Fisnik Kurshumliu - Academia.edu (original) (raw)

Papers by Fisnik Kurshumliu

Prognosis and management of patients with invasive breast carcinoma, NST is dependant on a few es... more Prognosis and management of patients with invasive breast carcinoma, NST is dependant on a few established parameters such as: TNM stage, Nottingham Prognostic Index, age, Estrogen and Progesterone Receptor expression, Her-2/neu amplification, proliferation index as measured by Ki67 and molecular profiling. In our study we analyzed immunohistochemical expression of Estrogen Receptor, Progesterone Receptor, Her-2/neu, Ki-67 and p53 in in patients classified according to Nottingham Prognostic Index, TNM stage and age. In patients classified according to the original Nottingham Prognostic Index there was significant difference in biomarker expression. In contrast, this difference was not observed when patients were classified according to TNM. In analysis of marker expression in different age groups, significant difference was observed only with p53, expression of which was seen more frequently in younger age group. In conclusion, prognostic stratification of patients by the original N...

Annals of Oncology, 2012

Introduction: Since 2006, the results of MAGIC trial demonstrated that a perioperative regimen of... more Introduction: Since 2006, the results of MAGIC trial demonstrated that a perioperative regimen of Epirrubicin-cisplatin-5FU (ECF) decreases tumour size and stage, with significantly improvement in overall survival (OS) and progression-free survival (PFS). However, the survival rate of patients (pts) with locally advanced resectable gastric cancer (LARGC) remains poor. Our aim was to identify prognostic factors and their correlation with a more aggressive disease in our area. Methods: We retrospectively reviewed 65 pts with LARGC who were planned to receive perioperative chemotherapy followed by surgery at our institution, between May 2008 and February 2012. We analysed the correlation between mOS and recurrence free survival (RFS) with patient characteristics, sex and age, and some tumour characteristics, as histology, tumour localization, both clinical and pathological stage, and tumour regression rate (TRR). OS and RFS was analysed using Kaplan-Meier curves and the differences with Log-Rank test. Results: 16 women and 49 men were analysed, with a median age of 63 years (range 38-78). 41% pts had a diffuse type, 49% an intestinal type and 10% a mixt type adenocarcinoma. 30% of tumours were proximal and 70% were distal. There were clinically 1.6% stage I, 49.2% stage II and 49.2% stage III pts. 58 pts (98%) completed 3 cycles of neoadjuvant chemotherapy. 42 pts received ECF, whereas 23 pts received other schemes (13 pts carboplatin+5FU, 8 pts cisplatin+5FU, 2 pts other combinations). Radiological downstaging was observed in 59% pts. 40 total gastrectomy, 14 partial gastrectomy and 9 Ivor-Lewis were conducted. There was 1 pt who underwent a palliative derivation. We found 1 surgery-related death. Adjuvant chemotherapy was delivered in 45 pts. There were pathologically 22% stage I, 47% stage II, 22% stage III and 9% stage IV pts. Pathological downstaging in terms of TRR (RG1+RG2+RG3) was obtained in 42% pts, achieving 3 complete responses (RG1). 4 pts had marked regression (RG2) and 19 pts had 10-50% viable tumour remaining (RG3), meanwhile 36 pts did not respond (RG4). The median follow-up of the whole group was 24 months. We did not reach nor the mOS neither the mRFS, given that 70% pts were alive after 2 years. 2 year OS was 72% (95 CI, 60.3%-83.6%) and 2 year RFS was 52.5% (95 CI, 39.8%-65.3%). Age<60 years (p=0.03; HR= 0.281, 95% CI 0.08-0.96) and pathological stage (stage I+II) (p=0.01; HR 0.176, 95% CI 0.06-0.4) were found to be significantly correlated with better OS. Pathological stage (stage I+II) (p=0.01; HR 0.20, 95% CI 0.09-0.44) and higher TRR (RG1+RG2) (p=0.033) were found to be significantly correlated with better RFS. Conclusion: Preoperative chemotherapy contributes to pathological downstaging and histologic tumour regression in less than 50% pts. Age>60 years, minor pathological downstaging and tumour regression rate have been objectively correlated to poor outcomes. New patient and tumour characteristics must be identified as prognostic and predictive factors. The development of targeted therapies should provide new possibilities in the treatment of LARGC.

Breast Care, 2018

Background: The aim of this study was to investigate the immunohistochemical expression of riboso... more Background: The aim of this study was to investigate the immunohistochemical expression of ribosomal protein (RP) S6-pS240 in non-special type invasive breast cancer in relation to other prognostic markers and gain new insights to facilitate more individualized treatment. Methods: The following clinical and histopathological parameters of 120 patients were determined: S6-pS240 expression, age, menopausal status, tumor size and grade, TNM stage, Nottingham Prognostic Index (NPI), lymph node stage, estrogen and progesterone receptor (ER/PR) expression, HER2/neu amplification, lymphovascular invasion, and proliferative index as measured by Ki-67. Treatment protocol and disease-free survival were evaluated accordingly. Results: Significant positive correlations were seen between S6-pS240 expression and Ki-67 values (rho = 0.530, p < 0.001), and NPI (rho = 0.370, p < 0.001) and HER2/neu amplification (rho = 0.368, p < 0.001). A negative correlation was found between S6-pS240 and...

