Vesna Božić

Centar za Promociju Nauke

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Vladan Živaljević

University of Belgrade

Svetislav Tatić

University of Belgrade

Ivan Paunović

University of Belgrade

Aleksandar Diklić

University of Belgrade

M Havelka

Croatian Institute of Transfusion Medicine

Ksenija Krgovic

Univerzitetski Klinički Centar Srbije

Nevena Kalezić

Univerzitetski Klinički Centar Srbije

Dubravka Cvejić

University of Belgrade

Jelena Janković

University of Belgrade

Lazar Davidović

University of Belgrade

Cooperative Institutions

University of Belgrade

Univerzitetski Klinički Centar Srbije

Centar za Promociju Nauke

Institute for Cardiovascular Diseases of Vojvodina

Institut za Reumatologiju

University of Belgrade – Faculty of Medicine

Center for Health, Exercise and Sport Sciences

Institute for the Application of Nuclear Energy

Oncology Institute of Vojvodina

Military Medical Academy

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Medullary thyroid carcinoma: Sporadic, hereditary

Acta chirurgica iugoslavica (2003)

Ivan Paunović Aleksandar Diklić Ksenija Krgovic Vladan Živaljević Svetislav Tatić

Medullary thyroid cancer (MTC) is uncommon thyroid tumor with specific characteristics which undoubtedly divide this tumor from other thyroid malignances. Patients with sporadic or hereditary form of MTC differ in clinical presentation, recurrence of the disease and outcome. The aim of study was to establish surgical characteristics of MTC as well as clinical factors that influence surgical treatment. The study group consisted of 68 patients with MTC managed at the Center for Endocrine Surgery between 1987. and 1999. Retrospective analysis included clinical form of the disease, general data, histological and other tumor characteristics. Mean age of the patients were 47.3 years (female/male ratio: 1.5:1). Mean size of tumor was 80.5 cm3, 72.1% patients had tumor greater than 4 cm. in diameter or extrathyroid spread. The majority of patients were in II and III stadium of the disease. Primary operation (at least total thyroidectomy) was performed in 57 (84%) patients. 2(3%) had postoperatively temporally nerve palsy and 7(10.29%) temporally hypoparathyroidism. The overall survival was 46.8 + 9.9% after 9 years and 63.6 + 7.2% at 5 years. Postoperative calcitonin value is significant predictor of survival /Spearman's coefficient (R=0.7048)/, worse prognosis is in correlation with high postoperative calcitonin values. The treatment of choice is at least total thyroidectomy and central lymph nodes resection if enlarged lymph nodes are found. Precise operative technique lowers the risk of postoperative complications. Complex approach to the patient with MTC includes all available methods in pre and postoperative evaluation as well as surgeon's knowledge and skill.

Medullary carcinoma

10.2298/aci0303113p

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Predictive Significance of Two MMP-9 Promoter Polymorphisms and Acetylated c-Jun Transcription Factor for Papillary Thyroid Carcinoma Advancement

Diagnostics (2022)

Jelena Rončević Jelena Janković Tijana Išić Denčić Vesna Božić Vladan Živaljević

Papillary thyroid carcinoma represents a challenge from a prognostic standpoint. Molecular alterations responsible for PTC advancement include MMP-9 genetic promoter polymorphisms that bind transcription factors with varying degrees of affinity and, hence, constitute a predisposition for MMP-9 expression. We examined how two promoter polymorphisms (the -1562 C/T transition and -131 (CA)n tandem repeats) as well as levels of the c-Jun transcription factor and its modified form acetylated at Lys271 influence MMP-9 expression and PTC progression. A significant proportion of PTC samples were heterozygous for the (CA)n tandem repeat number, had a transcription-promoting T allele at -1562, and expressed high levels of c-Jun, acetylated c-Jun, and MMP-9 protein. The T allele at the -1562 position accompanied the elevated MMP-9 protein expression, while high acetylated c-Jun levels accompanied the high MMP-9 protein levels on mRNA. The -1562 C/T transition, MMP-9, and acetylated c-Jun were associated with the presence of extra-thyroid invasion and degree of tumor infiltration, while the T allele and acetylated c-Jun also correlated with tumor stage. We conclude that the -1562 MMP-9 polymorphism and levels of acetylated c-Jun affect PTC progression via modulation of MMP-9 levels. Genotyping the MMP-9 at -1562 and estimating the levels of MMP-9 and acetylated c-Jun in PTC may prove beneficial in identifying high-risk patients.

