Snezana Cerović

Military Medical Academy, Beograd, Central Serbia, Serbia

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Publications (56)26.53 Total impact

  • Stevo Matijević, Zoran Damjanović, Snezana Cerović
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    ABSTRACT: Keratocystic odontogenic tumor (KCOT) is defined as a benign cystic neoplasm of the jaws of odontogenic origin with a high rate of recurrence. The most lesions occur in the posterior part of the mandible. Treatment of KCOT remains controversial, but the goals of treatment should involve eliminating the potential for recurrence while minimizing surgical morbidity. However, another significant therapeutic problem related to the management of KCOT is an adequate and early reconstruction of the existing jaw defect, as well as appropriate aesthetic and functional rehabilitation of a patient, especially in cases of a very large destruction of the jaws bone. We presented a 65-year-old female patient with very large KCOT of the mandible. Orthopantomographic radiography showed a very large elliptical multilocular radiolucency, located on the right side of the mandible body and the ascending ramus of the mandible, with radiographic evidence of cortical perforation at the anterior border of the mandibular ramus and the superior border of the alveolar part of the mandible. The surgical treatment included two phases. In the first phase, the tumor was removed by enucleation and additional use of Carnoy solution, performing peripheral ostectomy and excision of the affected overlying mucosa, while in the second phase, restorative surgery of the existing mandibular defect was performed 6 months later. Postoperatively, we did not register any of postoperative complications, nor recurrence within 2 years of the follow-up. Adequate and early reconstruction of the existing jaw defect and appropriate aesthetic and functional rehabilitation of the patient should be the primary goal in the treatment of KCOT, having in mind the need for a long-term post-surgical follow-up.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 08/2013; 70(8):789-93. · 0.27 Impact Factor
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    ABSTRACT: Bronchial carcinoids belong to a rare type of lung tumors. If they do not expose outstanding neuroendocrine activity, they develop without clearly visible symptoms. They are often detected during a routine examination. According to their clinical pathological features, they are divided into typical and atypical tumors. Typical bronchial carcinoids metastasize to distant organs very rarely. Localized forms are effectively treated by surgery. The methods of conservative treatment should be applied in other cases. We presented a 65-year-old patient with carcinoid lung tumor detected by a routine examination. Additional analysis (chest X-ray, computed tomography of the chest, ultrasound of the abdomen, skeletal scintigraphy, bronhoscopy, histopathological analysis of the bioptate of bronchial tumor, as well as bronchial brushing cytology and immunohistochemical staining performed with markers specific for neuroendocrine tumor) proved a morphologically typical lung carcinoid with dissemination to the liver and skeletal system, which is very rarely found in typical carcinoids. The presented case with carcinoid used to be showed morphological and pathohistological characteristics of typical bronchial carcinoid. With its metastasis to the liver and skeletal system it demonstrated unusual clinical course that used to be considered as rare phenomenon. Due to its frequent asymptomatic course and varied manifestation, bronchial carcinoid could be considered as a diagnostic challenge requiring a multidisciplinary approach.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 05/2013; 70(5):516-21. · 0.27 Impact Factor
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    ABSTRACT: Sclerosing mesenteritis is a rare pathological entity characterized by non-specific tumor-like expansion in mesentery. Accurate diagnosis of this disease is rarely made preoperatively. Surgery takes place in diagnosis, as well in treatment of the disease. We presented a case of sclerosing mesenteritis that affected the final portions of duodenum and initial part of jejunum with clinical picture of upper gastrointestinal obstruction. A 46-year-old man without previous medical history was presented with vomiting and loss of weight in the last 6 months. Due to suspicion of parapancreatic tumor by CT examination and clinical presentation of the disease, the patient underwent laparotomy. A mass infiltrated mesenteric root, initial part of superior mesenteric artery, the fourth duodenum portion and the ligament of Treitz, while the stomach and duodenum were dilatated. The intraoperative biopsy indicated a benign process. The mass was reduced with desobstruction of the duodenum. Definitively, histopathological finding showed fibromatosis in different phases of activity. Postoperative course passed without complications. The patient continued to receive an immunosuppressive drug therapy. After a 6-month treatment the patient showed no gastrointestinal problems. Sclerosing mesenteritis that affects the duodenum and the proximal part of the jejunum with subacute upper gastrointestinal obstruction is an extremely rare condition. In the presented case a surgical procedure was necessary for marking the diagnosis and treatment as well.