Medical archives (Sarajevo, Bosnia and Herzegovina), 2017

Tumors of salivary glands are very rare in children overall, and rarely in minor salivary glands.... more Tumors of salivary glands are very rare in children overall, and rarely in minor salivary glands. Among them pleoomorphic adenoma (PA) is the most common benign tumor of salivary glands in children and it acounts 60% of all salivary neoplasms, frequently found in major salivary glands (85 %) and rarely in minor salivary glands (10-15%). PA appears as painless oval mass, elastic consistency and smooth surface. It characterized by slow evolution of growing. The diagnosis can be confirmed only by histopathological features, after total excision of the lesion. This case report present the uncommon case of the formation well circumscribed in upper lip region, nearby the frenulum labii oris superior in 10 years old school girl. After clinical intraoral examination of the formation approximately 2cm in size the surgical treatment has been done and histopathologic analysis resulted as PA. Long term follow-up examination is necessary due to possible recurence or malignancy alteration.

BMC Research Notes, 2016

Background: Ameloblastoma is a benign epithelial odontogenic tumor. It is often aggressive and de... more Background: Ameloblastoma is a benign epithelial odontogenic tumor. It is often aggressive and destructive, with the capacity to attain great size, erode bone and invade adjacent structures. Unicystic ameloblastoma is a rare odontogenic lesion, with clinical, radiographic and gross features of jaw cysts. The lesion histologically shows typical ameloblastomatous epithelium lining part of the cyst cavity with or without and/or mural tumor growth. Unicystic ameloblastoma usually presents in posterior mandibular ramus region, while it is rare and atypical in posterior maxillary region.. Case presentation: We report a case of 16 year old Kosovar male, Albanian ethnicity, who presented with a swelling located in right maxillary region. Clinical examination revealed a painless swelling extending from the maxillary right central incisor to the maxillary right first molar tooth. Panoramic radiograph disclosed a well corticated unilocular radiolucent lesion approximately 5 × 5 cm in diameter which was in contact with the roots of the teeth present inferiorly and with the maxillary sinus superiorly. Maxillary right canine impaction was noted and unerupted lateral incisor tooth was present inside the radiolucency. Preoperative diagnosis of the lesion was made as dentigerous cyst based on the age of the patient, location of the swelling, clinical and radiographic findings, but the unicystic ameloblastoma was also taken into consideration. The patient was treated by surgical enucleation of the lesion and extraction of lateral incisor tooth which was present inside the lesion. The histopathological examination of the lesion revealed confirmed finding for unicystic ameloblastoma mural form. No recurrence was observed in 1 year follow-up. Conclusions: Maxillary region is considered a rare and atypical location for unicystic ameloblastoma. We emphasize the importance of differential diagnosis of an odontogenic lesion with common clinical and radiological features that will impact the treatment planning and follow up. As oral health providers we should be aware that the unilocular radiolucencies may be unicystic ameloblastoma.

Case Study and Case Report, 2013

BMC Research Notes, 2015

Background: Lung cancer is one of the most frequent malignancies, with high mortality rates. It c... more Background: Lung cancer is one of the most frequent malignancies, with high mortality rates. It can metastasize in almost all organs, but more often invades hilar nodes, liver, adrenal glands, bones and brain. There are various data on the incidence of lung cancer metastases in the skin. In 1-12% of patients with lung cancer are developed skin metastases. Metastases in the skin may be the first sign of lung cancer. Case presentation: Forty-five years old Albanian male, smoker, was admitted to our department with multiple nodules localized in the skin of the head, neck, back and chest. The nodules measuring 5-15 millimeters in greatest dimension were round and skin-colored, with telangiectasias, firm and tender. They appeared in an eruptive form about two weeks before being admitted at our hospital. In addition, the patient exhibited signs of weight loss, anorexia and fatigue. Excisional biopsy was performed to one of the lesions. Histopathology confirmed metastatic nature of the lesion namely, malignant tumor of neuroendocrine phenotype consistent with small-cell carcinoma. Chest X-ray and computed tomography revealed an expansive process in the 7 th segment of the left lung, left hilar and mediastinal lymphadenopathy and a suspicious initial secondary deposit in the left adrenal gland. The patient was referred to the department of oncology for further treatment. After the third cycle of chemotherapy, the magnetic resonance imaging revealed brain metastases. The patient passed away four months after the diagnosis of lung cancer first presented with skin metastases. Conclusions: Metastases in skin may be the first sign of lung cancer. Although rare appearing, we should raise suspicion in cases of atypical lesions in the skin not only of the smokers, but also of the non-smokers. Skin metastases from small-cell lung carcinoma are a poor prognostic indicator. The appearance of multiple skin metastases with other internal metastases shorten the survival time.

Case Reports in Dermatological Medicine, 2013

Darier’s disease, also known as keratosis follicularis or dyskeratosis follicularis, is a rare di... more Darier’s disease, also known as keratosis follicularis or dyskeratosis follicularis, is a rare disorder of keratinization. It is an autosomal dominant genodermatosis with high penetrance and variable expressivity. Its manifestation appears as hyperkeratotic papules, primarily affecting seborrheic areas on the head, neck, and thorax and less frequently on the oral mucosa. When oral manifestations are present, the palatal and alveolar mucosae are primarily affected. They are usually asymptomatic and are discovered in routine dental examination. Histologically, the lesions are presented as suprabasal clefts in the epithelium with acantholytic and dyskeratotic cells represented by “corps ronds and grains”. This paper reports a case of a 53-year-old woman that was admitted to our clinic with more than 10-year history of keratotic papules, presented on the hands and feet, nose, ears, genitalia, and whitish lesions on palatal mucosae.

Cases Journal, 2009

Introduction: Fibroadenoma is the most common benign tumor of the female breast with the highest ... more Introduction: Fibroadenoma is the most common benign tumor of the female breast with the highest incidence before age 30. Fibroadenoma may be associated with fibrocystic changes, proliferative epithelial changes, and extremely rarely, with non-invasive and invasive cancer. Case presentation: We present a rare case of a 39 years old female with invasive ductal carcinoma arising within fibroadenoma. Conclusion: There is a low percentage of fibroadenomas harboring carcinoma; however, all breast lumps should be seriously managed; extirpation and histological examination is recommended.

Abstract Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastro... more Abstract Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract. Surgery with complete removal of the tumor is the primary treatment for resectable GIST and the only chance of cure.We report the case of a 69-year-old Albanian female patient presenting with massive fresh blood vomiting. In Abdominal palpation are soft huge tumor with moderate sensitivity in epigastrium region. . Endoscopicaly bleeding cannot be stopped and resolved. After short evaluation and preoperative recovery, urgent Indication for Surgery intervention has been taken and total gastrectomy and Oesophago- Jejuno Anastomossis has been performed. However, the risk of postoperative recurrence was fairly high in such tumors with high-risk features, 2 years after operation the patient is well without any intestinal problems. Gigantic gastrointestinal stromal tumor presenting with severe bleeding had an uneventful surgical outcome. Surgery remains the primary treatment f...

Copyright © 2014 Nexhmi Hyseni et al.This is an open access article distributed under the Creativ... more Copyright © 2014 Nexhmi Hyseni et al.This is an open access article distributed under the Creative CommonsAttribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Ovarian dysgerminoma is a rare malignant ovarian germ cell tumor with its peak incidence in young women. Abdominal pain, abdominal distention, and the presence of a palpable mass are common symptoms at presentation. Depending on the FIGO stage at presentation the prognosis of dysgerminomas after surgical treatment, adjuvant chemotherapy, and radiotherapy is promising. Case Presentation. A 7-year-old girl was presented at our clinic with abdominal pain in all abdominal quadrants. Later the pain localized in the region of her right ovary. CT scan revealed a massive formation which was connected to her right ovary.

Background The aim of this study was to explore the clinical, patohistological and molecular char... more Background The aim of this study was to explore the clinical, patohistological and molecular characteristics of primary operable breast cancer in patients from Croatia and Kosovo, in order to compare disease stage at the time of diagnosis, in country with implemented mammography screening and early diagnostic methods with country without it. Methods The study prospectively included 213 female patients with breast cancer (BC) ranging from 28 to 87 years of age, from which 100 from Kosovo and 113 from Croatia. Age and menopausal status of the patients were recorded before surgery. Subsequent to surgery, histopathology and immunohistochemistry analysis was carried out and data were statistically analysed. Categorical variables were compared using chi-square analysis and presented as frequencies and percentages. For non-parametric data, Mann-Whitney U test was used in order to compare means of two independent groups. A value of P

Advances in Life Science and Technology, 2017

The history of testicular descent is closely connected with the expression of masculinity and as ... more The history of testicular descent is closely connected with the expression of masculinity and as such can be traced back to ancient Egypt. Research into testicular descent was initiated by Haller and Hunter. It was Hunter who discovered that the testes descend during embryonal life from dorsal abdominal wall into the scrotum. In the study conducted by “John Radcliffe Hospital” the incidence of cryptorchidism is 1.58%, spontaneous descent occurred postnatal in the first three months, and beyond that time, it was rare[1, 2]. As with other pathologies treatment and timing had changed during the years.Very important part of modern medical infrastructure is a functioning informative system, where the data about patients are registered. In the postwar developing country (Kosovo), rebuilding medical care and information system required a lot of effort and time. When the whole medical system needs to be rebuild and equipped, informative system is not in top priorities. What in normal circ...

Advances in Life Science and Technology, 2017

Introduction: Acute scrotum is a wide term that is used for cases that presenting with scrotal sw... more Introduction: Acute scrotum is a wide term that is used for cases that presenting with scrotal swelling and pain. Etiology can be infectious or strangulation from torsion of the testis, depending on its clinical diagnosis, requires surgical intervention or medical treatment .Aim of study : Aim of this study was to determine the rate of accuracy of the Echo Doppler scanning in the diagnosis of the testicular torsion. Considering that there are different protocols in diagnosis, some suggest surgical exploration, while some Hospitals report 100% accuracy in diagnosis of testicular torsion with Doppler ultrasound. Materials and methods: We retrospectively evaluated 4 year period, from 2011-2014, during this time all the patients that were admitted as acute scrotum where evaluated excluding the cases that were incarcerated hernias. In all admitted patients, physical examination, lab analysis and Echo Doppler study were performed. Results: In total, there were 83 patients, based on physic...

Current Pediatric Reviews, 2020

Background: Celiac disease is an immune-mediated disorder characterized by variable clinical mani... more Background: Celiac disease is an immune-mediated disorder characterized by variable clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy. Objectives: The aim of this study was to present the clinical spectrum and patterns of celiac disease in Kosovar Albanian children. Methods: A cross-sectional retrospective study was performed with Albanian children aged 0-18 years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from 2005 to 2016. Results: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02), while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2 years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly presented with gastrointestinal symptoms, while primary school children and adolescents mostl...

