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Gestational trophoblastic disease belongs to a spectrum of rare tumors originating from trophoblast. It spreads from the benignant disease uncomplicated partial mole to the most malignant choriocarcinoma in stage IV of disease with brain metastases. Fortunately, with adequate chemotherapy even patients in advanced stage of the disease have significant chances to be cured. In estimating prognosis and adequate therapy of disease, the most significant are clinical factors: serum hCG level, duration of the disease from termination of antecedent pregnancy, prior chemotherapy, brain or liver metastases. hCG is an ideal tumor marker for follow up and early diagnosis of recidivism and metastases. In the Institute of Oncology in Sremska Kamenica 32 patients with gestational trophoblastic disease were treated in the period from 1987 to 2001. All the patients with non-metastatic disease and low risk metastatic disease (stage I-III FIGO) were successfully cured. Five patients died, all in stage IV of the disease (FIGO) with liver and brain metastases; in 4 of them disease occurred after term pregnancy. Overall survival was 85%. Treatment of non-metastatic and low risk metastatic disease was successful in all cases. Treatment failures occurred in advanced disease with brain and liver metastasis Specificity and low incidence of this disease ask for the treatment to be carried out in specialized centers, as it is in developed countries (Trophoblastic Disease Centers).

BACKGROUND: Superficially invasive neoplasias of the uterine cervix are a matter of controversy in terms of their definition, prognostic factors and selection of treatment to minimize the risk of recurrences. METHODS: Forty-three women with invasive cervical carcinoma, operated from 1993 to 2003, were postoperatively staged as IA cervical carcinoma. There were 28 patients who were submitted to class III radical hysterectomy, 9 patients to class II hysterectomy, 2 patients to class I hysterectomy, and 2 patients to abdominal trachelectomy and pelvic lymph node dissection. Mean age of patients was 44 years (range, 27-64 years). RESULTS: Twenty-three patients (56.1%) were stage with IA1 and 18 (43.9%) with stage IA2 disease according to the 1995 FIGO classification. Tumor histology revealed squamous cell carcinoma in 38 (92.6%) cases, adenocarcinoma in 2 (4.8%) cases and glassy cell carcinoma in 1 (2.4%). The average number of examined lymph nodes was 17.4 (2-53). Lymphovascular space invasion was identified in 3 patients. None of the 41 patients had metastasis to the pelvic lymph nodes or developed recurrence of disease. CONCLUSION: The results suggest that patients with cervical cancer stage IA1 have an extremely low risk of pelvic lymph node metastasis and an excellent prognosis, so nonradical management that excludes pelvic lymph node dissection could be as effective as radical surgery in these patients. Stage IA2 invasive squamous carcinoma of the cervix should be treated with radical hysterectomy with lymph node dissection considering the presence of risk factors. The treatment should be individualized and based on an exhaustive pathological evaluation of an adequate cone biopsy specimen.

Borderline ovarian tumors are classified between benign cystadenoma and malignant cystadenocarcinoma. They are characterized as malignant tumors by histopathological features, which make them different from the benign ones. These tumors are commonly diagnosed at the early disease stage. The treatment of these tumors is surgical. The prognosis depends on the stage of disease and histopahtological types. We present 10 patients operated at the Institute of Oncology Sremska Kamenica because of malignant tumors with low malignant oncogenic potential in the period between 2000 and 2005. All patients had surgical treatment with ex tempore diagnostics, hysterectomy and adnexectomy with total omentectomy, or unilaterals adnexectomy. All patients had negative cytoanalytic findings of the small pelvis. Histopathological findings are necessary to confirm the diagnosis of disease. In young patients who had no children fertility can be preserved.

Primary uterine cervical non-Hodgkin's lymphomas (NHL) are rare. Limited experience dictates careful pretherapy evaluation and multidisciplinary approach in treatment planning. A 53-year-old woman presented with postmenopausal bleeding and PAP smear IIIb. Cervical biopsy and endocervical curettage biopsy revealed NHL of the uterine cervix. Abdominal hysterectomy with bilateral adnexectomy was followed by pelvic lymphadenectomy due to lymph node metastasis, 21 months after the primary operation. Subsequently, the patient received postoperative chemotherapy. Seven years after the onset of NHL she is alive with no evidence of disease recurrence.