Although collecting duct carcinoma is a subtype of renal cell carcinoma, several studies implicate association with urothelial carcinoma. The coexistence of collecting duct carcinoma and another ...renal neoplasm is rare. Endemic nephropathy is a renal disease causing chronic renal failure. It is highly associated with urothelial neoplasm and occurs in endemic villages in Bosnia, Croatia, Bulgaria, Romania and Serbia. Recent studies have confirmed the important role of exposure to aristolochic acid as an etiologic factor. We present three cases of collecting duct carcinoma with literature overview. In one case, we describe collecting duct carcinoma with metachronous urothelial carcinoma of the pyelon and urinary bladder in an endemic nephropathy patient. To our knowledge, this is the first case report describing this coexistence. Certain similarities between collecting duct carcinoma and urothelial carcinoma were found, e.g., higher incidence in female compared to male, higher mean age, and multifocal and multicentric occurrence of the tumor. Our observations support the hypothesis that collecting duct carcinoma and urothelial carcinoma could be connected. Key words: Collecting duct carcinoma; Bellini duct carcinoma; Endemic nephropathy; Kidney neoplasm; Renal failure; Urothelial carcinoma Iako je karcinom sabirnih kanalica podvrsta karcinoma bubreznih stanica, odredena istrazivanja ukazuju na povezanost ovog entiteta s karcinomom prijelaznog epitela. Istodobna pojava karcinoma sabirnih kanalica i drugih bubreznih neoplazma je rijetka. Endemska nefropatija je bubrezna bolest koja dovodi do kronicnog bubreznog zatajenja. Vrlo je povezana s urotelnim tumorima i javlja se u endemskim selima u Bosni, Hrvatskoj, Bugarskoj, Rumunjskoj i Srbiji. Nedavna istrazivanja potvrdila su znacajnu ulogu izlozenosti aristolohicnoj kiselini kao etioloskom cimbeniku. Predstavljamo tri slucaja karcinoma sabirnih kanalica s pregledom literature. U jednom slucaju opisujemo karcinom sabirnih kanalica s metakronom pojavom urotelnog karcinoma pijelona te mokracnog mjehura u bolesnika s potvrdenom endemskom nefropatijom. Prema nasim saznanjima ovo je prvi slucaj koji opisuje ovakvu koegzistenciju. Pronadene su odredene slicnosti izmedu karcinoma sabirnih kanalica i karcinoma prijelaznog epitela, a to su veca ucestalost u zenskoj populaciji, visa prosjecna dob, multifokalna i multicentricna pojava tumora. Nasa zapazanja podupiru hipotezu o mogucoj povezanosti karcinoma sabirnih kanalica i karcinoma prijelaznog epitela. Kljucne rijeci: Karcinom sabirnih kanalica; Karcinom Bellinijeva kanalica; Endemska nefropatija; Bubrezna novotvorina; Bubrezno zatajenje; Karcinom urotela
The aim of this study was to determine the incidence of incidental prostate cancer and its clinical significance among patients who underwent transurethral prostate resection or transvesical ...adenomectomy for benign prostate hyperplasia at the Department of Urology in Sestre milosrdnice University Hospital Center from January 1997 to December 2017. A total of 277/4,372 (6.34%) patients from our cohort were diagnosed with incidental prostate cancer (mean age 74.5 years). Due to incomplete data, 12 patents were excluded from further analysis. 44.91% (119/265 patents) of our cohort were stage T1a and 55.09% (146/265) were stage T1b. Clinically significant prostate cancer was found in 168/265 patients (63.40%). When divided into two groups, Gleason score less than or equal to6 (mean age 73.58 years) and Gleason score greater than or equal to7 (mean age 75.77 years), the results showed that Gleason score greater than or equal to7 patients were significantly older (p=0.0104) and that the tumor extent among patients in this group (mean = 34.58%) was higher than that in Gleason score less than or equal to6 group (mean = 11.11%) (p=0.0169). More than a half of patients in our cohort had T1b stage prostate cancer. We found that 63.4% of carcinomas were clinically significant, with 52/265 (19,62%) patients affected