World Journal of Surgical Oncology, 2019

Background: Ultrastructural and immunohistochemical differences have been described in FDCs of pr... more Background: Ultrastructural and immunohistochemical differences have been described in FDCs of primary and secondary follicles, illustrating the highly compartmentalized structure of lymph follicles. Differences in FDC immunophenotype in different grades of FL may reflect some parallelism between reactive and neoplastic conditions in terms of FDC-B cell interaction and may be used as a valuable additional tool for grading FL. Methods: A total of 60 paraffin blocks from patients with follicular lymphoma, 30 cases each of grade 1 and 3, were retrieved from our archive. Immunohistochemical analysis was carried out for CD21, CD23, cyclin A, and Ki-67. Results: Our study demonstrates that during evaluation, six patterns of FDC distribution were distinguished. The intensity of stain for CD21 was not statistically significant in grade 1 and grade 3 FL (p = 0.340). In contrast, grade 3 FLs exhibited a significant decrease of CD23 expression by the FDCs (p < 0.001). By CD21 stain, there was no significant difference in the distribution of pattern 1 in grades 1 and 3 (p = 0.098). In contrast, in grade 3, this pattern was significantly less observed by CD23 stain (p = 0.016). The same was observed for pattern 2 for CD21 (p = 0.940) and CD23 (p = 0.010) and pattern 4 for CD21 (p = 0.305) and CD23 (p = 0.005), respectively. Distribution of pattern 5 was significantly different between grades 1 and 3 both for CD21 (p = 0.005) and CD23 (p < 0.001). Distribution of patterns 2 and 6 was not significantly different between grades 1 and 3 for CD21 and CD23. The values of cyclin A and Mib-1 were also significantly different between grades 1 and 3 (p < 0.001). Conclusions: The observed patterns of FDCs lead us to believe that similar to reactive lymph node follicles, neoplastic follicles in FL, at least in early stages, have an organized structure. Hypothetically, with CD21, CD23, and cyclin A immunohistochemistry, the sequence of events in FL progression may be traced.

Acta clinica Croatica, 2017

Angiogenesis is essential for the development, growth and progression of tumors. Although vascula... more Angiogenesis is essential for the development, growth and progression of tumors. Although vascular endothelial growth factor (VEGF) is a well-known proangiogenic factor, its impact on lymphoma has not yet been fully clarified. The aim of this study was to evaluate VEGF-A -expression and microvessel density (MVD) in aggressive lymphoma such as diffuse large B-cell lymphoma (DLBCL), in indolent lymphomas such as low-grade follicular lymphoma (FL), and in lymph node reactive follicular hyperplasia (FH). In 80 prospective and retrospective cases (30 DLBCL, 30 FL and 20 FH), CD31 was analyzed by immunohistochemical staining assessing density of blood vessels, as well as the total number of CD31 positive endothelial cells. The results were compared with relevant clinical data. MVD was 85% in FH, followed by 60% in DLBCL and 43% in low-grade FL. VEGF-A was significantly higher in DLBCL than in low-grade FL and FH. A statistically significant association of MVD and VEGF-A with the Internati...

Open access Macedonian journal of medical sciences, Jan 15, 2017

The patient, a 40-year-old male, was referred to our clinic with intermittent nausea, vomiting an... more The patient, a 40-year-old male, was referred to our clinic with intermittent nausea, vomiting and symptomatic anemia for 4 months. Notable hematological indices were low hemoglobin levels of 9.6 g/dl and hematocrit levels of 35.8%, while after receiving two units of concentrated red blood cells, at discharge; they achieved levels of 15.2 g/dl and 42.3%, respectively. Esophagogastroduodenoscopy revealed a 3 cm antral pedunculated polyp, prolapsing into pylorus thus causing intermittent pyloric obstruction and anemia. Histological examination revealed a hyperplastic polyp without evidences of malignancy. No atrophy, metaplasia, dysplastic changes or Helicobacter pylori infection were detected in samples taken from the antrum and the corpus; however, the examination provided evidence for gastritis. Follow-up endoscopy was provided after 12 weeks to see polypectomy site after a course of Pantoprazole administration, and to define symptom-free time after polypectomy. Endoscopic removal ...

European Journal of Plastic Surgery, 2016

Background The most frequent complication after flexor tendon repair is the development of adhesi... more Background The most frequent complication after flexor tendon repair is the development of adhesions. Our purpose was to investigate the effects of 5-fluorouracil (5-FU) on tendon adhesions in partially divided profundus flexor tendons (flexor digitorum profundus (FDPs)) following surgical repair and in partially divided FDPs without surgical repair. Methods The study was performed on the deep flexor tendons of the second and third digits of the right hind paws of rabbits. Results Results of the repair versus the nonrepair of zone two injuries were compared via histopathological evaluations of tendon adhesions. Based on the results observed in our experimental study, during histological evaluation, the adhesion was significantly greater in subgroup 1a in which the tendons were repaired surgically and not treated with 5-FU than those of subgroup 2a in which the tendons were repaired surgically and treated with 5-FU. There were no significant differences in histological evaluation of the tendons of subgroups 1b and 2b. Based on the results observed in our experimental study, we conclude that 5-FU did not affect on the creation of adhesion in partially divided flexor tendons that have not been surgically repaired. Conclusions A single topical application of 5-FU at a concentration of 25 mg/ml was effective in controlling peritendinous adhesions following surgical repair in this animal model. Level of Evidence: Not ratable.

