INTRODUCTION: For many years, the gold standard in the localization of non-palpable malignant breast tumors has been the use of wire-guided method. However, this has recently been replaced by more modern localization techniques in many institutions. METHODS: This is a retrospective case-control study comparing two localization techniques (iodine seed 125I and wire-guided localization) for localizing non-palpable tumors in patients with histologically verified breast carcinoma. RESULTS: The study included 62 patients - 31 with localization of malignant breast tumor by iodine seed (subgroup 125I) and 31 by wire-guided localization (subgroup FV). The average volume of the resected tissue in subgroup 125I (46.2 cm3) was statistically significantly smaller compared to subgroup FV (83.7 cm3; P = 0.0063). R0 resection was achieved in 29 cases (93.5%) in subgroup 125I and in 24 cases (77.4%) in subgroup FV (P = 0.0714). In subgroup 125I, re-resection was not indicated in any case, while in subgroup FV, re-resection due to tumor reaching the margin was indicated in 6 cases (19.4%; P = 0.01). CONCLUSION: Our initial experience show that the use of iodine seeds for localizing non-palpable breast tumors is associated with the removal of a smaller volume of resected tissue compared to wire-guided localization, with a trend towards more frequent achievement of R0 resection. In the subgroup of patients localized with iodine seeds, there was a smaller proportion of re-resections due to inadequate safety margins.

• Klíčová slova
• breast cancer, iodine seed, localizations techniques, wire-guided localization,
• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory prsu * chirurgie   diagnostické zobrazování   patologie   MeSH
• radioizotopy jodu * terapeutické užití   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Názvy látek
• Iodine-125 MeSH Prohlížeč
• radioizotopy jodu * MeSH

OBJECTIVE: The objective of the study was to evaluate the feasibility of radio guided occult lesion localization (ROLL) in the cases of nonpalpable breast cancers with sentinel lymph node biopsy. DESIGN: Prospective clinical study SETTING: Department of Gynecology and Obstetrics, 2nd Medical Faculty and Teaching Hospital, Praha METHODS: Thirty-eight patients with nonpalpable breast cancer diagnosed by core cut biopsy underwent an injection of the radiopharmaceutical 18-20 hours before surgery. The dose of the radiopharmaceutical was 45 MBg into tumor and 15 MBg subdermaly. Surgical excision of radioactive breast tissue with nonpalpable tumor was carried out using the hand held gamma probe and the same technique was performed for biopsy of sentinel lymph node. Standard localization technique with hook-wire was performed in the control group of fifty-one patients. RESULTS: Radioguided surgery of nonpalpable tumor was successful in all cases. Surgical margins were clear in all cases, in four cases (10.5%) the margins were only 2 mm. The sentinel node was identified in all cases, in 3 patients (7.9%) the sentinel node was involved by tumor and axillary lymphadenectomy was performed. Infiltrating carcinomas were diagnosed in the "hook-wire" group in 21 cases (41.2%), all with clear margins over 3mm. Proportion of margins status between ROLL and hook-wire was the same. It seems that the health tissue loss around the tumor is in hook-wire technique bigger but it requires next study. CONCLUSION: Simultaneous performance of ROLL and sentinel node biopsy is useful and practicable methods in the management of nonpalpable breast cancer. In comparison to hook-wire, radioguided removal allows reduced excision volume and better lesion centering within the specimen.

• MeSH
• biopsie sentinelové lymfatické uzliny * MeSH
• dospělí MeSH
• karcinom diagnóza   diagnostické zobrazování   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory prsu diagnóza   diagnostické zobrazování   chirurgie   MeSH
• radioisotopová scintigrafie MeSH
• radionuklidy * MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• radionuklidy * MeSH

BACKGROUND Hepatic artery (HA) pseudoaneurysm (PSA) after liver transplantation (OLTx) is rare but often fatal complication requiring quick repair. Its prevalence in patients after OLTx is around 0.94%. CASE REPORT A 41-year-old female patient underwent a full-graft orthotopic liver transplantation (OLTx) for alcoholic liver cirrhosis in 2017. During regular postoperative Doppler ultrasonography (DU) check-ups, a large 3-cm pseudoaneurysm (PSA) was detected on the hepatic artery. The patient underwent a computed angiography (CTA) to verify the PSA anatomical localization and relationship with the transplanted liver graft. Selective celiac arteriography showed HA PSA and 90% stenosis of the hepatic artery after PSA. The stent graft placement was unsuccessful as the guiding wire was unable to pass through the post-PSA HA stenosis. The patient was scheduled for an open repair under general anesthesia. Through a right subcostal incision, the HA PSA was resected and the HA was mobilized and re-anastomosed using an end-to-end technique. Three months after the procedure, the patient has a good liver graft perfusion through the HA with no sign of PSA reoccurrence or stenosis. CONCLUSIONS Early detection of the HA PSA after OLTx is a life-threatening complication requiring prompt treatment. If endovascular treatment options fail, open surgical repair, despite its challenges, is the only possible treatment option.

• MeSH
• anastomóza chirurgická MeSH
• arteria hepatica chirurgie   MeSH
• dospělí MeSH
• lidé MeSH
• nepravé aneurysma etiologie   MeSH
• přežívání štěpu MeSH
• stenóza komplikace   MeSH
• stenty škodlivé účinky   MeSH
• transplantace jater škodlivé účinky   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH