Search

Background/Aim. Surgical extraction of impacted lower third molars is inevitably followed by the postoperative occurrence of trismus, swelling, and pain sensations to some degree. Corticosteroids (dexamethasone in particular) are commonly used drugs in the prevention of these complications. The aim of this study was to determine the effectiveness of dexamethasone in the prevention of postoperative complications, edema, trismus, and pain after the surgical extraction of impacted lower third molars, depending on the method of its administration. Methods. This prospective study involved 30 healthy patients, aged 18 years and above, of both sexes, with fully impacted lower third molar – class I or II and position B or C, according to Pell and Gregory classification system and vertical position according to Winter classification. All patients were divided randomly into three groups de-pending on the way of dexamethasone administration: oral – dexamethasone administered in the form of oral tablets in a dose of 4 mg one hour before the surgery; submucosal – dexamethasone solution administered submucosally in a dose of 4 mg in the area of the buccal sulcus, after the inferior alveolar nerve block anesthesia and additional anesthesia for the buccal nerve; intramuscular – dexamethasone solution administered intramuscularly in a dose of 4mg into the area of the deltoid muscle, right before the intervention. Preoperatively and at every follow-up (on the first, second, and seventh day postoperatively), interincisal distance, the degree of edema, and the level of pain with the use of a visual analog scale (VAS) were measured. On the seventh postoperative day, the total number of analgesics taken by the patients was recorded. Results. In the postoperative period, there was no statistically significant difference be-tween the examined groups in terms of effectiveness in swelling, trismus, and pain reduction (p > 0.05). Conclusion. There is no significant difference in dexamethasone effectiveness in postoperative trismus, swelling, and pain reduction after the third lower molar surgery, regarding the route of administration – oral, intramuscular, or local submucosal.

Background/Aim. Although apicoectomy is performed routinely and yields excellent results, a close patient observation during the postoperative course is desirable in order to avoid possible complications. The aim of this study was to investigate the adequacy of postoperative control visits a day after surgery using the store-and-forward telemedicine method compared to the clinical in-person controls. Methods. A total of 122 apicoectomies were performed during 115 dental surgery interventions. The follow-up dental ex-amination a day after apicoectomy consisted of reviewing extraoral and intraoral photographs on the internet and re-viewing responses to the questionnaire. After that, patients were examined in-person. Cohen’s kappa („store-and-forward” method) coefficient, diagnostic sensitivity (SE), sensitivity (SP), and efficiency (EFF) were determined. Statistical comparisons were performed using the Z-test, and nonparametric characteristics were tested using McNemar’s χ2-test at the statistical significance cut-off value of p = 0.05. Results. There were 106 (92%) patients seen at the control dental examination. The agreement between in-person and store-and-forward telemedicine method was found in 104 (98%) cases. The obtained agreement values (K = 0.85, S = 0.99, SP = 0.86, EFF = 0.98) indicated an almost complete diagnostic agreement. Conclusion. Based on the internet transmission of patients’ digital photographs and ac-companying patient medical history records, the study showed that the in-person control dental examinations a day after surgery can be successfully replaced with the remote store-and-forward method of telemedicine.

Background/Aim. Myocardial bridges (MB) are narrower or wider fascicles of the atrial or ventricular muscle fibres which form a “bridge” either across the main trunks of coronary arteries or their major subepicardial branches. The aim of this research was to determine and present the exact frequency, morphological, morphometric and histological characteristics of the MB in the level of anterior interventricular branch (AIB) in human fetal hearts. Methods. The study was performed on 63 human fetal hearts. Images of the analyzed hearts were captured with a digital camera and afterwards morphometrically evaluated with ImageJ. Characteristic cases of the MB were dissected, sampled and further routinely processed for the subsequent histological analysis. Finally, the obtained morphometric data were statistically analyzed. Results. The presence of the MB on the AIB was proven histologically and under the magnifying glass. Myocardial bridges were found in 53.97% of the hearts. The percentage of the hearts with only one MB detected on AIB 88.24% was significantly higher than the percentage of the hearts with two MBs on the AIB (11.76%) (p < 0.001). Conclusion. We suggest that the MBs are just one anatomical variation of the fetal period as well as of adulthood. [Projects of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175092 and Grnat no. III 41017]

Background/Aim. Duodenogastric reflux occurs after gastroenteroanastomosis, with or without resection of the stomach (Billroth I, Billroth II), after vagotomy and pyloroplasty, gastroduodenostomy as well as in conservatively treated patients. The aim of this study was to analyse the effect of carcinogenic N-nitroso compounds (MNNG) influence in conjunction with duodenogastric reflux, in the function of time for precancerous lesions development in gastric mucosa. A particular purpose of the study has been to suggest some effective surgical procedures, which could prevent the harmful effects of duodenogastric reflux on gastric mucosa, as a potential activator of carcinogenesis. Methods. The research included 90 experimental, male Wistar rats, divided into 3 groups. The two experimental groups were subjected to two surgical procedures: Billroth II gastric resection (group B2), and the Roux-en-Y reconstruction (group RY), respectively. The control group (group C) animals did not receive any surgical treatment. All groups were administered per os chemical cancerogen MNNG. All anastomoses were performed by extra mucosal suture with monofilament polypropilene 7–0, and 8–0. The animals were sacrificed consecutively, and subjected to total gastrectomy after 8, 16 and 24 weeks. Results. Pathohistological analysis was performed on defined regions of the rat stomach in three time period. The B2 group, at the end of our experiment, showed predominant incidence of severe lesions: hyperplasia (0%), gastritis (0%), metaplasia (6.7%), dysplasia (46.7%), early carcinoma (20%) and carcinoma (26.7%). At the end of our experiment, the RY and C groups showed the similarities of the obtained results related to time with predominant incidence of mild lesions: hyperplasia (13.3% vs 0%, respectively), gastritis (13.3% vs 13.3%, respectively), metaplasia (6.7% vs 13.3%, respectively), dysplasia (66.7% vs 66.7%, respectively), with an extremely low incidence of early carcinoma (0% vs 6.7%, respectively) and no incidence of carcinoma (0% vs 0%, respectively). Conclusion. Without the presence of duodenogastric reflux, MNNG causes a low degree of precancerous gastric lesions. However, direct contacts of MNNG with gastric mucosa, including the presence of duodenogastric reflux, induce precancerous lesions and carcinoma. The percentage of reversible changes decreases with time, while the percentage of irreversible lesions and carcinoma increases. A lack of distinction in the findings between the RY and C groups confirms a gastroprotective role of the Roux-en-Y procedure.

Background/Aim. The wearing of acrylic dentures is the cause of the inflammatory reaction of the oral mucosa. The aim of this study was to investigate the response of rat tissues to subcutaneous and intramuscular implantation of different acrylic samples, by histopathological analysis of the tissue. Methods. The study included two samples of hard and three samples of soft acrylic resins (heat and cold polymerized), that were subcutaneously and intramuscularly implanted in rats tissues. Implantation tests were designed to test the biological response of the surrounding tissue to the tested materials after their application for the period of two weeks and the period of four months. Results. After two weeks, regardless of the type of implantation, histopathological analysis showed an acute inflammatory response. There was an intense hyperplasia of inflammatory cells, multiplication of connective tissue as well as formation of many new blood vessels. The highest level of inflammatory changes was observed after the application of cold-polymerized resins. A lower intensity of inflammation in the case of heat polymerised resin was the result of its more complete polymerization. After the second observation period, fibrotic capsules were formed around the implanted samples indicating a chronic course of the inflammatory process. Less visible signs of inflammation and chronicity of the processes indicate that with time, i.e. with the length of the observation period, reduces inflammation. Conclusion. The subcutaneous and intramuscular implantation of acrylic resins material samples led to inflammatory response whose intensity was decreased over time. Heat polymerized resin was a biologically more acceptable in comparison to the cold polymerized acrylates.

Background/Aim. Results of previous studies gave support to the idea that machines in power plants produce noise of different levels of loudness and frequency, and that it could cause deterioration of the hearing ability of workers. As a matter of fact, noiseinduced hearing loss is the most widespread occupational disease nowadays. As noise is a complex acoustic phenomenon, more factors have to be considered when studying it, such as frequency, intensity and the period of exposure. The aim of this study was to find if there are differences in the absolute threshold of hearing between workers in the factory production lines that are constantly exposed to the industrial noise of higher spectrum and those exposed to the noise of standard spectrum at different frequencies of sound. Methods. In the research plan, there were 308 workers employed in the production line of the Factory “Knjaz Miloš”, Aranđelovac. A total of 205 of them were working in the conditions of higher spectrum noise (4,000 Hz – 8,000 Hz) and 103 workers were exposed to standard noise spectrum (31.5 Hz – 2,000.0 Hz). The objective measures of noise (frequency and amplitude) were acquired by phonometer, and measures of absolute threshold of hearing for both ears were obtained by audiometer by exposure to nine sound frequency levels. Data were statistically analyzed by establishing the significance of differences between absolute thresholds of hearing for both groups and for all nine frequency levels. Results. It was found that the absolute threshold of hearing is significantly higher for the group exposed to highfrequency noise at the 4,000 Hz and 8,000 Hz levels of frequency. Conclusion. Reduction of hearing sensitivity is evident for those exposed to higher spectrum noise, which is particularly evident at the higher frequency levels. Employees are often unaware of its effects because they are the results of prolonged exposure. Therefore, working in those conditions requires preventive measures and regular testing of the hearing ability.

