nádoru patologie   MeSH
• Kaplanův-Meierův odhad MeSH
• karcinom mortalita   patologie   chirurgie   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokální recidiva nádoru mortalita   patologie   MeSH
• lymfatické metastázy MeSH
• lymfatické uzliny patologie   MeSH
• míra přežití MeSH
• multivariační analýza MeSH
• nádory štítné žlázy mortalita   patologie   chirurgie   MeSH
• papilární karcinom štítné žlázy MeSH
• papilární karcinom mortalita   patologie   chirurgie   MeSH
• přežití bez známek nemoci MeSH
• prognóza MeSH
• program SEER MeSH
• proporcionální rizikové modely MeSH
• staging nádorů MeSH
• tyreoidektomie metody   mortalita   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• srovnávací studie MeSH

INTRODUCTION: Tumors of appendix vermiformis are quite rare; they represent only about 0.4% of gastrointestinal tract tumors. They can be both benign and malignant (primary or secondary). Carcinoid is the most common tumor of the appendix. The symptoms can include nothing but non-specific abdominal pain, or on the contrary they can imitate inflammatory acute abdomen. Liver metastases are associated with an advanced stage of malignancy; their surgical treatment is presented rarely in the literature. The aim of this publication is to present two cases with different results of surgical treatment of liver metastases with the primary tumor located in the appendix. CASES: The first patient is a 50 years old female who underwent right hepatectomy for liver metastases of Goblet-cell carcinoid of the appendix in 2013 and died six months later due to tumor progression. The second patient is a 58 years old male, still alive, undergoing repeated liver and lung resections and RFA from 2009 due to metastases from appendix carcinoma. CONCLUSION: Examples of dissemination of malignant appendix tumors to the liver need to be evaluated individually. In indicated cases, surgical treatment of liver metastases is justifiable.Key words: tumors of appendix liver metastases surgical treatment.

• MeSH
• hepatektomie MeSH
• karcinom patologie   sekundární   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory apendixu patologie   chirurgie   MeSH
• nádory jater sekundární   chirurgie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

INTRODUCTION: Complete mesocolic excision (CME) ensures the removal of all sentinel and regional lymph nodes during colon cancer surgery. For right-sided hemicolectomy it is essential to dissect the wall of vena mesenterica superior, which increases the risk of injuring surrounding organs. So far, no randomized studies comparing long-term oncological results of standard right hemicolectomy and hemicolectomy with CME have been published. METHOD: 83 patients operated for colon carcinoma in 2014 and 2015 were included in this study, all of them undergoing right-sided hemicolectomy using laparotomy access. The standard procedure was done in 63 cases and hemicolectomy with CME was done in 20 cases. We compared the incidence of complications, and the characteristics and descriptions of obtained specimens evaluated by a pathologist for both groups. RESULTS: The operation times of right-sided hemicolectomies with CME was longer by 20 minutes on average. The incidence of postoperative complications was similar in both groups. Pancreatic fistula in the group of patients undergoing right-sided hemicolectomy with CME was an unusual complication; the fistula was healed through conservative treatment. Comparing the resecate parameters, we found no significant differences in the lengths of the resected terminal ileum. But the length of the resected colon was significantly longer for the CME technique (median 42 cm versus 22 cm). The incidence of lymph node metastases was similar in both groups. However, the total number of removed lymph nodes in the group with CME was significantly higher (median 23). CONCLUSION: Right-sided hemicolectomy with complete mesocolic excision offers the removal of more lymph nodes than the standard technique. The central vascular ligation technique elongates the operation time and may be associated with more intraoperative injuries. Introduction of the concept of complete mesocolic excision is derived from an effort to standardize the surgical technique for colon cancer resection.Key words: right-sided hemicolectomy complete mesocolic excision colon cancer lymphadenectomy.

• MeSH
• délka operace MeSH
• incidence MeSH
• karcinom patologie   chirurgie   MeSH
• kolektomie metody   MeSH
• lidé MeSH
• ligace MeSH
• lymfadenektomie metody   MeSH
• lymfatické metastázy MeSH
• lymfatické uzliny patologie   chirurgie   MeSH
• mezokolon chirurgie   MeSH
• nádory tračníku patologie   chirurgie   MeSH
• pankreatická píštěl epidemiologie   MeSH
• pooperační komplikace epidemiologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: The investigation of prognostic and predictive factors for early diagnosis of tumors, their surveillance and monitoring of the impact of therapeutic modalities using hybrid laboratory models in vitro/in vivo is an experimental approach with a significant potential. It is preconditioned by the preparation of in vivo tumor models, which may face a number of potential technical difficulties. The assessment of technical success of grafting and xenotransplantation based on the type of the tumor or cell line is important for the preparation of these models and their further use for proteomic and genomic analyses. METHODS: Surgically harvested gastrointestinal tract tumor tissue was processed or stable cancer cell lines were cultivated; the viability was assessed, and subsequently the cells were inoculated subcutaneously to SCID mice with an individual duration of tumor growth, followed by its extraction. RESULTS: We analysed 140 specimens of tumor tissue including 17 specimens of esophageal cancer (viability 13/successful inoculations 0), 13 tumors of the cardia (11/0), 39 gastric tumors (24/4), 47 pancreatic tumors (34/1) and 24 specimens of colorectal cancer (22/9). 3 specimens were excluded due to histological absence of the tumor (complete remission after neoadjuvant therapy in 2 cases of esophageal carcinoma, 1 case of chronic pancreatitis). We observed successful inoculation in 17 of 28 tumor cell lines. CONCLUSION: The probability of successful grafting to the mice model in tumors of the esophagus, stomach and pancreas is significantly lower in comparison with colorectal carcinoma and cell lines generated tumors. The success rate is enhanced upon preservation of viability of the harvested tumor tissue, which depends on the sequence of clinical and laboratory algorithms with a high level of cooperation.Key words: proteomic analysis - xenotransplantation - prognostic and predictive factors - gastrointestinal tract tumors.

• MeSH
• biologické markery MeSH
• gastrointestinální nádory chirurgie   MeSH
• karcinom chirurgie   MeSH
• kardie MeSH
• kolorektální nádory chirurgie   MeSH
• lidé MeSH
• myši SCID * MeSH
• myši MeSH
• nádorové buněčné linie MeSH
• nádory jícnu chirurgie   MeSH
• nádory slinivky břišní chirurgie   MeSH
• nádory žaludku chirurgie   MeSH
• prognóza MeSH
• proteomika MeSH
• transplantace heterologní metody   MeSH
• transplantace nádorů metody   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biologické markery MeSH