Hepatocellular carcinoma (HCC) is the most often primary cancer of the liver and is one if the leading cause of cancer-related death worldwide. The incidence of HCC has geographic distribution with the highest levels in countries with developing economies. Patients with hepatocellular carcinoma have poor prognosis despite the achievements in surgery techniques and other therapeutic procedures and it is a reason why continuous attention should be paid to this issue.This article provides an overview of this disease based on an extensive review of relevant literature. The article summarizes the current risk factors, diagnosis, staging and the management of HCC.

BACKGROUND:Tumor-infiltrating lymphocytes (TIL) in tumour stroma are considered to be involved in the elimination of malignant cells and prevention of metastasis formation. TIL consist of T lymphocytes including cytotoxic lymphocytes that are a constituent part of the effector mechanism of anti-tumour immunity and B lymphocytes that can form tertiary lymphoid structures (TLS). TLS has been described in several solid tumours and colorectal carcinoma (CRC), and the influence on the local and systemic anti-cancer response.AIM:This study aimed to quantify the presence of TLS in CRC patients and to determine their role in tumour progression.PATIENTS AND METHODS:The study included 103 patients with CRC who underwent surgery at the University Clinic of Digestive Surgery in Skopje, whose operative material was analysed at the Institute of Pathology, Medical Faculty in Skopje. The density of TLS was determined and correlated with the neoplasm status of local growth (T), positive lymph nodes, lymphatic invasion, and stage of the disease and tumour grade.RESULTS:The density of TLS was significantly higher in patients with higher stage, lower T status, and negative lymph nodes, in patients with no lymphatic invasion and with better-differentiated tumours.CONCLUSION:The density of TLS plays an important role in controlling the tumour growth, and it can be a parameter for neoplasm progression in CRC patients. The density of TLS influences the control of tumour progression.

Immunohistochemical expression of MMPs is a useful indicator of the disease development and progression in patients with colorectal cancer.

Pancreas is an extremely rare abdominal localization of the solitary fibrous tumor (SFT). It usually grows asymptomatically for a long time before a diagnosis can be made on the basis of symptoms and/or mechanical complications. Due to the rarity and nonspecific clinical presentation, this entity is diagnostically challenging. We present a 47-year-old man with a history of progressive epigastric pain for the last two weeks, and jaundice, who was admitted to hospital for further investigation. Cystadenocarcinoma was suspected based on the radiologic findings, and a pancreatoduodenectomy was performed. The removed portion of the pancreas contained a 3.5 × 2 × 1.8 cm well-circumscribed, but not encapsulated white tumor mass with smooth cut surface, cystic component and duct dilatation within the tumor and within the adjacent pancreatic tissue. Based on the histology and immunostaining profile, a diagnosis of the solitary fibrous tumor was made. One week post-operatively, the patient died due to surgical complications. Microscopic and immunohistochemical examinations are necessary for accurate diagnosis of cystic SFT of the pancreas. Because there is limited data regarding the biological behavior of SFT with extra-pleural localization the authors recommend clinical follow-up for SFT treatment if the criteria of malignancy are not met.

Background: Gastrointestinal tract is uncommon localization for lipomas, but if present they are 90% submucosal and 10% subserosal. Intestinal submucosal lipomas are the most common benign nonepithelial intestinal tumors usually found incidentally. Rarely, they may cause obstruction, ulceration, perforation, intussusceptions, prolapse and massive hemorrhage.