Introduction: To the best of our knowledge, this is the first study about malignant eyelid tumors in the region of Tuzla, Bosnia and Herzegovina, and it shows similar results comparing with other countries (the annual incidence of eyelid tumors in Tuzla region is about 3.73/100 000 population). Malignant eyelid tumors are relatively uncommon, but potentially fatal disease. However, if detected early and treated adequately, the prognosis is generally excellent. Aim: The aim of this study was the clinical and microscopical analysis of malignant eyelid tumors in treated patients, the presentation of surgical treatment and reconstructive methods of eyelid tumors. Methods: This retrospective study included 60 patients surgically treated at the University Clinical Center Tuzla from January 2012 to December 2016, who were initially diagnosed with malignant eyelid tumors in accordance to the final results obtained by histological examination of excised lesions. Results: In the group of malignant tumors, the most common tumors were BCC (85%), which were predominantly found on the lower eyelids (92.16%) and showed female predominance (51.06%). SCC was the second most common eyelid malignancy (15%) and showed a predilection for the lower eyelid involvement and male predominance (55.56%). Tumors up to 2 cm in diameter (clinical stage T1) were found in 78.33% of cases, 95.74% of which with radical excision, while 4.26% with non-radical excision. Conclusion: Treatment by complete excision with histological confirmation of tumor clearance is recommended. Perineural spread is an adverse prognostic sign, which may require postoperative radiotherapy. Orbital invasion is a rare complication but, if recognized early, it can be treated effectively with exenteration. Because presentation varies and histological examination is required for accurate diagnosis, any suspicious lesion occurring on the eyelids should be excised or biopsied. All patients with malignant tumors should be advised of the risk of recurrent or new tumors and encouraged to attend lifelong follow up.

Introduction: The aim of this study was to determine the serum levels of malondialdehyde (MDA) in patients with invasive breast cancer in relation to its serum levels in patients with benign breast disease, and to investigate correlation between MDA serum levels with pathohistological prognostic factors (tumor size, lymph node involvement, and histologic grade [HG]), estrogen receptor (ER) status, and with breast cancer patient’s age and menopausal status. Methods: A total of 43 with well-documented invasive breast cancer were included in this study: 27 with positive axillary’s lymph nodes, and 16 with negative axillary’s lymph nodes, and 39 patients with findings of benign breast diseases. MDA determination in serum of breast cancer and benign breast disease patients was performed by the fluorimetric method, immunohistochemical staining was performed for ER, and routine pathohistological examination was conducted for pathohistological factors. Results: MDA serum levels in breast cancer patients were significantly higher than MDA serum levels in benign breast disease patients (p = 0.042). No statistically significant difference between MDA serum levels in breast cancer patients with and without lymph node metastases was found (p = 0.238). No statistically significant correlations between MDA serum levels and tumor size (p = 0.256), HG (p = 0.124), or number of positive lymph nodes (0.113) were found. A statistically significant correlation between serum MDA levels and ages of breast cancer patients with lymph node metastases was found (p = 0.006). Conclusion: Obtained results support the importance of MDA in the carcinogenesis of breast cancer. According to our findings, serum level of MDA could not be a useful prognostic factor in breast cancer.

Due to better understanding complex immune-inflammatory responses following surgical injury, the aim of present study was to investigate the changes of VEGF and IL-6 levels in serum and seroma of invasive breast cancer patients after surgery and their correlation with breast cancer tumour expression of VEGF Samples from 20 breast cancer patients and 15 benign breast disease patients were included in the study. Immunohistochemical staining was used for determining VEGF expression in tissue samples from tumour, stromal and normal breast. Measuring VEGF and IL-6 levels was conducted by ELISA. Differences in VEGF expression between tumour and stroma (p=0,007) and between tumour and normal breast tissue were significant (p=0,0001), as well as differences in VEGF expression between stromal and normal breast tissue (p=0,004). Serum level of VEGF was higher in patients with breast cancer then in patients with benign breast disease, before surgery (p=0,023).VEGF was significantly elevated postoperatively in serum (p=0,009) and seroma (p=0,0001) in patients with breast cancer. Level of IL-6 was elevated after surgery in serum (p=0,015) and seroma (p=0,0001) in patients with breast cancer, as well as in serum of patients with benign breast disease (p=0,018). Significant correlation was found between seroma levels of VEGF and IL-6 in breast cancer patients (p=0,009). The findings suggest involvement of VEGF and IL-6 in physiological changes after breast cancer surgery. Normal 0 21 false false false BS-LATN-BA X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

