AbstractAim Hydatidiform mole is a rare pregnancy disorder, with wide variety of reported incidence. The aim of the study was to estimate the incidence of hydatidiform moles (HM) in Tuzla Canton, specifically partial (PHM) and complete (CHM) forms.Material and methods All cases of HM that have been diagnosed at the University Clinical Center, Tuzla, between January 2011 and December 2015 were registered. The overall incidence of HM, as well as the incidence of PHM and CHM was calculated using the Tuzla Canton's live birth rate during the study period. A second review of tissue slides and p57 immunohistochemistry (IHC) staining was performed to determine the validity of the criteria for the diagnosis and distinction of the molar specimens.  Results There have been 256 cases of HM, 243 cases of PHM, 12 cases of CHM, and one case of unspecified HM. The average incidence of PHM was estimated at 11.03/1,000 and CHM at 0.54/1,000 live births. A second pathologist review revealed one PHM as a non-molar specimen, confirmed all CHM and identified an unknown HM as a PHM. Out of the 50 randomly chosen samples of PHM, p57 expression confirmed the diagnosis in 48 cases, disclosed one case as unrecognized CHM, and one sample showed discordant staining. IHC staining for p57 approved the diagnosis for all cases of CHM.Conclusion: HM incidence reporting remains a challenge due to the study design. p57 immunohistochemistry confirmed the strong validity of histopathological criteria in the diagnosis of CHM.

Breast cancer is the most common cancer among women. In Bosnia and Herzegovina (BiH), accurate data on the status of breast cancer are lacking due to the absence of a central registry. Multiple international guidelines imply that institutions that monitor breast cancer patients should have optimal therapeutic options for treatment. In addition, there have been several international consensus guidelines written on the management of breast cancer. Application of consensus guidelines has previously been demonstrated to have a positive influence on breast cancer care. The importance of specialty breast centers has previously been reported. As part of the 2021 Bosnian-Herzegovinian American Academy of Arts and Sciences (BHAAAS) conference in Mostar, a round table of multidisciplinary specialists from BiH and the diaspora was held. All were either members of BHAAAS or regularly participate in collaborative projects. The focus of the consortium was to write the first multidisciplinary guidelines for the general management of breast cancer in BiH. Guidelines were developed for each area of breast cancer treatment and management. These guidelines will serve as a resource for practitioners managing breast cancer in the BiH region. This might also be of benefit to the ministry of health and any future investors interested in developing breast cancer care policies in this region of the world.

Abstract Background We compared the accuracy of preoperative transvaginal ultrasound (TVUS) versus magnetic resonance imaging (MRI) for the assessment of myometrial invasion (MI) in patients with endometrial cancer (EC), while definitive histopathological diagnosis served as a reference method. Patients and methods Study performed at a single tertiary centre from 2019 to 2021, included women with a histopathological proven EC, hospitalized for scheduled surgery. TVUS and MRI were performed prior to surgical staging for assessment MI, which was estimated using two objective TVUS methods (Gordon’s and Karlsson’s) and MRI. Patients were divided into two groups, after surgery and histopathological assessment of MI: superficial (≤ 50%) and deep (> 50%). Results Sixty patients were eligible for the study. According to the reference method, there were 34 (56.7%) cases in the study with MI < 50%, and 26 (43.3%) with MI > 50%. Both objective TVUS methods and MRI showed no statistical significant differences in overall diagnostic performance for the preoperative assessment of MI. The concordance coefficient between both TVUS methods, MRI and histopathology was statistically significant (p < 0.001). Gordon’s method calculating MI reached a positive predictive value (PPV) of 83%, negative predictive value (NPV) of 83%, 77% sensitivity, 88% specificity, and 83% overall accuracy. Karlsson’s method reached PPV of 82%, NPV of 79%, 69% sensitivity, 88% specificity, and 80% overall accuracy. Accordingly, MRI calculating MI reached PPV of 83%, NPV of 97%, 97% sensitivity, 85% specificity, and 90% overall accuracy. Conclusions We found that objective TVUS assessment of myometrial invasion was performed with a diagnostic accuracy comparable to that of MRI in women with endometrial cancer.