Prognosis and management of patients with invasive breast carcinoma, NST is dependant on a few es... more Prognosis and management of patients with invasive breast carcinoma, NST is dependant on a few established parameters such as: TNM stage, Nottingham Prognostic Index, age, Estrogen and Progesterone Receptor expression, Her-2/neu amplification, proliferation index as measured by Ki67 and molecular profiling. In our study we analyzed immunohistochemical expression of Estrogen Receptor, Progesterone Receptor, Her-2/neu, Ki-67 and p53 in in patients classified according to Nottingham Prognostic Index, TNM stage and age. In patients classified according to the original Nottingham Prognostic Index there was significant difference in biomarker expression. In contrast, this difference was not observed when patients were classified according to TNM. In analysis of marker expression in different age groups, significant difference was observed only with p53, expression of which was seen more frequently in younger age group. In conclusion, prognostic stratification of patients by the original N...

Annals of Oncology, 2012

Introduction: Since 2006, the results of MAGIC trial demonstrated that a perioperative regimen of... more Introduction: Since 2006, the results of MAGIC trial demonstrated that a perioperative regimen of Epirrubicin-cisplatin-5FU (ECF) decreases tumour size and stage, with significantly improvement in overall survival (OS) and progression-free survival (PFS). However, the survival rate of patients (pts) with locally advanced resectable gastric cancer (LARGC) remains poor. Our aim was to identify prognostic factors and their correlation with a more aggressive disease in our area. Methods: We retrospectively reviewed 65 pts with LARGC who were planned to receive perioperative chemotherapy followed by surgery at our institution, between May 2008 and February 2012. We analysed the correlation between mOS and recurrence free survival (RFS) with patient characteristics, sex and age, and some tumour characteristics, as histology, tumour localization, both clinical and pathological stage, and tumour regression rate (TRR). OS and RFS was analysed using Kaplan-Meier curves and the differences with Log-Rank test. Results: 16 women and 49 men were analysed, with a median age of 63 years (range 38-78). 41% pts had a diffuse type, 49% an intestinal type and 10% a mixt type adenocarcinoma. 30% of tumours were proximal and 70% were distal. There were clinically 1.6% stage I, 49.2% stage II and 49.2% stage III pts. 58 pts (98%) completed 3 cycles of neoadjuvant chemotherapy. 42 pts received ECF, whereas 23 pts received other schemes (13 pts carboplatin+5FU, 8 pts cisplatin+5FU, 2 pts other combinations). Radiological downstaging was observed in 59% pts. 40 total gastrectomy, 14 partial gastrectomy and 9 Ivor-Lewis were conducted. There was 1 pt who underwent a palliative derivation. We found 1 surgery-related death. Adjuvant chemotherapy was delivered in 45 pts. There were pathologically 22% stage I, 47% stage II, 22% stage III and 9% stage IV pts. Pathological downstaging in terms of TRR (RG1+RG2+RG3) was obtained in 42% pts, achieving 3 complete responses (RG1). 4 pts had marked regression (RG2) and 19 pts had 10-50% viable tumour remaining (RG3), meanwhile 36 pts did not respond (RG4). The median follow-up of the whole group was 24 months. We did not reach nor the mOS neither the mRFS, given that 70% pts were alive after 2 years. 2 year OS was 72% (95 CI, 60.3%-83.6%) and 2 year RFS was 52.5% (95 CI, 39.8%-65.3%). Age<60 years (p=0.03; HR= 0.281, 95% CI 0.08-0.96) and pathological stage (stage I+II) (p=0.01; HR 0.176, 95% CI 0.06-0.4) were found to be significantly correlated with better OS. Pathological stage (stage I+II) (p=0.01; HR 0.20, 95% CI 0.09-0.44) and higher TRR (RG1+RG2) (p=0.033) were found to be significantly correlated with better RFS. Conclusion: Preoperative chemotherapy contributes to pathological downstaging and histologic tumour regression in less than 50% pts. Age>60 years, minor pathological downstaging and tumour regression rate have been objectively correlated to poor outcomes. New patient and tumour characteristics must be identified as prognostic and predictive factors. The development of targeted therapies should provide new possibilities in the treatment of LARGC.

Breast Care, 2018

Background: The aim of this study was to investigate the immunohistochemical expression of riboso... more Background: The aim of this study was to investigate the immunohistochemical expression of ribosomal protein (RP) S6-pS240 in non-special type invasive breast cancer in relation to other prognostic markers and gain new insights to facilitate more individualized treatment. Methods: The following clinical and histopathological parameters of 120 patients were determined: S6-pS240 expression, age, menopausal status, tumor size and grade, TNM stage, Nottingham Prognostic Index (NPI), lymph node stage, estrogen and progesterone receptor (ER/PR) expression, HER2/neu amplification, lymphovascular invasion, and proliferative index as measured by Ki-67. Treatment protocol and disease-free survival were evaluated accordingly. Results: Significant positive correlations were seen between S6-pS240 expression and Ki-67 values (rho = 0.530, p < 0.001), and NPI (rho = 0.370, p < 0.001) and HER2/neu amplification (rho = 0.368, p < 0.001). A negative correlation was found between S6-pS240 and...