by ISUP grade 4 and 5 cancers. Based on our research, we cannot give any recommendations regarding incidental prostate cancer treatment due to lacking preoperative (PSA, DRE) and follow-up data.Key words: Benign prostate hyperplasia; BPH; Incidental prostate cancer; TURPCilj ovog rada bio je utvrditi ucestalost incidentalnog karcinoma prostate i klinicki znacaj istog u pacijenata podvrgnutih transuretralnoj resekciji prostate i transvezikalnoj prostatektomiji zbog benigne prostaticne hiperplazije na Klinici za urologiju KBC-a "Sestre milosrdnice" od sijecnja 1997. do prosinca 2017. godine. Incidentalni karcinom prostate pronaden je kod 277/4,372 (6,34%) pacijenata iz nase studije (prosjecna dob 74,5 godina). Zbog neadekvatnih podataka, 12 pacijentata iskljuceno je iz daljnje analize. 44,91% (119/265 pacijenata) nalazilo se u T1a stadiju, a 55,09% (145/265) u T1b stadiju bolesti. Klinicki znacajan karcinom pronaden je kod 168/246 pacijenata (60,40%). Kada se pacijenti podijele u dvije skupine, Gleason zbroj less than or equal to6 (srednja dob 73,58 godina) i Gleason zbroj greater than or equal to7 (srednja dob 75,77 godina), rezultati pokazuju da su pacijenti s karcinomom prostate Gleason zbroja greater than or equal to7 statisticki znacajno stariji (p=0,0104) te da karcinom zahvaca veci dio pregledanog tkiva (prosjek= 34,58%) nego u bolesnika s karcinomom Gleason zbroja less than or equal to6 (prosjek= 11,11%) (p=0,0169). U nasoj studiji, vise od polovice pacijenata s dijagnosticiranim karcinomom imalo je T1b stadij karcinoma prostate, 63,4% pacijenata imalo je klinicki znacajan karcinom, od cega je 52/265 (19,62%) pacijenata bolovalo od karcinoma ISUP stadija 4 i 5. Na temelju ovog istrazivanja ne mozemo dati preporuke o lijecenju novodijagnosticiranog incidentalnog karcinoma prostate zbog insuficijentnih preoperativnih parametara (PSA, digitorektalni pregled) te nedostatnih podataka o postoperativnom pracenju tih pacijenata.Kljucne rijeci: Benigna hiperplazija prostate; BPH; Incidentalni karcinom prostate; TURP
One of the main reasons for the introduction of a new grading system was Gleason sum 7, which differed significantly in the prognosis of the disease depending on the primary Gleason. The aim of this ...study was to compare grade group 2 and grade group 3, and the impact of cancer percentages in final pathology reports after radical prostatectomy on the occurrence of T3 stage of the disease after radical prostatectomy of clinically localized prostate cancer. The study covered 365 patients with clinically localized prostate cancer who underwent radical retropubic prostatectomy (RRP) over the period of two years. The average percentage of carcinomas found in pathology reports after RRP was 20.1%. With the increase in the grade group, the average percentage of carcinomas in pathology reports increased significantly, p<0.001. With regard to grade groups 2 and 3, irrespective of cancer percentages in pathology reports, more cases of T3 stage were found in grade group 3 when compared to grade group 2, which was statistically significant (p<0.001). However, grade group 2 and grade group 3 patients with less than or equal to10% cancer occurrences in final pathology reports after RRP did not show any statistical significance in the occurrence of T3 stage, p=0.96. Prognostic differences in grade group 2 and grade group 3 patients after RRP are significant, but not in all cases, because of their dependence on the percentage of cancer in the final pathology report after RRP of clinically localized prostate cancer.Key words: Gleason grade; Grade group; Prostate cancer; Pathology report; Radical prostatectomyKao jedan od glavnih uzroka uvodenja novih gradus skupina bio je Gleasonov zbroj 7, koji se bitno razlikovao u prognozi bolesti ovisno o primarnom Gleasonu. U ovom istrazivanju usporedili smo gradus skupinu 2 (GZ 3+4) i gradus skupinu 3 (GZ 4+3) u pojavnosti T3 stadija kod pacijenata s less than or equal to10% karcinoma u patohistoloskom nalazu nakon