Intraoperative ultrasound for nonpalpable breast lesions - experience and operative time.

INTRODUCTION: The essential tools doctors need to diagnose breast cancer tumors at the early stages and with no clinical presentation are screening mammography and ultrasonography. Nonpalpable breast lesions are a current problem nowadays and there are various types of navigation techniques that are utilized in order to achieve cancer cell-free resection margins in the first place. Intraoperative ultrasound has been proven to be a safe and effective way to excise this type of breast tumors. AIM: To study the correlation between the experience we obtained while using intraoperative ultrasound for excision of nonpalpable breast lesions, and the duration of surgery. MATERIALS AND METHODS: Twenty-five women with nonpalpable breast lesions underwent breast-conserving surgery using ultrasound navigation. Nominal and ordinal data were presented using numbers and percentages. Spearman's rank-order correlation was used to assess the effect of experience gained on the duration of surgery. RESULTS: The tumor distribution was 72% malignant tumors and 28% benign. A 100% identification rate in the effective surgical excisions was reported. In the process of gaining experience using the method, the duration of surgery shortened by 30%. No tumor cells on ink were found in all specimens and there was no need for secondary surgeries. CONCLUSIONS: Our results demonstrate a relatively short learning curve, and we believe that breast surgeons should be helped and encouraged to gather adequate expertise to ensure patient safety and gain confidence.

Primary synovial sarcoma of the shoulder: Case report of the "triple sign" on proton density magnetic resonance imaging.

The first case of synovial sarcoma was published in 1893. The disease is a type of primary malignancy of the soft tissues. It is a rare and aggressive neoplasm of unknown tissue origin, characterized by strong metastatic potential and poor prognosis. The present case of a 64-year-old male patient with pain and swelling in his right shoulder and progressive loss of movement demonstrates an uncommon location for the neoplasm. Magnetic resonance proton-density fat-suppressed turbo spin-echo sequences show a heterogeneous mass in the right shoulder. The lack of homogeneity in the signal has been described in medical literature as the "triple sign" and is represented by low, intermediate, and high signal intensity areas through the neoplasm. Visible serpentine vessels spread through the tumor. There was a visible metastatic disease in the regional lymph nodes and metastatic foci in the adjacent bones. Pathological analysis of the tumor confirmed the diagnosis of biphasic synovial sarcoma. An oncological committee advised chemotherapy and radiotherapy. More prominent magnetic resonance imaging findings in synovial sarcoma that may facilitate the diagnostic process are the inhomogeneity and "triple sign" in proton density and T2 sequences, multilobulated tumors, septa, irregular borders, serpentine vascular channels, engagement of the adjacent bones and bone marrow, and involvement of the joint synovia.

Immunohistochemical phenotype of colorectal carcinoma in patients with KRAS mutation and mismatch repair status.

INTRODUCTION: Aberrant expression of CK7/CK20/CDX2 is reported in percentage of colorectal carcinomas (CRC).

Immunohistochemical expression of CK20, CK7, and CDX2 in colorectal carcinoma in correlation with pathomorphological characteristics.

INTRODUCTION: Colorectal carcinoma is the third most common cancer worldwide. The usual immunophenotype of colorectal adenocarcinoma is CDX2 positive, CK20 positive, and CK7 negative. Aberrant expression is reported in a variety of colorectal carcinomas but its relation to morphological variables and survival data is still unclear.