Introduction: Skin melanoma has been one of the most researched malignant melanoma of today. Its "popularity" among the researchers and clinicians arises from variety of forms and biological behaviour, it's characteristic appearance, genetic and immunologic certainty and its prognostic uncertainty. Patients and methods: We analyzed 62 patients with a primary skin melanoma diagnosed in the period from January 2001, to June 2010 (patients were divided in two groups; Group A: patients with melanoma development based on pre-existed nevi and Group B: de novo melanomas). The clinicopathological parameters determined for each tumour were histological type, Breslow thickness, Clark level, and pathological disease stage. The results were correlated with expression of estrogen receptor beta (Ers) and Bcl2. Results: Comparing individual groups according to the intensity of positivity in relation to the stage of Clark, we recognize differences in the distribution of patients with pre-existent nevi (group A), but not in de novo melanoma (group B). Significant differences between individual groups for Ers and Bcl2 expression in terms of intensity of positivity in relation to Clark level (III/IV) showed differences in distribution in patients with pre-existing nevi (Group A). After adjusting for age and sex, we found that Ers and Bcl2 expression was significantly higher in patient with pre-existing nevi in higher melanoma tissue compared with thin melanoma tissue. Conclusion: Expression of ER in Clark level III and IV is higher in melanoma arising from pre-existing nevi, giving better chance of survival to our patients in comparison to de novo melanoma.

VEGF-A is the most potent angiogenic factor in tumour angiogenesis. Its effects are mediated via two receptors VEGFR-1 and VEGFR-2. Primary aim of our study was to examine the expression of VEGFR-1 in breast cancer and its correlation to VEGF expression, lymph node status, tumour size, histological grade, and hormone receptor status. To examine the VEGFR-1 and VEGF expressions in tumour and surrounding tissue of 51 breast cancer patients, and in healthy breast tissue of 30 benign breast diseases patients, we used three-step immunohistochemical staining. VEGFR-1 and VEGF expressions were significantly increased in breast cancer tumour in relation to surrounding tissue (P < 0.01), and the VEGF expression was significantly increased in lymph node positive breast cancer patients (P < 0.01). VEGFR-1 and VEGF expressions were significantly higher in breast cancer tumour compared with healthy breast tissue (P < 0.01). Significant correlation between VEGF and VEGFR-1 expressions was found (P < 0.05). No significant correlations between VEGF and VEGFR-1 expressions and tumour size, histological grade, and hormone receptor status were found. Increased expression of VEGFR-1 and VEGF in breast cancer tumour and significant correlation between these proteins suggest the possible role of VEGF/VEGFR-1 signalization in breast cancer development, although VEGFR-1 potential prognostic value was not confirmed.

Use of an autologous latissimus flap in breast reconstruction accounts for a supple and natural look of reconstructed breast. Most common postoperative complication, seroma, became more of a rule then an exception when it comes to postoperative evaluation of the patients who underwent this reconstructive procedure. A retrospective study analysing and evaluating different complication rates in 20 patients who underwent breast reconstruction by autologous latissimus flap, was conducted. All patients included in the study were operated at the Department of plastic surgery of Hôpital Civil in Strasbourg, France, between 1996 and 2008. The complication rates were noted as follows: seroma in 19 of our 20 patients (95%), late hypertrophic scarring in 3 patients (15%), postoperative surgical site hematoma in 3 patients (15%), and 2 patients (10%) presented postoperative chronic back pain. Different options used in seroma treatment and prevention (subcutaneous-fascia anchor sutures of donor site, application of corticosteroids by injection into donor site postoperatively, passive drainage) can reduce seroma formation and thus overall complication rates, leading to much faster patient's recovery time and return to normal daily activities.

Introduction: Melanoma is a malignant tumor of melanocytes and it is the most malignant tumor of skin and mucous membranes. We do not have any data about incidence and characteristics of skin melanoma in Bosnia and Herzegovina. Aim: We aimed to analyze hospital records on skin melanoma cases from the region of Tuzla during the 5-year period in order to obtain preliminary data about melanoma incidence and clinical characteristics. Patients and methods: This retrospective study included all patients surgically treated at the University Clinical Center Tuzla, from January 2001 to December 2005, who were initially diagnosed with skin melanoma. Results: Most of pathologically verified skin melanoma, disregarding primary tumor (T), were presented in both genders at stage T4 (41.67 %) and T2 (28.33 %). Histological analysis showed that the majority of observed skin melanoma were diagnosed in Clark level III (36.36 %) and Clark level IV (33.33 %) stage. The average tumor thickness of the examined sample, according to Breslow’s classification, was found to be over than 4.0 mm. Conclusion: Our findings are similar to those reported in other countries in the region. Further studies are necessary in order to asses the burden of the disease in the national level. A national melanoma register is of great importance for further surveilance.