The HERe2Cure project, which involved a group of breast cancer experts, members of multidisciplinary tumor boards (MTB) from health-care institutions in Bosnia and Herzegovina, was initiated with the aim of defining an optimal approach to the diagnosis and treatment of HER2 positive breast cancer. After individual multidisciplinary consensus meetings were held in all oncology centers in Bosnia and Herzegovina, a final consensus meeting was held to reconcile the final conclusions discussed in individual meetings. Guidelines were adopted by consensus, based on the presentations and suggestions of experts, which were first discussed in a panel discussion and then agreed electronically between all the authors mentioned. The conclusions of the panel discussion represent the consensus of experts in the field of breast cancer diagnosis and treatment in Bosnia and Herzegovina. The objectives of the guidelines include the standardization, harmonization, and optimization of the procedures for the diagnosis, treatment, and monitoring of patients with HER2-positive breast cancer, all of which should lead to an improvement in the quality of health care of mentioned patients. The initial treatment plan for patients with HER2-positive breast cancer must be made by a MTB comprised of at least: A medical oncologist, a pathologist, a radiologist, a surgeon, and a radiation oncologist/radiotherapist.

Introduction: Angiomyofibroblastoma is a tumor which is consists of two components: blood vessels and stromal cells, with always prominent vascular component. Angiomyofibroblastoma is benign tumor, but in literature is reported a case of recurrence and one case with sarcomatous transformation, which shoved that these tumors may rarely be associated with malignant component. Case report: A 78-year-old multiparous housewife was hospitalized at University Clinical Center because of painless, asymptomatic tumor of vaginal portion (posterior side). Tumor size was 7 millimeters in diameter. Internal genital organs did not present abnormalities. The patient underwent operative removal of the tumor and went to home at some day. At the histological examination the tumor presented as a angiomyofibroblastoma cervices uteri.

AIM To determine the efficiency and safety of talc pleurodesis in treating the malignant pleural effusion and recurrent spontaneous pneumothorax. METHODS The study included 54 patients with malignant pleural effusion and recurrent spontaneous pneumothorax, who underwent talc pleurodesis using the "talc slurry" method of pleural talc obliteration. RESULTS Pleurodesis was successful in 52 (96%) patients. The average duration of thoracic drainage was 4.4 days. Procedure complications included higher body temperature, pneumonia and pleural effusion separation. All of the patients had satisfying radiological findings at the point of discharge and three months later. There was no death outcome related to the procedure of pleurodesis itself. CONCLUSION Our study has proved the efficiency and simplicity of talc pleurodesis in treating symptomatic malignant pleural effusions and cases with recurrent spontaneous pneumothorax.Appropriate patient selection and compliance with surgical principles during the procedure make this method safe, efficient and successful in treating pleuropulmonal diseases. Large particle talc should be used for pleurodesis because of the minimum risk of complications.

Introduction: Angiomyofibroblastoma is a tumor which is consists of two components: blood vessels and stromal cells, with always prominent vascular component. Angiomyofibroblastoma is benign tumor, but in literature is reported a case of recurrence and one case with sarcomatous transformation, which shoved that these tumors may rarely be associated with malignant component. Case report: A 78-year-old multiparous housewife was hospitalized at University Clinical Center because of painless, asymptomatic tumor of vaginal portion (posterior side). Tumor size was 7 millimeters in diameter. Internal genital organs did not present abnormalities. The patient underwent operative removal of the tumor and went to home at some day. At the histological examination the tumor presented as a angiomyofibroblastoma cervices uteri.

A case of a 45-year-old Caucasian male initially reported with symptoms of acute intestinal obstruction was presented. Diagnostic tests revealed presence of eosinophilic ascites with marked peripheral eosinophilia, a significant thickening of stomach and intestinal wall and infiltration of gastric and duodenal mucosa with eosinophiles. Findings were conclusive with subserosal type of eosinophilic gastroenteritis and the patient's treatment started with a combination of parenteral methylprednisolone and oral loratadine. A prompt clinical response was encountered after 5 days of treatment with complete resolution.

A 6.6-year-old girl presented for leftsided cardiac enlargement on chestradiography (Panel A). Th ree yearsearlier she had undergone a lobectomyof the lower lobe of the leftlung for extraction of an echinococcalcyst.

Sarcomas of the female genital tract in general are rare and ovarian sarcomas comprise less than 1% of ovarian malignancies. In the literature there are 15 reported angiosarcomas of patients 21 year old and younger with no one originated in the ovary. We report a case of ovarian angiosarcoma in an 11 year old girl, presented with left side hip pain. MRI of abdomen and pelvis confirmed expansive solid and cystic mass occupied both ovaries. Imunohistochemistry staining was performed, CD34, Factor VIII, CD31, in order to confirm the diagnosis. Final diagnosis was angiosarcoma. The patient received 6 cycles of chemotherapy, according to the CWS-2002P protocol. 8 months after the diagnosis was established, there were no signs of any tumors according to the ultrasound, CT scan, and MRI. Although, extremely rare, angiosarcoma can also affect children and this diagnosis should be considered carefully in tumor with rich vascular network, necrosis and brisk mitotic activity.