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 03/2013; 70(3):326-30. · 0.27 Impact Factor
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    ABSTRACT: Parathyroid hyperplasia (PHP) is defined as an absolute increase in the mass of parenchymal cells of the parathyroid gland. PHP is classified as primary, secondary and tertiary. The enlargement of parathyroid glands (PG) is usually asymmetric, resulting in a "dominant" gland. In order to confirm the diagnosis, at least two glands should be examined histologically. Subtotal parathyroidectomy, i.e. removal of the three PG and leaving a small remnant of the forth, is the treatment of choice. High percent of PHP recurrence imposes the need for preoperative high sensitivity localizing procedures. Parathyroid scintigraphy localizes about 60% of hyperplastic glands. The aim of this study was to correlate findings of subtraction parathyroid scintigraphy (SPS) with weight, pathohistologic finding and oxyphil cell (OC) content of PG in patients with primary, secondary and tertiary parathyroid hyperplasia. Twenty-seven patients with primary/secondary PHP underwent SPS before surgery. Scintigraphic results were graded from 1-5, in relation to the degree of uptake. SPS graded 3, 4 and 5 were considered positive. The number and weight of operated PG were evaluated macroscopically. Pathohistologic and cellular types were defined on standard stained hematoxylin-eosin slides. OC content was defined as a percent of OC and graded from 1 to 3: grade 1 < 10%, grade 2 > or = 10% and grade 3 > or = 20% of OC. SPS localized dominant gland in all patients with sensitivity 100%, and 51 from 73 hyperplastic PG, with sensitivity per gland of 70%. PG weighed 0.1 g to 6.7 g (median 1 g). A significant positive correlation (p < 0.0001) was found between the SPS results and PG weight. A significant positive correlation was found between PG weight and OC content (p = 0.0002). An insignificant correlation was found between SPS and OC content. Thirty-eight PG had < 10% of OC, 32 PG had > or = 10% and 3 PG had > or = 20% of OC. Four patients had diffuse PHP and 23 patients nodular PHP. There was no statistically significant difference in SPS results compared to hyperplasia type, and between OC content and hyperplasia type. A significant positive correlation (p = 0.05) was found between PG weight and hyperplasia type. A high positive correlation was found between SPS results and PG weight, PG weight and OC content and PG weight and hyperplasia type. Between SPS results and OC content, and between SPS results and hyperplasia type, an insignificant correlation was found. Our results showed that SPS is a reliable and very sensitive diagnostic tool in detecting abnormal PG in parathyroid hyperplasia, reaching 100% sensitivity in detecting a "dominant gland" and sensitivity per localized gland of 70%. Causes that affect increased uptake of liposolubile Tc99m radiopharmaceuticals (RF) in the hyperfunctional PG tissue and conditions which prevent RF admission into the PG cells still remain to be accurately and precisely determined.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 04/2012; 69(4):345-52. · 0.27 Impact Factor
  • European Urology Supplements 10/2011; 10(9):596-597. · 3.37 Impact Factor
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    ABSTRACT: BACKGRAUND/AIM: Conventional cytomorphology of thyroid cell aspirates is limited in preoperative differential diagnosis of follicular adenomas (FA) and hyperplastic adenomatoid nodular goiters from well differentiated thyroid follicular carcinoma (FTC) and follicular variant of thyroid papillary carcinoma (PTC). This is the reason of inaccurate presurgical differential diagnosis and in the same cases of inadequate operative managament. The aim of the study was to evaluate the role of quantitative estimation of thyreocite nuclear features (cariomorphometry) in thyroid aspirated smears in preoperative differential diagnosis of benign from malignant thyroid lesions. A total of 48 patients with thyroid nodular