Medical archives (Sarajevo, Bosnia and Herzegovina), 2017

Tumors of salivary glands are very rare in children overall, and rarely in minor salivary glands.... more Tumors of salivary glands are very rare in children overall, and rarely in minor salivary glands. Among them pleoomorphic adenoma (PA) is the most common benign tumor of salivary glands in children and it acounts 60% of all salivary neoplasms, frequently found in major salivary glands (85 %) and rarely in minor salivary glands (10-15%). PA appears as painless oval mass, elastic consistency and smooth surface. It characterized by slow evolution of growing. The diagnosis can be confirmed only by histopathological features, after total excision of the lesion. This case report present the uncommon case of the formation well circumscribed in upper lip region, nearby the frenulum labii oris superior in 10 years old school girl. After clinical intraoral examination of the formation approximately 2cm in size the surgical treatment has been done and histopathologic analysis resulted as PA. Long term follow-up examination is necessary due to possible recurence or malignancy alteration.

BMC Research Notes, 2016

Background: Ameloblastoma is a benign epithelial odontogenic tumor. It is often aggressive and de... more Background: Ameloblastoma is a benign epithelial odontogenic tumor. It is often aggressive and destructive, with the capacity to attain great size, erode bone and invade adjacent structures. Unicystic ameloblastoma is a rare odontogenic lesion, with clinical, radiographic and gross features of jaw cysts. The lesion histologically shows typical ameloblastomatous epithelium lining part of the cyst cavity with or without and/or mural tumor growth. Unicystic ameloblastoma usually presents in posterior mandibular ramus region, while it is rare and atypical in posterior maxillary region.. Case presentation: We report a case of 16 year old Kosovar male, Albanian ethnicity, who presented with a swelling located in right maxillary region. Clinical examination revealed a painless swelling extending from the maxillary right central incisor to the maxillary right first molar tooth. Panoramic radiograph disclosed a well corticated unilocular radiolucent lesion approximately 5 × 5 cm in diameter which was in contact with the roots of the teeth present inferiorly and with the maxillary sinus superiorly. Maxillary right canine impaction was noted and unerupted lateral incisor tooth was present inside the radiolucency. Preoperative diagnosis of the lesion was made as dentigerous cyst based on the age of the patient, location of the swelling, clinical and radiographic findings, but the unicystic ameloblastoma was also taken into consideration. The patient was treated by surgical enucleation of the lesion and extraction of lateral incisor tooth which was present inside the lesion. The histopathological examination of the lesion revealed confirmed finding for unicystic ameloblastoma mural form. No recurrence was observed in 1 year follow-up. Conclusions: Maxillary region is considered a rare and atypical location for unicystic ameloblastoma. We emphasize the importance of differential diagnosis of an odontogenic lesion with common clinical and radiological features that will impact the treatment planning and follow up. As oral health providers we should be aware that the unilocular radiolucencies may be unicystic ameloblastoma.

Case Study and Case Report, 2013

BMC Research Notes, 2015

Background: Lung cancer is one of the most frequent malignancies, with high mortality rates. It c... more Background: Lung cancer is one of the most frequent malignancies, with high mortality rates. It can metastasize in almost all organs, but more often invades hilar nodes, liver, adrenal glands, bones and brain. There are various data on the incidence of lung cancer metastases in the skin. In 1-12% of patients with lung cancer are developed skin metastases. Metastases in the skin may be the first sign of lung cancer. Case presentation: Forty-five years old Albanian male, smoker, was admitted to our department with multiple nodules localized in the skin of the head, neck, back and chest. The nodules measuring 5-15 millimeters in greatest dimension were round and skin-colored, with telangiectasias, firm and tender. They appeared in an eruptive form about two weeks before being admitted at our hospital. In addition, the patient exhibited signs of weight loss, anorexia and fatigue. Excisional biopsy was performed to one of the lesions. Histopathology confirmed metastatic nature of the lesion namely, malignant tumor of neuroendocrine phenotype consistent with small-cell carcinoma. Chest X-ray and computed tomography revealed an expansive process in the 7 th segment of the left lung, left hilar and mediastinal lymphadenopathy and a suspicious initial secondary deposit in the left adrenal gland. The patient was referred to the department of oncology for further treatment. After the third cycle of chemotherapy, the magnetic resonance imaging revealed brain metastases. The patient passed away four months after the diagnosis of lung cancer first presented with skin metastases. Conclusions: Metastases in skin may be the first sign of lung cancer. Although rare appearing, we should raise suspicion in cases of atypical lesions in the skin not only of the smokers, but also of the non-smokers. Skin metastases from small-cell lung carcinoma are a poor prognostic indicator. The appearance of multiple skin metastases with other internal metastases shorten the survival time.

Case Reports in Dermatological Medicine, 2013

Darier’s disease, also known as keratosis follicularis or dyskeratosis follicularis, is a rare di... more Darier’s disease, also known as keratosis follicularis or dyskeratosis follicularis, is a rare disorder of keratinization. It is an autosomal dominant genodermatosis with high penetrance and variable expressivity. Its manifestation appears as hyperkeratotic papules, primarily affecting seborrheic areas on the head, neck, and thorax and less frequently on the oral mucosa. When oral manifestations are present, the palatal and alveolar mucosae are primarily affected. They are usually asymptomatic and are discovered in routine dental examination. Histologically, the lesions are presented as suprabasal clefts in the epithelium with acantholytic and dyskeratotic cells represented by “corps ronds and grains”. This paper reports a case of a 53-year-old woman that was admitted to our clinic with more than 10-year history of keratotic papules, presented on the hands and feet, nose, ears, genitalia, and whitish lesions on palatal mucosae.

