Background: Invasive ductal cancer (IDC) represents about 75% of all breast malignancies. There are many breast cancer prognostic factors, but the ones that have the most impact on the survival rates in advanced breast cancer are tumor size and regional lymph node involvement. Axillary lymph node dissection (ALND) has particularly important and undoubtful role in current surgical options for breast cancer treatment. With the introduction of sentinel lymph node biopsy (SLNB) for breast cancer patients it was possible to identify those to whom regional spread of the disease did not occur at the time of surgery, and thus spare them an unnecessary ALND procedure. Objective: To determine the rate of sentinel lymph node (SLN) detection using only methylene blue dye as a mapping agent, as well as to correlate the number of positive SLNs with the number of positive non-sentinel lymph nodes (non-SLNs). Methods: The study represents a prospective study that included 50 female patients with histologically confirmed invasive ductal carcinoma (IDC) who underwent SLNB using only methylene blue dye as the mapping agent, while the detection and harvest of SNL was done by visual control only. All patients also underwent an obligatory complete ALND, which was as that time the institutional oncological protocol for surgical treatment of histologically confirmed IDC. The final data such as tumor size, SLN and non-SLN status were obtained by further analysis of pathohistological reports from tumor biopsy and other surgical specimens. Results: The accuracy rate of SLN detection was 98%. The number of detected SLN was in the range of 1 to 6, with an average of 2 for each patient. The number of positive SLN was in significant correlation with the number of tumor-affected non-SNL (p<0,001). Further analysis showed that for each increase in the number of positive SLN by 1, the risk of positive non-SLN increased 6-fold, OR=6,22 (p<0,001). Conclusion: Use of methylene blue dye as a sole mapping agent when performing SLNB in patients with IDC is a reliable and effective method that can be safely implemented in medical institutions that lack availability of nuclear medicine services or significant monetary funds.

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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

We report a case of recurrent painful and disabling granulomatous flexor tenosynovitis of the right wrist in 50-year-old female patient. The proper diagnosis was made ex juvantibus after repeated cultivation of Mycobacteria yielded negative results and local disease control was surgically unsuccessful. It was then decided to start at first with oral Clarithromycin at 500mg 2x daily during 6-month period throughout which there was no sign of local recurrence. However, synovectomy had to be performed 3 times in total during the period of two years. While the noninfectious causes were excluded, and infectious agent was not to be determined, the decision was made to administer full anti-tuberculosis medication therapy. At about the same time, we were finally able to obtain a positive Mycobacterium tuberculosis culture after a sudden onset of right axillary lymphadenitis, but only two and half years from the occurrence of first symptoms related to right wrist tenosynovitis.