Background/Aim. Health care system is specific for each country, and therefore involves different motivation and job satisfaction factors. The aim of this study was to confirm the validity and applicability of the General Nordic Questionnaire translated into Serbian for analyzing motivation and job satisfaction, as well as to analyze the motivation factors and job satisfaction of health workers at the Institute for Treatment and Rehabilitation "Niška Banja". Methods. The General Nordic Questionnaire was translated into Serbian. It included 73 questions (5 answers by the Likert scale), which formed 24 scales. In May, 2012, 196 (82.3%) health workers filled in the questionnaire. Results. A correlation of Ceronbach’s alpha values between the Scandinavian study results and the results of Serbian study was statistically significant (r = 0.424; p < 0.05). The lowest Cronbach’ alfa coefficient was for the scale “learning demand in job demands” (alpha 0.28). The other scale with no satisfactory reliability was “control of work pacing” (alpha 0.46). Intrinsic motivation positively correlated with all the scales of organizational module, apart from inequality. Within this module, the degree of extrinsic motivation correlated with the support from the superior and coworkers, with fair leadership and human resources primacy. A negative correlation appeared with inequality. Conclusion. The general Nordic Questionnaire can be applied to a great extent to the conditions in our country. Our study shows a low consistency of the scales learning job demands, control of decision, control of work pacing, so the questions in them should be adjusted to the conditions in our country. Extrinsic motivation resulted in higher values than the values of intrinsic motivation in our workers, which is opposite to the results of the original questionnaire.

Backround/Aim. Retraction agents for temporary vertical and lateral suppression of gingival tissue as well as bleeding control and fluid flow in the gingival sulcus are expected to have maximal efficiency without irreversible damage of local tissue and adverse systemic effects. The research started from the assumption that tetrahydrozoline is a biologically more acceptable means of gingival retraction than commercially available preparations. The aim of the study was to comparatively analyse the inflammatory effects of different retraction materials and tetrahydrozoline. Methods. The effect of retraction liquid on the basis of aluminum chloride and epinephrine and tetrahydrozoline hydrochloride on gingival tissue of rabbits was investigated. The application time in the rabbit's gingival sulcus was 7 minutes. Tissue biopsy was performed after an hour, a day, and 7 and 30 days. Tissue preparations were analyzed under a microscope. Results. The obtained results indicate a reversible damage of gingival tissues as a result of local application of aluminum chloride- and epinephrine-based retraction agents. Their use led to acute inflammatory response after an observation period of 1 and 7 days. After 30 days reparation of damaged tissue was observed. The use of tetrahydrozoline resulted in a visibly weaker inflammatory response. Conclusion. Retraction liquids insertion led to an acute inflammatory response of gingival tissue which in time assumed a chronic character. The inflammatory response to the administered tetrahydrozoline was significantly lower with complete reparation of gingival tissue. Taking this fact into account it is recommended as a potential retraction agent. [Projekat Ministarstva nauke Republike Srbije, br. 41017]

Introduction. Angiomyolipomas (AML) are benign neoplasms composed of fat, smooth muscle and thick-walled blood vessels in varying proportions. These tumors have a significant female predominance. Case report. We reported a 61-year-old man with spontaneous rupture of AML. Computerized tomography revealed a change in morphology of both kidneys. Multiple lesions of fat density with dilated blood vessels were found in the left kidney. The right retroperitoneum was obliterated with a giant heterogeneous mass originating from the right kidney with a massive hemorrhage, active extravasations, compression of inferior the vena cava and intraperitoneal collections. After radical nephrectomy, histological examination revealed that the tumor was composed of relative proportions of fat, smooth muscle and blood vessels. We incidentally found small renal adenoma. Conclusion. The true nature of AML is unclear, but they are usually classified as hamartomas. Angiomyolipomas are generally benign lesions, although the epithelioid angiomyolipoma, a subtype that occurs in about 3% of cases, can behavior aggressively. [Projekat Ministarstva nauke Republike Srbije, br. 41017]