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10.3390/diagnostics12081953

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Papillary thyroid carcinoma

Acta chirurgica iugoslavica (2003)

Ksenija Krgovic Ivan Paunović Aleksandar Diklić Vladan Živaljević Svetislav Tatić

Papillary thyroid cancer is after ovarian cancer the most frequent malignant disease of the endocrine system and because of this fact, early detection and appropriate surgical treatment is essential. Radical surgical treatment lower the risk of the disease relapse and postoperative adjuvant therapy with radio iodine is possible as well as postoperative follow up with tireoglobulin measurement. If the total thyroidectomy is performed in highly specialized institution the risk of postoperative complications is acceptable and therefore is the treatment of choice for papillary thyroid cancer. Only the patients with occult papillary thyroid cancer can be treated with hemythyroidectomy. In our series of 410 patients the majority of the patients (85,12%) were in the early phase of the disease and the degree of successfully performed radical surgery for papillary thyroid cancer was very high (tumor reduction was performed in only 1,46% of cases).

Occult

Papillary adenocarcinoma

10.2298/aci0303078k

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Stomatin‐like protein 2 overexpression in papillary thyroid carcinoma is significantly associated with high‐risk clinicopathological parameters and BRAFV600E mutation

Apmis (2016)

Aleksandar Bartolome S. Bošković Ivan Paunović Vesna Božić Dubravka Cvejić

Stomatin‐like protein 2 (SLP‐2), a member of the stomatin protein family, has emerged as a potential molecular hallmark of tumor progression in several human malignancies. The aim of this study was to analyze SLP‐2 expression pattern in benign and malignant thyroid tumors (n = 210) and to examine its relationship with clinicopathological parameters and BRAFV600E mutation in thyroid cancer. SLP‐2 immunohistochemical expression was not detected in benign adenomas and was absent/weak in follicular and anaplastic carcinomas. High expression levels of SLP‐2, found only in papillary thyroid carcinoma (PTC), particularly in the classical variant, were significantly associated with adverse clinicopathological parameters: lymph node metastasis (p = 0.002), extrathyroid invasion (p < 0.001), pT status (p < 0.001), and advanced tumor stage (p = 0.001). Additional genotyping of PTC cases for the BRAFV600E mutation revealed for the first time a close relation between SLP‐2 overexpression and the presence of BRAF mutation (p = 0.02) with high positive rates of lymph node metastasis (70%) and extrathyroid invasion (80%) in these cases. The significant association of SLP‐2 overexpression with unfavorable clinicopathological characteristics and BRAFV600E mutation indicates that SLP‐2 may have a role in aggressiveness of BRAF‐mutated PTC and that SLP‐2 evaluation could be clinically useful in identification of high‐risk PTC patients.

10.1111/apm.12505

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Citations (14)

MMP-9-1562 C/T single nucleotide polymorphism associates with increased MMP-9 level and activity during papillary thyroid carcinoma progression

Pathology (2018)

Jelena Rončević Ilona Djoric Sonja Šelemetjev Jelena Janković Tijana Išić Denčić

10.1016/j.pathol.2018.10.008

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Right ventricular myxoma: A case report

Vojnosanitetski pregled (2013)

Biljana Obrenović-Kirćanski Aleksandar Mikić Miloš Velinović Vesna Božić Nataša Kovačević-Kostić

Introduction. Myxomas arising from the right ventricle are extremely rare. Case report. We presented a 71-year-old patient with worsening symptoms of the exertional dyspnea and atypical chest pains lasting 6 months. A transthoracic and transesophageal echocardiogram revealed a large, 2.6 x 2.2 cm, ovoid, well-circumscribed, echogenic mass in the right ventricle outflow tract attached by small pedicle, partly obstructing the right ventricular outflow tract and protruding through the pulmonic valve during systole. The tumor was completely removed with the stalk and 5 mm of the surrounding tissue. The histopathological findings confirmed the diagnosis of myxoma. Conclusion. This case illustrates the usefulness of echocardiography both in diagnosis of patients with atypical symptoms without family history and associated syndromes (like Carney?s complex), and in surgical approach planning. It also stresses the importance of surgical excision of tumor as soon as possible following the diagnosis to prevent the complications such are: valvular obstruction, pulmonary embolization and syncopes.