retropubicne radikalne prostatektomije, klinicki lokaliziranog karcinoma prostate. Studijom je obuhvaceno 365 pacijenata s klinicki lokaliziranim karcinomom prostate koji su podvrgnuti radikanoj retropubicnoj prostatektomiji izmedu 1. sijecnja 2015. i 31. prosinca 2016. godine. Najzastupljenije gradus skupine bile su gradus skupina 2 s 50,41% i gradus skupina 3, s udjelom od 36,16%. Postotak karcinoma u PHD nalazu nakon RRP bio je u rasponu od 5 do 80%, prosjek 20,1%. Kod gradus skupina 2 i 3, neovisno o postotku karcinoma prostate u konacnom PHD nalazu, bilo je statisticki znacajno vise T3 stadija u gradus skupini 3 u odnosu na gradus skupinu 2, p=0,001. Medutim, pacijenti gradus skupina 2 i 3 s postotkom karcinoma less than or equal to10% u konacnom PHD nalazu nakon RRP nisu pokazali razliku u pojavnosti T3 stadija, p=0,96. Razlike u prognozi za pacijente gradus skupine 2 i gradus skupine 3 nakon RRP su znacajne, ali ne uvijek. Svakako pri procjeni rizika moramo uzeti u obzir i znacajnost postotka karcinoma prostate nakon RRP, u ovom istrazivanju nizi postotak karcinoma (less than or equal to10%).Kljucne rijeci: Gleason ocjena; Gradus skupine; Karcinom prostate; Patohistoloski nalaz; Radikalna prostatektomija
Multiparametric magnetic resonance is assuming an increasingly important role in the diagnosis, initial assessment and monitoring of patients with prostate cancer. This paper offers a more complex ...insight into the application of magnetic resonance imaging with prostate cancer, with a current literature overview. The focus is on the problem of initial prostate cancer evaluation which strongly affects further decision-making and therapeutic interventions. Clinical suggestions based on the current guidelines are also offered.Key words: Cancer staging; Diagnostic imaging; Guidelines; Magnetic resonance; Prostate cancer; Radical prostatectomyMultiparametrijska magnetska rezonancija preuzima sve znacajniju ulogu u dijagnostici, inicijalnoj procjeni, kao i pracenju pacijenata s karcinomom prostate. Ovaj rad nudi slozeniji uvid u pitanje primjene magnetske rezonancije kod karcinoma prostate, uz pregled trenutne literature iz podrucja. Posebno teziste je stavljeno na problem inicijalne procjene karcinoma prostate koje uvelike determinira daljnje odlucivanje i terapijsko postupanje. Ponudene su i preporuke temeljene na trenutnim smjernicama.Kljucne rijeci: Dijagnostika; Magnetska rezonanca; Karcinomprostate; Radikalna prostatektomija; Smjernice; Stadij tumora
The aim of this prospective clinical study was to determine the detection rate of prostate cancers by multiparametric magnetic resonance and transrectal ultrasound (mpMRI-TRUS) cognitive fusion ...biopsies in patients with a previously negative TRUS-guided biopsy. Between 1 October 2016 and 1 July 2017, in 101 consecutive patients with elevated antigen (PSA) and/or positive digital rectal examination and after a negative first TRUS biopsy, a second, repeated prostate biopsy was performed. In 24 patients, cognitive fusion mpMRI-TRUS biopsy of the prostate with 8-10 system cores and 1-3 target biopsies was performed, in line with the European Association of Urology guidelines. In 77 patients, only a classic, repeated TRUS guided biopsy was performed. In patients with mpMRI, the detection rate according to PIRADS-v2 reporting system was: PIRADS 1, n = 0; PIRADS 2, n = 0; PIRADS 3, n = 0; PIRADS 4, n = 6/8 (75%); and PIRADS 5, n = 2/3 (67%). In the group of patients with MR-TRUS cognitive fusion biopsy, the prostate cancer detection rate was 8/24 (33%), while in the control group the detection rate was 12/77 (16%), which was statistically significant (t test, p = 0.037, CI 95% is 0.01 to 0.37). Patients with PIRADS less than or equal to 3 (54%) could have avoided the biopsy.Key words: Prostate cancer; Multiparametric magnetic resonance; BiopsyU ovoj prospektivnoj klinickoj studiji cilj je odrediti stopu detekcije raka prostate biopsije vodene kognitivnom fuzijom multiparametrijske magnetne rezonance i transrektalnog ultrazvuka (mpMRI-TRUS) kod bolesnika s prethodno negativnom TRUS vodenom biopsijom. U razdoblju od 1. 