Introduction. Sinus histiocytosis with massive lymphadenopathy is a rare benign self-limiting disease of unknown etiology. The salivary gland involvement, indicating the extranodal character of the disease, often presents a diagnostic dilemma requiring immunohistochemical staining of surgically removed tumor to confirm the diagnosis. Case report. We report a 43-year-old man presented with an asymptomatic mass in the left mandibular angle. On physical examination, the lesion was described as a painless, mobile, firm-elastic consistency nodule, which measured 4 × 3 cm in diameter, with normal overlying skin. A mass with the same characteristics, dimensions 2 × 2 cm, was also noted in the right parotid region. No other changes in regional lymph nodes were detected. On macroscopic examination the lesion was firm, multilobulated, yellowish and rounded, while on microscopic examination the lesion was composed almost entirely of polygonal histiocytes with abundant cytoplasm, emperipolesis, plasma cells arranged in sheets, and lymphocytes scattered or within clusters. The observed histiocytes were found to be CD68 and S100 protein positive. Conclusion. Rosai-Dorfman disease is a beningn and frequently overlooked clinical and pathological entity that may be misinterpreted as a neoplastic disease. [Projekat Ministarstva nauke Republike Srbije, br. 41017]

Introduction. Malignant Triton tumor is a very rare malignant peripheral nerve sheath tumor with rhabdomyosarcomatous differentiation. Most of those tumors occur in patients with von Recklinghausen’s disease or as a late complication of irradiation and commonly seen in the head, neck, extremities and trunk. Case report. We reported retroperitoneal malignant Triton tumor in a 57-year-old female patient. Skin lesions were not present, and there was no family history of neurofibromatosis or previous irradiation. The presented case is one of a few recorded in the specialized literature that occurs in the retroperitoneal space in sporadic form. In this case, tumor consisted of a multilobular mass was in close relation with the abdominal aorta and inferior vena cava and involved the renal vein with gross invasion of the small intestine. The patient underwent total resection of the tumor and left nefrectomy was performed. The small intestine 10 cm in length was also resected and end-to-end anastomosis was conducted. The postoperative course was uneventful and the patient was discharged from the hospital ten days after the surgery. Conclusion. Diagnostically, it is crucial to recognize this uncommon histological variant because malignant Triton tumor has a worse prognosis than classic malignant peripheral nerve sheath tumor does. The use of the immunohistochemistry is essential in making the correct diagnosis. Only appropriate pathological evaluation supported by immunostaining with S-100 protein and desmin confirmed the diagnosis. Aggressive surgical management treatment improves the prognosis of such cases with adjuvant radiotherapy.

Introduction. Primary melanocytosis of the leptomeninges is a rare tumor, most likely originating from the melanocytes in the leptomeninges. The average survival is only about 5 months. Case report. A 61- years-old woman presented with headache, amaurosis and hallucinations lasted for two months, and she had been treated at the Clinic for Psychiatry and Clinic for Infectious Diseases. The cerebrospinal fluid analysis showed a lower level of glucose and a higher level of proteins. Small shaded areas of basal leptomeninges and hydrocephalus were found by computed tomography and magnetic resonance imaging. The autopsy showed a dark brown mass on basal leptomeninges with blurred boundaries. No pigmented skin lesions were found. Histopathological analysis revealed a primary leptomeningeal melanocytosis. Conclusion. Primary leptomeningeal melanocytosis is a rare tumor, difficult to diagnose. This case is being presented for its specificity, since this diagnosis is not frequently seen in practice.

