[Oncocytoma of the pancreas. A case report]. / Vurkhu edin sluchai s onkotsitom na pankreasa.

For the first time in the bulgarian literature a case with pancreatic oncocytoma is described, initially diagnosed as carcinoma. The patient survived for 13 years being nowadays in perfect condition.

[Mucinous breast carcinomas with neuroendocrine differentiation]. / Mutsinozni kartsinomi na g'rdata s nevroendokrinna diferentsiatsiia.

Mucinous breast carcinomas, denominated also gelatinous, mucoid and colloid (collomas), represent a heterogeneous group of neoplasms. More than half of them exhibit signs of neuroendocrine differentiation. Eighteen mucus producing carcinomas of the breast are subjected to morphological study. On the ground of demonstrating argyrophilia by the methods of Grimelius and Churukian--Shenk, and presence of secreting granules during electron microscopic study, they are assigned under the heading apudomas, i.e. tumors of the diffuse endocrine system, or the so-called APUD-system. The important practical implications of demonstrating neuroendocrine cells with a special reference to the biological patterns of this particular type of tumors are discussed.

[A case of somatostatinoma of the pancreas]. / Vurkhu edin sluchai sus somatostatinom na pankreasa.

A case of a 36-year-old man with pancreatic somatostatinoma is reported. Such cases are very rare. The following signs were found; quick ESR, increased alpha 2- and beta-globulins, shortened Weltmann's coagulation band, increased serum bilirubin level, especially of the conjugated fraction, enzyme constellation of cholestasis and moderate liver cytolysis. Ultrasound examination of the abdomen, retrograde cholangiopancreatography and percutaneous liver cholangiography were performed in order to prove the diagnosis. They demonstrated an obstruction in Vater's papilla region and a bulky process in the head of the pancreas. The patient was operated. The microscopic, electron microscopic and immunohistochemical examinations proved a somatostatinoma of the pancreas. The positive immunohistochemical tests for somatostatin and carcinoembryonal antigen in the tumor cels are especially indicative.

[Recurrent adenoma of the hypophysis]. / Retsidiviruiushchie adenomy gipofiza.

Adenoma recurrences were established in 24 (9.7%) of 247 patients with operated pituitary adenomas; 7 of them were with chromophobic non-secreting adenomas, 9 patients with acromegaly, 5 female and 3 male patients were with prolactinomas. Transcranial operations were performed on patients with large-size tumors and transsphenoidal ones on patients with small-size adenomas. Our experience has shown that adenoma recurrence was more frequent in larger tumors. Our results are supported by those of other authors. Early diagnosis and surgical treatment of pituitary adenomas prevent their recurrences.

[Principles of selection of the method of treating Itsenko-Cushing disease]. / Printsipy vybora metodov lecheniia bolezni Itsenko-Kushinga.

Various methods for therapy of Icenko-Cushing's disease: radiotherapeutic, surgical and medicinal were evaluated. A total of 184 patients were treated. The authors have been of opinion that therapeutic methods depended on function of the neuroendocrine system and adrenal cortex, e. g. reserpine used after gamma-therapy alone or in combination with unilateral adrenalectomy increased the efficacy of therapy and reduced the time of remission. Parlodel used alone or in combination with chloditan could be used in therapy of early forms of the disease in young patients. Transsphenoidal adenomectomy and proton beam therapy of the hypophysis were recommended in hypophysial adenomas. Proton beam therapy of the hypophysis was an effective method for therapy of patients with diffuse hyperplasia of the adrenal cortex and could be used in diffuse nodular hyperplasia of the adrenal cortex in combination with unilateral adrenalectomy.