disease underwent fine needle aspiration biopsy for cytomorphology, cariomorphometric analysis of the aspirates, and histopathologic explorations conducted fully postoperatively. On the basis of cytomorphology classification the patients were divided into three groups: benign (B), n = 8; malignant (M), n = 15, and suspicious for malignancy (S), n = 25. Using a microscope connected to a computerized video system, mean nuclear area, the nuclear area coefficient of variation (NACV) and anisocariosis ratio were measured and calculated. In all the 15 patients with cytologically malignant results the diagnosis of PTC was confirmed histopathologically. All cytologically benign lesions were confirmed histopathologically. Thyroid carcinoma was found in 15 out of 25 patients with suspicious lesions. The highest mean values of nuclear area were in the PCT (90.74 +/- 26.71 microm2), and were significantly different from all other groups (p < 0.001). The mean nuclear area in FTC was 69.20 +/- 27.31 microm2 and was significantly higher than in the benign adenomatous group (p < 0.01). There was no significant difference in mean nuclear area between FTC and FA, but there was a significant difference in NACV between these two groups (FTC: 39.46% vs FA: 23.42%,p < 0.001). In 27 out of 30 patients with thyroid carcinoma higher values of NACV than 18% were found. Preoperatively cariomorphometry is a useful method in differential diagnosis of thyroid carcinoma from benign lesions, as a complementary method to convencional cytodiagnostics. The NACV showed highest sensitivity as a parameter of malignant thyroid cell transformation.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 08/2011; 68(8):669-75. · 0.27 Impact Factor
  • The Journal of Urology 04/2011; 185(4). · 3.75 Impact Factor
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    ABSTRACT: Our aim was to determine whether serum prostate specific antigen (PSA) and total Gleason score (GS) on biopsy in newly diagnosed prostate cancer (PCa) can predict osseous metastases and eliminate the need for a bone scan as a routine procedure in initial staging. We studied retrospectively 155 patients with previously untreated PCa who underwent bone scintigraphy. Relationship between PSA, GS and bone metastases was examined. Sensitivity, specificity, likelihood ratio (LR) and odds ratio (OR) were calculated with corresponding 95% conidence interval. Results showed that thirty of all bone scans (19.35%) were positive for metastases. This proportion was significantly higher in patients with PSA>20ng/mL (31.66% , P=0.002) vs. PSA<10ng/mL (10.52%). For PSA<10ng/mL as well as 10ng/mL≤ PSA≤ 20ng/mL the test was not a predictor for bone metastases (OR=0.36; OR=0.55). For PSA>20 ng/mL (OR=3.53) the likelihood of bone metastases was increased by 13% . The proportion of positive scintigraphy findings was significantly lower in patients with GS≤ 7 (11.47% ) vs. GS≥ 8 (48.48% , P<0.0001). The GS≥ 8 was highly predictive for bone metastases (OR=7.260). The analysis showed that GS≥ 8 increases the risk of bone metastases by 29%. In conclusion, bone scintigraphy is not necessary in asymptomatic patients with localized disease, GS≤ 6 and PSA<10ng/mL, because of the negligible risk of bone metastases in that stage. Higher levels of GS and PSA may predict bone metastases.
    Hellenic journal of nuclear medicine 01/2011; 14(2):126-30. · 0.93 Impact Factor
  • European Urology Supplements - EUR UROL SUPPL. 01/2011; 10(9):605-606.
  • European Urology Supplements 09/2010; 9(6):595-595. · 3.37 Impact Factor
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    ABSTRACT: Primary hyperparathyroidism (pHPT) is an endocrine disease with the third highest incidence of all endocrine disorders after diabetes mellitus and hyperthyroidism. pHPT is typically caused by a solitary parathyroid adenoma, less frequently by multiple parathyroid gland disease (MGD) and rarely by parathyroid carcinoma. Secondary hyperparatyroidism (sHPT) is a common complication in patients with chronic renal failure. The aim of this study was to estimate sensitivity of dual tracer 99mTc-tetrofosmin and 99mTc-pertechnetate subtraction scintigraphy in detection of abnormal parathyroid glands in patients with pHPT and sHPT confirmed by histopathology. In 46 patients, (77 abnormal parathyroid glands), 30 with pHPT and 16 with sHPT parathyroid scintigraphy was done preoperatively. All the patients had histopathological confirmation of diagnosis. Abnormal parathyroid glands weighted from 0.1 to 7 g. After iv injection dynamic scintigraphy during 25 minutes (one frame-one minute) using 555 MBq of 99mTc-tetrofosmin, and three hours latter using 111 MBq of 99mTc/pertechnetate was performed. 