Transthoracic echocardiogram

Ventricular outflow tract

Echogenicity

Exertional dyspnea

10.2298/vsp1306609o

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Giant Posttraumatic Cervical Hematoma: Acute Presentation of Papillary Thyroid Carcinoma in an Adolescent

Medical Principles and Practice (2016)

Miroslav Marković Ivan Paunović Marko Dragaš Vesna Božić Nikola Ilić

To describe a rare case of acute presentation of papillary thyroid carcinoma (PTC).A 19-year-old male presented with an expanding cervical mass following blunt trauma. A computed tomography scan revealed a mass suspected to be hematoma that was compressing the vessels and thereby deviating the trachea. Immediate surgery was performed. Neither vascular injury nor active bleeding was seen; instead, a solid, hematoma-like tumefaction in the right thyroid lobe was revealed. A total thyroid lobectomy was performed. A histologic paraffin section confirmed a PTC that was permeated by hematoma.This was a unique case of an acute, life-threatening presentation of previously asymptomatic PTC in an adolescent.

Presentation (obstetrics)

10.1159/000445117

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Anaplastic thyroid carcinoma

Acta chirurgica iugoslavica (2003)

Vladan Živaljević Aleksandar Diklić Ivan Paunović Ksenija Krgovic R Zívić

The aim of the present paper was to study some characteristics and posibility of surgery of anaplastic thyroid cancer. During five years period in Center for endocrine surgery, we found anaplastic thyroid cancer in 65 patienst (44 female and 21 male), median age 63 years (from 37 to 88 years). Surgical treatment was peerformed in one half (32) anaplastic thyroid cancer patients, at majority of them operative biopsy or tumor reduction only. Radical syrgery was performed in about 10% patients. Posibility of surgery in anaplastic thyroid cancer are very limited. In one third patients there were longstanding goter or thyroid nodul or histological verified dediferentiation of papillary thyroid cancer. This patienst should be operated formerly, before anaplastic transformation.

Anaplastic carcinoma

10.2298/aci0303131z

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Comprehensive Investigation of Angiogenesis, PASS Score and Immunohistochemical Factors in Risk Assessment of Malignancy for Paraganglioma and Pheochromocytoma

Diagnostics (2024)

Marija Milinković Ivan Soldatović Vladan Živaljević Vesna Božić Maja Životić

A challenging task in routine practice is finding the distinction between benign and malignant paragangliomas and pheochromocytomas. The aim of this study is to conduct a comparative analysis of angiogenesis by assessing intratumoral microvascular density (MVD) with immunohistochemical (IHC) markers (CD31, CD34, CD105, ERG), and S100 immunoreactivity, Ki67 proliferative index, succinate dehydrogenase B (SDHB) expressiveness, tumor size with one the most utilized score Pheochromocytoma of Adrenal Gland Scales Score (PASS), using tissue microarray (TMA) with 115 tumor samples, 61 benign (PASS < 4) and 54 potentially malignant (PASS ≥ 4). We found no notable difference between intratumoral MVD and potentially malignant behavior. The group of potentially malignant tumors is significantly larger in size, has lower intratumoral MVD, and a decreased number of S100 labeled sustentacular cells. Both groups have low proliferative activity (mean Ki67 is 1.02 and 1.22, respectively). Most tumors maintain SDHB expression, only 6 cases (5.2%) showed a loss of expression (4 of them in PASS < 4 group and 2 in PASS ≥ 4). PASS score is easily available for assessment and complemented with markers of biological behavior to complete the risk stratification algorithm. Size is directly related to PASS score and malignancy. Intratumoral MVD is extensively developed but it is not crucial in evaluating the malignant potential.

CD31

Tissue microarray

SDHB

10.3390/diagnostics14080849

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Follicular thyroid carcinoma

Acta chirurgica iugoslavica (2003)

Ksenija Krgovic Ivan Paunović Aleksandar Diklić Vladan Živaljević Svetislav Tatić

Follicular thyroid cancer is the second most common thyroid malignancy. This tumor has a predisposition for hematogenous dissemination an extrathyroid spread. Accurate cytological diagnosis of follicular thyroid cancer is not possible and this fact highlights the necessity for surgical treatment of any suspicious thyroid nodule. Aggressiveness of this tumor is greater than in the case of papillary thyroid cancer and it is the reason for radical surgical treatment of follicular thyroid cancer. Total thyroidectomy facilitates later adjuvant therapy with thyroid hormones and radioiodine. This procedure improves the outcome and the risk of relapse. Results of our study clearly demonstrate that diagnosis of follicular thyroid cancer in us is established in the early phase of the disease (78.57%), but the significant number of the patients (21.43%) is still in the advanced phase of the disease.

Follicular carcinoma

10.2298/aci0303107k

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