Cases Journal, 2009

Introduction: Fibroadenoma is the most common benign tumor of the female breast with the highest ... more Introduction: Fibroadenoma is the most common benign tumor of the female breast with the highest incidence before age 30. Fibroadenoma may be associated with fibrocystic changes, proliferative epithelial changes, and extremely rarely, with non-invasive and invasive cancer. Case presentation: We present a rare case of a 39 years old female with invasive ductal carcinoma arising within fibroadenoma. Conclusion: There is a low percentage of fibroadenomas harboring carcinoma; however, all breast lumps should be seriously managed; extirpation and histological examination is recommended.

Abstract Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastro... more Abstract Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract. Surgery with complete removal of the tumor is the primary treatment for resectable GIST and the only chance of cure.We report the case of a 69-year-old Albanian female patient presenting with massive fresh blood vomiting. In Abdominal palpation are soft huge tumor with moderate sensitivity in epigastrium region. . Endoscopicaly bleeding cannot be stopped and resolved. After short evaluation and preoperative recovery, urgent Indication for Surgery intervention has been taken and total gastrectomy and Oesophago- Jejuno Anastomossis has been performed. However, the risk of postoperative recurrence was fairly high in such tumors with high-risk features, 2 years after operation the patient is well without any intestinal problems. Gigantic gastrointestinal stromal tumor presenting with severe bleeding had an uneventful surgical outcome. Surgery remains the primary treatment f...

Copyright © 2014 Nexhmi Hyseni et al.This is an open access article distributed under the Creativ... more Copyright © 2014 Nexhmi Hyseni et al.This is an open access article distributed under the Creative CommonsAttribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Ovarian dysgerminoma is a rare malignant ovarian germ cell tumor with its peak incidence in young women. Abdominal pain, abdominal distention, and the presence of a palpable mass are common symptoms at presentation. Depending on the FIGO stage at presentation the prognosis of dysgerminomas after surgical treatment, adjuvant chemotherapy, and radiotherapy is promising. Case Presentation. A 7-year-old girl was presented at our clinic with abdominal pain in all abdominal quadrants. Later the pain localized in the region of her right ovary. CT scan revealed a massive formation which was connected to her right ovary.

Background The aim of this study was to explore the clinical, patohistological and molecular char... more Background The aim of this study was to explore the clinical, patohistological and molecular characteristics of primary operable breast cancer in patients from Croatia and Kosovo, in order to compare disease stage at the time of diagnosis, in country with implemented mammography screening and early diagnostic methods with country without it. Methods The study prospectively included 213 female patients with breast cancer (BC) ranging from 28 to 87 years of age, from which 100 from Kosovo and 113 from Croatia. Age and menopausal status of the patients were recorded before surgery. Subsequent to surgery, histopathology and immunohistochemistry analysis was carried out and data were statistically analysed. Categorical variables were compared using chi-square analysis and presented as frequencies and percentages. For non-parametric data, Mann-Whitney U test was used in order to compare means of two independent groups. A value of P

Advances in Life Science and Technology, 2017

The history of testicular descent is closely connected with the expression of masculinity and as ... more The history of testicular descent is closely connected with the expression of masculinity and as such can be traced back to ancient Egypt. Research into testicular descent was initiated by Haller and Hunter. It was Hunter who discovered that the testes descend during embryonal life from dorsal abdominal wall into the scrotum. In the study conducted by “John Radcliffe Hospital” the incidence of cryptorchidism is 1.58%, spontaneous descent occurred postnatal in the first three months, and beyond that time, it was rare[1, 2]. As with other pathologies treatment and timing had changed during the years.Very important part of modern medical infrastructure is a functioning informative system, where the data about patients are registered. In the postwar developing country (Kosovo), rebuilding medical care and information system required a lot of effort and time. When the whole medical system needs to be rebuild and equipped, informative system is not in top priorities. What in normal circ...

Advances in Life Science and Technology, 2017

Introduction: Acute scrotum is a wide term that is used for cases that presenting with scrotal sw... more Introduction: Acute scrotum is a wide term that is used for cases that presenting with scrotal swelling and pain. Etiology can be infectious or strangulation from torsion of the testis, depending on its clinical diagnosis, requires surgical intervention or medical treatment .Aim of study : Aim of this study was to determine the rate of accuracy of the Echo Doppler scanning in the diagnosis of the testicular torsion. Considering that there are different protocols in diagnosis, some suggest surgical exploration, while some Hospitals report 100% accuracy in diagnosis of testicular torsion with Doppler ultrasound. Materials and methods: We retrospectively evaluated 4 year period, from 2011-2014, during this time all the patients that were admitted as acute scrotum where evaluated excluding the cases that were incarcerated hernias. In all admitted patients, physical examination, lab analysis and Echo Doppler study were performed. Results: In total, there were 83 patients, based on physic...

Current Pediatric Reviews, 2020

Background: Celiac disease is an immune-mediated disorder characterized by variable clinical mani... more Background: Celiac disease is an immune-mediated disorder characterized by variable clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy. Objectives: The aim of this study was to present the clinical spectrum and patterns of celiac disease in Kosovar Albanian children. Methods: A cross-sectional retrospective study was performed with Albanian children aged 0-18 years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from 2005 to 2016. Results: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02), while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2 years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly presented with gastrointestinal symptoms, while primary school children and adolescents mostl...