99mTc-tetrofosmin dynamic study was followed by static scintigraphy of the neck and chest 30 minutes, 1, 2 and 3 hours after iv injection. An abnormal scintigraphic finding was found in 44 of 46 patients with sensitivity of 96%. In pHPT sensitivity was 93% (28 of 30 patients, and 28 of 30 glands). In sHPT scintigraphy was abnormal in all the patients (sensitivity 100%). In the patients with sHPT scintigraphy detected 30 of 47 abnormal parathyroid glands (sensitivity 64%). An overall sensitivity of scintigraphy per gland, for pHPT and sHPT in detecting 58 of 77 abnormal parathyroid glands was 75%. An abnormal scintigraphic result per patient was found in 44 patients (sensitivity 96%) and 58 of 77 abnormal parathyroid glands were detected (sensitivity 750/0). A high sensitivity of dual tracer subtraction 99mTc-tetrofosmin/99mTc-pertechnetate parathyroid scintigraphy in detecting abnormal parathyroid glands in primary and secondary hyperparathyroidism was achieved.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 12/2009; 66(12):949-53. · 0.27 Impact Factor
  • European Urology Supplements 09/2009; 8(8):617-617. · 3.37 Impact Factor
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    ABSTRACT: Fine needle aspiration (FNA) cytology is an established technique associated with minimal complications compared with more invasive techniques such as wide core needle biopsy or open biopsy, and as such, very suitable for obtaining material in the delicate region of head and neck (H&N). The aim of this study was to assess the diagnostic accuracy of FNA cytology H&N masses. Aspirations were performed by cytologists using 25 or 27G needles with 20 ml syringes attached, and smears were stained with May-Grunwald-Giemsa. Four hundred and ninety-four patients with palpable H&N masses underwent FNA during the study period of 2 years. Based on cytology alone, the most common findings were reactive lymphoid hyperplasia (28.5%), metastatic carcinoma (22.7%) and lymphoma (13.4%). Sixty-four (12.6%) FNA specimens were inadequate for diagnosis. Histological correlation was available in 164 (33.2%) patients who went on to have surgical excision of the mass. Nondiagnostic aspirate was in 16 (9.75%) patients, so the final group for cyto- histological correlation included 148 patients. The overall accuracy rate of FNA cytology, whether malignant or benign, was 91.89%, while the diagnostic accuracy for the exact type of tumor was 87.16%. There were 3 (2%) false-positive (FP) and 9 (6.1%) false-negative (FN) cytological diagnoses. The sensitivity and specificity of FNA cytology in determining a malignant diagnosis were 91.5% and 92.85%, respectively. Positive (PPV) and negative predictive value (NPV) were 97 and 81.25%, respectively. Our results showed that FNA cytology is a simple, safe, and cost-effective diagnostic method, suitable as a first-line investigation in palpable H&N masses. The main causes of the wrong diagnoses were sampling errors, inexperience and misinterpretation.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 01/2009; 14(4):653-9. · 0.71 Impact Factor
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    ABSTRACT: Simultaneous presence of Hashimoto's thyroiditis and papillary thyroidal carcinoma in thyroidal gland with papillary carcinoma association in thyroglossal duct is quite rare. The questions like where the original site of primary process, is where metastasis is, what the cause of coexisting of these diseasesis present a diagnostic dilemma. We presented a case of a 53-year old female patient, with the diagnosis of Hashimoto's thyroiditis and symptoms of subclinical hypothyreosis and nodal changes in the right lobe of thyroidal gland, according to clinical investigation. Morphological examination of thyroidal gland, ultrasound examination and scintigraphy with technetium (Tc) confirmed the existence of nonhomogenic tissue with parenchyma nodular changes in the right lobe of thyroidal gland that weakly bonded Tc. Fine needle biopsy in nodal changes, with cytological analyses showed no evidence of atypical thyreocites. Hashimoto's thyroiditis was confirmed on the basis of the increased values of anti-microsomal antibodies, the high levels of thyreogobulin 117 ng/ml and TSH 6.29 microIU/ml. The operation near by the nodular change in the right lobe of thyroidal gland revealed pyramidal lobe spread in the thyroglossal duct. Total thyroidectomia was done with the elimination of thyroglossal duct. Final patohystological findings showed papillary carcinoma in the nodal changes pT2, N0 and in the thyroglossal duct with the presence of Hashimoto's thyroiditis in the residual parenchyme of the thyroid gland. After the surgery the whole body scintigraphy with iodine 131 (131I) did not reveal accumulation of 131I in the body, while the fixation in the neck was 1%. After that, the patient was treated with thyroxin with suppression-substitution doses. Abnormality in embrional development of thyroidal tissue might be the source of thyroidal carcinoma or the way of spreading of metastasis of primary thyroidal carcinoma from thyroid gland. The cause of this process is most probably a hereditary mutation in RET oncogenes.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 11/2007; 64(10):714-8. · 0.27 Impact Factor