Introduction/Aim. Gingivitis is a common occurrence in children and may well be thought as a risk factor for the appearance and progression of the diseases of parodontal tissues. It is thus necessary to react in a timely and adequate fashion to prevent the disease to become serious and produce parodontopathy. The aim of the study was to establish the efficacy of hyaluronic acid in the treatment of chronic gingivitis in children. Methods. The study enrolled 130 children with permanent dentition. All of the examinees were divided into three groups: group I - 50 patients with chronic gingivitis in which only the basic treatment was applied; group II - 50 patients with chronic gingivitis in which hyaluronic acid was applied in addition to basic treatment; group III - 30 examinees with healthy gingiva (control group). Assessment of oral hygiene and status of the gingiva and parodontium was done using the appropriate indexes before and after the treatment. Inflammation of the gingiva was monitored by way of cytomorphometric studies. Results. The pretreatment values of the plaque index (PI) were high: in the group I PI was 1.94; in the group II PI was 1.68. After the treatment, the PI value was reduced to null in both groups (PI = 0). In the group III PI was 0.17. The bleeding index (BI) in the group I was 2.02 before and 0.32 after the treatment; the BI value in the group II was 1.74 before and 0.16 after the treatment. In the group III BI was 0. In the group I, the Community Periodontal Index of Treatment Needs (CPITN) was 1.66 before and 0.32 after the treatment; in the group II, the CPITN value was 1.5 before and 0.24 after the treatment. In the group III, the CPITN value was 0. In the group I, the size of the nuclei of the stratified squamous epithelium of the gingiva was reduced, although not so much as the nuclear size in the group II of examinees. Conclusion. Basic treatment is able to successfully treat chronic gingivitis in children. The use of hyaluronic acid together with the basic treatment can markedly improve the treatment effect.

Background/Aim. There is clear evidence on direct relationship between periodontal disease and diabetes mellitus. Many investigations point out greater prevalence and severity of periodontal disease among diabetic patients. During last decade, low level laser therapy has been used in periodontal therapy. It has biostimulative effect, accelerates wound healing, minimizes pain and swelling, and there is almost no contraindication for its usage. The aim of the paper was to investigate the efficiency of low level laser therapy as adjuvant tool in reduction of gingival inflammation in diabetic patients. Methods. The study incuded 150 participants divided into three groups: group I (50 participants with diabetes mellitus type 1 and periodontal disease), group II (50 participants with diabetes mellitus type 2 and periodontal disease), group III (nondiabetic participants with periodontal disease). Gingival health evaluation was done using gingival index Löe-Silness. Soft and hard deposits were removed, periodontal pockets cleaned and GaAlAs low level laser therapy (5 mW) applied five consecutive days. In each patient, low level laser therapy was not applied on the left side of the jaw in order to compare the effects of the applied therapy. After the first, third and fifth therapy and one month after the last visit gingival index was evaluated. Before the first and after the fifth therapy exfoliative cytology of gingiva was done and nuclei areal was analyzed morphometrically. Results. After all investigated periods, gingival index and nuclei areal were significantly decreased comparing to values before the therapy, at both jaw sides (p < 0.001). After the 1st, 3rd and 5th therapy, the t-test showed a significantly decreased gingival index at the lased side of jaw comparing to non-lased side. Conclusion. Low level laser therapy is efficient in gingival inflammation elimination and can be proposed as an adjuvant tool in basic periodontal therapy of diabetic patients.

Background/Aim. Bacterial flora is a very important factor in pathogenesis of chronic suppurative otitis media (CSOM) and significantly influences the type and intensity of osteolytic process. There are few histomorphometric investigations of middle ear mucosa in chronic otitis. The aim of this study was to identify aerobic bacteria responsible for chronic suppurative otitis media as well as their association with histomorphometric changes of middle ear mucosa. Methods. A prospective study that comprised 153 patients treated in the Clinc for Ear, Thorat and Nose Diseases, Niš, was conducted. Bacteriologic analysis of diseased ear secretion was carried out in all patients. Intraoperatively removed granulation tissue was used for histomorphometry. The analysed parameters were: the number of inflammatory cells, as well as vascularization and vasodilatation. Results. The most frequently isolated aerobic bacteria from chronic suppurative otitis media were Staphylococcus aureus (29.02%), Pseudomonas aeruginosa (29.02%) and Proteus spp. (21.76%). There was no correlation between the type of pathologic process and the type of bacteria.The number of inflammatory cells in the granulation tissue in pure cultures of Staphylococcus aureus was 1,597.33 ± 549.45 and in Pseudomonas auriginosa cultures was 2,639 ± 648. Conclusion. This study showed that there is a statistically significant correlation between the number of inflammatory cells in the granulation tissue and the type of aerobic bacteria we isolated. The intensity of the infection in chronic suppurative otitis media depends on the type of the isolated bacteria, which emphasizes the importance of adequate preoperative antimicrobial therapy.