10. 2016. do 1. 7. 2017. kod 101 uzastopnog bolesnika s povisenim prostata specificnim antigenom (PSA) i/ili pozitivnim digitorektalnim pregledom, a nakon negativne prve TRUS biopsije je ucinjena druga, ponovljena biopsija prostate. Kod 24 bolesnika ucinjena je, u skladu sa Smjernicama Europskog uroloskog drustva, prethodna mpMRI i potom kognitivna fuzijska biopsija prostate s 8-10 sistemskih cilindara i 1-3 ciljane biopsije prema mpMRI nalazu. Kod 77 bolesnika je ucinjena samo klasicna, ponovljena TRUS biopsija bez prethodne slikovne obrade. Kod bolesnika s mpMRI, stopa detekcije raka prema PIRADSU-v2 je PIRADS 1, n = 0; PIRADS 2, n = 0; PIRADS 3, n = 0; PIRADS 4, n = 6/8 (75%) i PIRADS 5, n = 2/3 (67%). U skupini bolesnika s MR-TRUS kognitivnom fuzijskom biopsijom stopa detekcije raka prostate je 8/24 (33%), dok je u kontrolnoj skupini stopa detekcije 12/77 (16%), sto se pokazalo statisticki znacajnom razlikom (t test; p=0.037, CI 95% je 0.01 to 0.37). Bolesnici s PIRADS less than or equal to 3 (54%) su mogli izbjeci biopsiju.Kljucne rijeci: Rak prostate; Magnetna rezonancija; Biopsija prostate
Continuous increase of the cost of medical services around the world has become a major topic in the world today. Multiparametric prostate MRI has recently become a new standard in prostate cancer ...detection, especially in repeated biopsy settings. The method, although superior in cancer detection rates, is costly and requires additional training and equipment. The purpose of our study was to determine the costs and benefits that arise when introducing this method in prostate cancer diagnostics. Repeated prostate biopsy was performed in 101 consecutive patients in the period from 1 October 2016 to 1 July 2017. Patients were divided into two groups based on whether prostate mp-MRI was performed or not. The prices of specific procedures were obtained from the billing service of the Sestre milosrdnice University Hospital Center and patient models were created to determine financial costs and benefits. The cost of the entire diagnostic process per patient in the non-MRI group was HRK 1.931,05 and HRK 1.848,42 in the mpMRI group, or 4.28% less. Prostate mpMRI and subsequent mpMRI guided biopsies can reduce the overall cost in prostate cancer diagnostics despite the procedure itself being an additional cost. This is achieved by omitting prostate biopsies in patients with low malignancy risk.Key words: Prostate mp-MRI; Prostate cancer, cost benefitKontinuirani rast troskova medicinskih postupaka aktualna je tema i razlog zabrinutosti u cijelome svijetu. Ciljana, multiparametrijskim magnetom (mpMRI) navodena biopsija prostate polako postaje standard u dijagnostici karcinoma prostate, pogotovo kod ponovljene biopsije. Iako superiorna klasicnoj, sistemskoj biopsiji prostate, navedena metoda zahtijeva skupu dodatnu opremu i vjeste, educirane klinicare. Nas cilj je analizirati ekonomsku isplativost uvodenja multiparametrijske magnetne rezonance prostate i posljedicne kognitivno mpMRI-om navodene biopsije prostate u dijagnosticki protokol bolesnika sa inicijalno negativnom sistemskom biopsijom prostate, kod kojih postoji daljnja klinicka sumnja na karcinom prostate. U periodu od 01.10.2016. do 01.07.2017 kod 101 uzastopnog bolesnika s povisenim PSA i/ili pozitivnim DRP, a nakon negativne prve TRUS biopsije ucinjena je druga, ponovljena biopsija prostate. Bolesnici su podijeljeni u dvije skupine ovisno o tome dali je ucinjen mpMRI prostate ili ne. Ucinjena je analiza broja i troskova posjeta specijalisti urologu kao i broja i troskova ordiniranih pretraga za svaku skupinu. Tijek klinickih postupaka standardiziran je na temelju prosjeka za pojedine promatrane skupine te preracunat na 100 bolesnika za svaku skupinu radi lakse usporedbe rezultata. Kalkulacije su vrsene na temelju dobivenih modela. Prosjecna cijena obrade bolesnika u skupini bez mpMRI-a iznosi 1931,05 HRK dok u sa mpMRI-em iznosi 1848,42 HRK tj. 4,28% manje. Iako mpMRI prostate pojedinacno predstavlja znacajan dodatan trosak u dijagnostici karcinoma prostate, kod bolesnika sa inicijalno negativnom biopsijom prostate isti omogucava velikom broju bolesnika izbjegavanje biopsije te posljedicno smanjenje ukupnog troska.Kljucne rijeci: Karcinomprostate; Navodena biopsija, isplativost; Multiparametrijska magnetska rezonanca