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    ABSTRACT: Feasibility of radical prostatectomy (RP) in patients with locally invasive prostate cancer (PC) is assessed by the standard parameters such as the stage of the disease, serum prostate-specific antigen (PSA) and bioptic Gleason grade (GG). Intermediate values of PSA are important in predicting the local confines of the tumor, but can also be detected in more than 30% of patients with locally advanced PC. The aim of this study was to find out the incidence of locally advanced PC in the patients with intermediate serum PSA in whom RP had been performed. We used the biopsy cores and the tissue obtained after RP from 46 patients who had intermidiate PSA values which were defined as PSA from 2.6-10 ng/ml. In all the patients classical regional lymphadenectomy was performed. In all the patients, preoperative stage was determined according to the Partin tables (PT) from 2001. In 52, 17% of the patients biopsy GG was < or = 6, while it was 7 in 47.83% of the patients. Clinically localized disease (cT2b) was found in 86.96% of patients; other 13.04% of the patients had locally advanced PC. After RP, the incidence of localized PC was 47.83%, while the advanced disease was found in 52.17%. Metastasis in one or two regional lymph nodes (N1) was found in 10.87% of the patients with the advanced PC. According to PT, the expected incidence of positive lymph nodes should have been 8% for pT3 stage. Positive correlation between the assumed N1 stage according to PT and N1 stage in our radical prostatectomies was statistically significant (p = 0.012). In more than 50% of patients with intermediate values of PSA locally advanced disease can be expected after RP. The use of the Partin tables have an important predictive value in assessing the local confines of the cancer and metastasis in regional lymph nodes.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 08/2007; 64(8):531-7. · 0.27 Impact Factor
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    ABSTRACT: Radical prostatectomy (RP) provides the best cancer control in patients with clinically prostate gland confined cancer. Multiple models and nomograms combining preoperative prostate-specific antigen (PSA) serum level, clinical stage and Gleason score have been developed to predict the probability of metastatic disease. In prostate cancer (PC) the presence of metastases to the pelvic lymph nodes (PLNs) is recognized widely as an unfavorable prognostic factor. Currently, PLNs dissection is not done in a low-risk group of prostate cancer patients. The aim of this study was to analyze PLN metastases in PC patients, in clinically localized stages of PC. Radical prostatectomy specimens with pelvic lymphadenectomy specimens from 82 PC patients were reviewed. In this group of patients, serum preoperative PSA values ranged from 2 to 23 ng/ml. We diagnosed 11/82 (13.4%) patients with PLN metastases. There were 8 (72%) patients with pT3c pathological stage, and 3 (28%) patients with pT4a stage. PSA below 4 ng/ml was detected in 2/5 (40%) patients with PLN metastases. There was no statistically significant difference between preoperative PSA values and postoperative T stage, and PLN metastases. A statistically significant correlation between PLN metastases and the stage was found in the patients with pT4 and the patients with pT3c PC stages (p < 0.05). Recent RP series indicate PLN metastases to be less than 10%. We demonstrated higher detection of PLN metastases (13.4%) in our RP series. Our results suggest that PLNs dissection should be performed even in patients with low-risk PC.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 01/2007; 63(12):1011-4. · 0.27 Impact Factor
  • Vojnosanitetski pregled. Military-medical and pharmaceutical review 01/2007; 64(8):531-537. · 0.27 Impact Factor
  • Snezana Cerović, Goran Brajusković
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 01/2007; 63(12):1049-53. · 0.27 Impact Factor
  • Goran Brajusković, Snezana Cerović
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 06/2006; 63(5):489-93. · 0.27 Impact Factor
  • Vojnosanitetski pregled. Military-medical and pharmaceutical review 01/2006; 63(12):1011-1014. · 0.27 Impact Factor