World Journal of Surgical Oncology, 2019

Background: Ultrastructural and immunohistochemical differences have been described in FDCs of pr... more Background: Ultrastructural and immunohistochemical differences have been described in FDCs of primary and secondary follicles, illustrating the highly compartmentalized structure of lymph follicles. Differences in FDC immunophenotype in different grades of FL may reflect some parallelism between reactive and neoplastic conditions in terms of FDC-B cell interaction and may be used as a valuable additional tool for grading FL. Methods: A total of 60 paraffin blocks from patients with follicular lymphoma, 30 cases each of grade 1 and 3, were retrieved from our archive. Immunohistochemical analysis was carried out for CD21, CD23, cyclin A, and Ki-67. Results: Our study demonstrates that during evaluation, six patterns of FDC distribution were distinguished. The intensity of stain for CD21 was not statistically significant in grade 1 and grade 3 FL (p = 0.340). In contrast, grade 3 FLs exhibited a significant decrease of CD23 expression by the FDCs (p < 0.001). By CD21 stain, there was no significant difference in the distribution of pattern 1 in grades 1 and 3 (p = 0.098). In contrast, in grade 3, this pattern was significantly less observed by CD23 stain (p = 0.016). The same was observed for pattern 2 for CD21 (p = 0.940) and CD23 (p = 0.010) and pattern 4 for CD21 (p = 0.305) and CD23 (p = 0.005), respectively. Distribution of pattern 5 was significantly different between grades 1 and 3 both for CD21 (p = 0.005) and CD23 (p < 0.001). Distribution of patterns 2 and 6 was not significantly different between grades 1 and 3 for CD21 and CD23. The values of cyclin A and Mib-1 were also significantly different between grades 1 and 3 (p < 0.001). Conclusions: The observed patterns of FDCs lead us to believe that similar to reactive lymph node follicles, neoplastic follicles in FL, at least in early stages, have an organized structure. Hypothetically, with CD21, CD23, and cyclin A immunohistochemistry, the sequence of events in FL progression may be traced.

Acta clinica Croatica, 2017

Angiogenesis is essential for the development, growth and progression of tumors. Although vascula... more Angiogenesis is essential for the development, growth and progression of tumors. Although vascular endothelial growth factor (VEGF) is a well-known proangiogenic factor, its impact on lymphoma has not yet been fully clarified. The aim of this study was to evaluate VEGF-A -expression and microvessel density (MVD) in aggressive lymphoma such as diffuse large B-cell lymphoma (DLBCL), in indolent lymphomas such as low-grade follicular lymphoma (FL), and in lymph node reactive follicular hyperplasia (FH). In 80 prospective and retrospective cases (30 DLBCL, 30 FL and 20 FH), CD31 was analyzed by immunohistochemical staining assessing density of blood vessels, as well as the total number of CD31 positive endothelial cells. The results were compared with relevant clinical data. MVD was 85% in FH, followed by 60% in DLBCL and 43% in low-grade FL. VEGF-A was significantly higher in DLBCL than in low-grade FL and FH. A statistically significant association of MVD and VEGF-A with the Internati...

Open access Macedonian journal of medical sciences, Jan 15, 2017

The patient, a 40-year-old male, was referred to our clinic with intermittent nausea, vomiting an... more The patient, a 40-year-old male, was referred to our clinic with intermittent nausea, vomiting and symptomatic anemia for 4 months. Notable hematological indices were low hemoglobin levels of 9.6 g/dl and hematocrit levels of 35.8%, while after receiving two units of concentrated red blood cells, at discharge; they achieved levels of 15.2 g/dl and 42.3%, respectively. Esophagogastroduodenoscopy revealed a 3 cm antral pedunculated polyp, prolapsing into pylorus thus causing intermittent pyloric obstruction and anemia. Histological examination revealed a hyperplastic polyp without evidences of malignancy. No atrophy, metaplasia, dysplastic changes or Helicobacter pylori infection were detected in samples taken from the antrum and the corpus; however, the examination provided evidence for gastritis. Follow-up endoscopy was provided after 12 weeks to see polypectomy site after a course of Pantoprazole administration, and to define symptom-free time after polypectomy. Endoscopic removal ...

European Journal of Plastic Surgery, 2016

Background The most frequent complication after flexor tendon repair is the development of adhesi... more Background The most frequent complication after flexor tendon repair is the development of adhesions. Our purpose was to investigate the effects of 5-fluorouracil (5-FU) on tendon adhesions in partially divided profundus flexor tendons (flexor digitorum profundus (FDPs)) following surgical repair and in partially divided FDPs without surgical repair. Methods The study was performed on the deep flexor tendons of the second and third digits of the right hind paws of rabbits. Results Results of the repair versus the nonrepair of zone two injuries were compared via histopathological evaluations of tendon adhesions. Based on the results observed in our experimental study, during histological evaluation, the adhesion was significantly greater in subgroup 1a in which the tendons were repaired surgically and not treated with 5-FU than those of subgroup 2a in which the tendons were repaired surgically and treated with 5-FU. There were no significant differences in histological evaluation of the tendons of subgroups 1b and 2b. Based on the results observed in our experimental study, we conclude that 5-FU did not affect on the creation of adhesion in partially divided flexor tendons that have not been surgically repaired. Conclusions A single topical application of 5-FU at a concentration of 25 mg/ml was effective in controlling peritendinous adhesions following surgical repair in this animal model. Level of Evidence: Not ratable.