The history of Croatian urology clearly shows its affiliation to the medical and civilizational circle of the Western world. The Department of Urology at the Sestre milosrdnice University Hospital ...Center is the oldest urology institution in the Republic of Croatia. The Department was established in 1894, when the new Sestre milosrdnice Hospital was open in Vinogradska cesta in Zagreb. It was then that doctor Dragutin Masek founded the so-called III Department, which, in addition to treating urology patients, also treated patients with conditions of the ear, nose and throat, eye diseases and dermatologic conditions. Dragutin Masek had already realized that medicine would soon be divided into fields and had assigned younger doctors joining the III Department to specific fields. As a result, urology was given to Aleksandar Blaskovic, who founded the first independent department of urology in Croatia in 1926. In 1927, he was appointed Professor of urology at the Zagreb School of Medicine, where he established the first department of urology and was giving lectures and practicals. Under his leadership, the Department of Urology was given the status of a Clinic, a teaching department, the first of its kind in Croatia. Owing to all his activities in the field of urology, the history remembers him as the "father of modern Croatian urology". Over the course of the following years, department chairs had changed, but luckily for the patients, approach to work had not. Conscientiousness, trust, competence and charity. After all, charity is the idea that the hospital carries even in its name, after the Sisters of Charity who had founded it. In all the decades, the Department of Urology has been following global development paths, objectively legging behind top facilities in the world by only a few years. Overall professional and scientific urology activities culminated in 1998, when the Clinic became the Reference Center of the Ministry of Health of the Republic of Croatia for prostate cancer, and in 2011, when it became the European Board of Urology Certified Center. All that has been achieved could not have been done without wholehearted help and cooperation of the nurses, as well as every other department employee from the beginnings of urology until today. Despite its rich history, the Department does not rest on laurels. Today, it is a modern urology department together with its European role models.Key words: Sestre milosrdnice University Hospital Center; Masek's III Department; Doctor Aleksandar Blaskovic; Department of Urology, Sestre milosrdnice University Hospital CenterProslost hrvatske urologije jasno odreduje njezinu pripadnost medicinskom i civilizacijskom krugu zapadnoga svijeta. Klinika za urologiju KBC "Sestre milosrdnice" najstarija je uroloska ustanova u Republici Hrvatskoj. Osnovana je 1894. kad je otvorena nova Bolnica sestara milosrdnica u Zagrebu u Vinogradskoj ulici. Te je godine dr Dragutin Masek osnovao tzv. III Odjel na kojem su se operativno zbrinjavali osim uroloskih bolesnika, bolesnici sa bolestima uha, grla i nosa, sa ocnim i dermatoloskim bolestima. Dragutin Masek vec tada je vidio da ce se medicina uskoro dijeliti na uza podrucja, pa je dolaskom mladih lijecnika na III. odjel njima prepustao odredena podrucja, tako da je urologiju preuzeo Aleksandar Blaskovic koji 1926. godine osniva prvi samostalni odjel za urologiju u Hrvatskoj. Imenovan je 1927. za profesora urologije na Medicinskom fakultetu u Zagrebu gdje osniva prvu katedru za urologiju i vodi predavanja i vjezbe. Pod njegovim