Background/Aim. The symptoms of gastroesophageal reflux desease (GERD) are among the most common complaints for which patients are indicated for visiting gastroenterologist. It occurs as a result of the effect made by gastric reflux contents that moves into the esophagus. The prevalence of all forms of GERD is 40%. The aim of this study was to analyze the grade of esophagitis, chromendoscopical and histological findings of esophagus in patients with GERD before and after the therapy. Methods. A prospective study included 90 patients with symptoms of GERD, divided into 2 groups depending on whether they had endoscopic signs of gastroezophageal reflux (group ERD), or not (group NERD). All the patients had esophagogastroduodenoscopy, chromoendoscopy staining, test for Helicobacter pylori and histological findings of the esophagus. In the patients with Helicobacter pylori infection eradication therapy was done. Results. Esophagitis-B level was present in most of the patients. Among the groups, roughly the same number responded to positive findings on chromoendoscopy. After the therapy, chromoendoscopy was significantly negative in both groups of the patients comparing to chromoendoscopy before the therapy (p = 0.00001). Multiplication and elongation of papilla, basal cell hyperplasia, vascular dilatation, increasing of mitotic activity and the presence of polymorphonuclear leukocyte cells were statistically more frequent histological findings in the group ERB compared to the group NERB. After the therapy, the patients in both groups had statistically less histological findings of appropriate esophageal parameters. Conclusion. Chromoendoscopy combined with the standard endoscopy increases the sensitivity and specificity for reflux disease. Histology in the reflux disease is associated with endoscopic and clinical findings so that the localization of taking biopsies and histological criteria of pathohistological changes must be clearly defined. Multiplication and elongation of papilla, basal cell hyperplasia and the presence of polymorphonuclear leukocytes are the most relevant criteria in the diagnosis NERD.

Background/Aim. Lichen planus is a chronic, immunologic, mucocutaneous disease with a wide range of clinical manifestations. The aim of this retrospective study was to evaluate the most common forms of oral lichen planus (OLP) and its symptoms and to describe treatment responses in patients during 10-year period. Methods. The study was conduced on 163 OLP patients who came in the Department of Oral medicine and Periodontology between 1997 and September 2007. Each case was classified into one of four clinical subtypes: reticular, atrophic, erosive-ulcerative, bullous. Results. There was no significant difference in patients age. Women were found to be significantly more likely to have OLP (p < 0.001). Corticosteroids were effective in reducing symptoms, erythema and healing ulcers. Improvement was shown over a long term in 61.35% patients. Over the long term 38.65% patients maintained the same type of OLP or it became a more severe type. Two patients (1.22%) developed oral carcinoma during the follow-up period. Conclusion. The response of patients with erosive OLP to a short course of systemic corticosteroids often was quite remarkable. However, symptoms and signs tended to recur after this treatment. Periodic examinations, patient education, medical treatment, monitoring of side-effects as well as follow-up biopsies are necessary for management of OLP patients.

Background/Aim. Inflammatory myofibroblastic tumor (IMT) of the larynx is a rare borderline lesion composed of myofibroblastic and inflammatory cells. Case report. We presented a case of 77-year-old male with hoarseness for about three months. Laryngoscopy showed a polypoid tumor originated from the anterior commissure with glottic projection. Grossly, the tumor was 22 × 15 mm, whitish, oval nodus with firm consistency. Histologically, the lesion was composed of spindled to stellate cells arranged in a fascicular to storiform pattern and inflammatory cells: lymphocytes, histiocytes, plasma cells and neutrophils. The stroma was fibromyxoid and collagenous. Immunohistochemically, tumor cells showed strong positivity for actin and vimentin and negativity for cytokeratin, CD34, S100 and desmin. The proliferation (Ki67) was less than 10%. Conclusion. Inflammatory myofibroblastic tumor may be mistaken as a malignancy and the differential diagnosis can be difficult without immunohistochemistry. It is critical to recognize this uncommon entity to avoid unnecessary aggressive treatment.

Background. A variety of benign cyst may occur in and around the ovary and broad ligament and may simulate serous cystadenomas. The majority of broad ligament and paraovarian epithelial tumors are serous neoplasms of low malignant potential and presented with a pelvic mass with or without ascites or pain, but without involvement of the ovary. Ovarian torsion and paraovarian serous cystadenoma are rarely reported. Case report. We presented a case of giant paraovarian cyst in an 14-year-old girl, with characteristics of serous cystadenomas grossly and microscopically, and complicated with double adnexal torsion. A computed tomography scan showed large hypodense cystic mass (measuring 30 × 26 × 12 cm), occupying the whole abdominal cavity, with no adhesion to the surrounding organs. Conclusion. Precise clinical data as well as pathological examinations based on immunohistochemical stainings were important in making the diagnosis. These rare cystic lesions of para/mesoovarian location in children and their unclear histogenesis might be a histopathological diagnostical problem.