vodstvom Odjel za urologiju dobio 1943. godine status Klinike za urologiju, prve u Hrvatskoj. Temeljem svih tih aktivnosti na uroloskom podrucju povijest ga pamti kao "oca moderne hrvatske urologije". U godinama koje slijede celnici urologije su se mijenjali, a svjetonazor u radu na srecu bolesnika ne. Savjest, povjerenje, strucnost i milosrde. Uostalom, to je znamen koji bolnica nosi u svom imenu. Svih tih desetljeca Klinika za urologiju je pratila suvremene svjetske pravce razvoja, objektivno kasneci tek nekoliko godina za vrhunskim ustanovama u svijetu. Cjelokupna strucna i znanstvena uroloska djelatnost kulminira 1998. godine, kada Klinika postaje Referentni centar za tumore prostate Ministarstva zdravstva Republike Hrvatske i 2011. godine kada je postala Centar obuke Europskog odbora za urologiju (European Board of Urology). Sve postignuto ne bi se moglo ostvariti bez svesrdne pomoci i suradnje medicinskih sestara i drugih djelatnika klinike od prvih pocetaka urologije do danasnjih dana. Unatoc bogatojj proslosti, Klinika ne zivi na uspjesima svojih prethodnika. Danas je ta urologija zajedno s njezinim uzorima europska moderna urologija.Kljucne rijeci: Bolnica sestara milosrdnica; Masekov III. odjel; Dr. Aleksandar Blaskovic; Klinika za urologiju KBC Sestre milosrdnice
The Department of Urology at the Sestre milosrdnice University Hospital Center is the oldest urological institution in the Republic of Croatia and this part of Europe. Today, the Department is a ...modern tertiary healthcare institution, where the most complex methods of urological practice are performed using modern medical devices and highly sophisticated technology. In 2011, our urology specialist education program was certified by the European Board of Urology (EBU) as the only one of its kind in Croatia. The program was recertified in 2017. The Department runs a program for the early detection of prostate cancer and performs more than 240 radical prostatectomies annually, which is the highest number of such interventions in Croatia. The aim of this study is to present the work and the activities of the Reference Center for Prostate Tumors of the Ministry of Health at the Department of Urology in Sestre milosrdnice University Hospital Center over the last 20 years. The database of the Reference Center for Prostate Tumors of the Ministry of Health at the Department of Urology in Sestre milosrdnice University Hospital Center was reviewed. During the twenty-year period, approximately 15,000 prostate interventions were performed due to benign and malignant diseases. Of this, 7,374 transrectal ultrasound guided prostate biopsies, 2,632 radical prostatectomies with open retropubic access, 3,988 transurethral prostate resections and 1,097 open suprapubic adenomectomies were performed. With the achieved scientific and professional results in monitoring, studying and improving the prevention, diagnosis and therapy of prostate tumors, as well as with the professional conditions and personnel, the Department of Urology in Sestre milosrdnice University Hospital Center truly justifies the title of the Reference Center for Prostate Tumors of the Ministry of Health of the Republic of Croatia awarded to it in 1998.Key words: Prostate; Prostate cancer; Department of Urology; Reference Center for Prostate Tumors; European Board of Urology (EBU)Klinika za urologiju Klinickog bolnickog centra Sestre milosrdnice najstarija je uroloska ustanova u Republici Hrvatskoj, a i u ovom dijelu Europe. Danas je Klinika za urologiju moderna medicinska ustanova tercijarne zdravstvene zastite gdje se najslozenije metode uroloske prakse izvode pomocu suvremenih medicinskih uredaja i visoko sofisticirane tehnologije. Program edukacije specijalizanata je 2011. godine certificiran od strane European Board of Urology (EBU) kao jedini takav u Hrvatskoj, a recertificiran je 2017. godine. U nasoj se Klinici provodi program ranog otkrivanja raka prostate, a godisnje se obavlja preko 240 radikalnih prostatektomija sto je ujedno i najveci broj takvih zahvata u Hrvatskoj. Cilj rada je prikazati rad i aktivnost Referentnog centra Ministarstva zdravstva za tumore prostate u Klinici za urologiju KBC "Sestre milosrdnice" u posljednjih 20 godina. Ucinjen je pregled baze podataka Referentnog centra za tumore prostate Ministarstva zdravstva u Klinici za urologiju KBC "Sestre milosrdnice". Tijekom dvadesetogodisnjeg razdoblja ucinjeno je oko 15 000 zahvata na prostati zbog benignih i malignih bolesti. Od toga je ucinjena 7 374 biopsija prostate vodene transrektalnim ultrazvukom, 2 632 radikalnih prostatekomija otvorenim retropubicnim pristupom, 3 988 transuretralnih resekcija prostate i 1 097 otvorenih suprapubicnih adenomektomija. Postignutim znanstvenim i strucnim rezultatima u pracenju, proucavanju i unaprjedenju prevencije, dijagnostike i terapije tumora prostate kao i strucno-kadrovskim uvjetima, Klinika za urologiju KBC Sestre milosrdnice opravdava naslov Referentnog centra za tumore prostate Ministarstva zdravstva Republike Hrvatske koji nosi od 1998. godine.Kljucne rijeci: Prostata; Karcinom prostate; Klinika za urologiju; Referentni centar za tumore prostate; European Board of Urology (EBU)
Rak prostate najčešći je karcinom u muškaraca. Dijagnoza raka prostate predstavlja značajan izazov zbog nekoliko različitih
ključnih parametara koje je potrebno procijeniti, kao što su dob, povijest ...prostata specifičnog antigena (PSA), klinički pregled
i u novije vrijeme multiparametrijski MRI (mp-MRI). Trenutna dijagnostika raka prostate rezultirala je prekomjernom
dijagnostikom i liječenjem, kao i poddijagnozom i propuštenom dijagnozom kod mnogih muškaraca. Multiparametrijski
MRI prostate identificiran je kao test koji bi mogao ublažiti ove pogreške. Prije liječenja raka prostate obavezna je patološka
potvrda. Biopsija prostate je invazivan postupak s rijetkim, ali ne i zanemarivim potencijalnim komplikacijama. Postoji nekoliko
metoda biopsije prostate od kojih su najčešće sistemska ili planarna biopsija prostate i kognitivna ili ciljana biopsija prostate
vođena MRI-om. Mp-MRI pokazao je bolju točnost i reproducibilnost u otkrivanju, lociranju i procjeni raka prostate,
a također je poštedio neke muškarace nepotrebne biopsije. Nedavne studije pokazale su korist mpMRI-e za bolje planiranje
zahvata s podacima o lokaciji raka prostate, opsegu bolesti i duljini uretre. Pred nama su još neki izazovi, poput osiguravanja
visokokvalitetne izvedbe i izvješćivanja o mpMRI-u te osiguravanja da je ovaj dijagnostički put isplativ. Prema najnovijim
urološkim kliničkim smjernicama mpMRI je postao temeljni alat u liječenju raka prostate. Cilj ove studije je dati kratak uvid
u upotrebu mpMRI-e u dijagnostici i liječenju raka prostate.
Iako je karcinom sabirnih kanalića podvrsta karcinoma bubrežnih stanica, određena istraživanja ukazuju na povezanost ovog entiteta s karcinomom prijelaznog epitela. Istodobna pojava karcinoma ...sabirnih kanalića i drugih bubrežnih neoplazma je rijetka. Endemska nefropatija je bubrežna bolest koja dovodi do kroničnog bubrežnog zatajenja. Vrlo je povezana s urotelnim tumorima i javlja se u endemskim selima u Bosni, Hrvatskoj, Bugarskoj, Rumunjskoj i Srbiji. Nedavna istraživanja potvrdila su značajnu ulogu izloženosti aristolohičnoj kiselini kao etiološkom čimbeniku. Predstavljamo tri slučaja karcinoma sabirnih kanalića s pregledom literature. U jednom slučaju opisujemo karcinom sabirnih kanalića s metakronom pojavom urotelnog karcinoma pijelona te mokraćnog mjehura u bolesnika s potvrđenom endemskom nefropatijom. Prema našim saznanjima ovo je prvi slučaj koji opisuje ovakvu koegzistenciju. Pronađene su određene sličnosti između karcinoma sabirnih kanalića i karcinoma prijelaznog epitela, a to su veća učestalost u ženskoj populaciji, viša prosječna dob, multifokalna i multicentrična pojava tumora. Naša zapažanja podupiru hipotezu o mogućoj povezanosti karcinoma sabirnih kanalića i karcinoma prijelaznog epitela.
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