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Introduction. Most patients with liver hemangiomas are unrecognized, when symptoms occur it is usually due to the size of the hemangioma. Hemangioma of the liver are benign tumors which affects women more often. Surgical indications for liver resection remain unclear. Case outline. We present a patient with a giant hemangioma of the left liver lobe that was misdiagnosed in a primary care unit. The patient underwent resection of the left liver lobe and fully recovered after several days. Conclusion. Symptoms, size, and risk of rupture should be considered when decision for surgery is made. Linear stapler can be useful especially when left and middle hepatic vein have common trunk.

Pheochromocytoma is a tumor that arises from adrenal medulla and it is characterized by increased secretion of catecholamines. The incidence of pheochromocytoma is 3 to 8 cases per million inhabitants, of which about 10 to 20% of diagnosed pheochromocytomas occurs in the pediatric population, with a higher frequency in boys. In 1.7% of the pediatric population with hypertension, the cause of hypertension is pheochromocytoma. Due to headaches and verified hypertension on twenty-four-hour holter blood pressure monitoring, the 13-year-old female patient underwent ultrasound, followed by scintigraphy and magnetic resonance imaging of the abdomen, which described an oval change above the right kidney about 4.5 cm in diameter suspected of pheochromocytoma. Twenty-four-hour urine cateholamines showed elevated noradrenaline values as much as 45 times higher than the reference range, as well as elevated Dopamine values. After adequate preparation with phenoxybenzamine and bisoprolol for two weeks, a right laparoscopic adrenalectomy was performed at the University Children's Clinic in Tirsova, which is also the first operation of this type in the pediatric population. Intraoperatively, the maximum value of tension was 180/120 mmHg. Pathohistological findings confirmed pheochromocytoma. Although a rare cause of hypertension in the pediatric population, young patients with newly diagnosed hypertension should be examined for possible pheochromocytoma. Laparoscopic adrenalectomy through both the lateral transabdominal and posterior retroperitoneoscopic approach is the gold standard for the treatment of pheochromocytomas in both the adult and pediatric populations.

Psychosis is a set of symptoms that lead to contact disorders or even cessation of contact with reality. It can be in the form of disorders of perception, emotions, thoughts, and behavior. Psychosis has many causes, and one of them is hypothyroidism. Thyroxin is important for the global function of brain activity, cholinergic activity in the frontal cortex and hippocampus increases significantly in its presence. The diagnosis of psychotic episodes is made on the basis of autoanamnesis and heteroanamnesis, as well as psychiatric examination. The presence of: positive syndrome, disorganization and negative syndrome. After the diagnosis of a psychotic disorder, antipsychotics are included in the therapy, and upon arrival, the findings that verify hypothyroidism, include thyroxin in the therapy. The therapeutic response is achieved after a few days or a week. In patients with an acute psychosis, and especially in those with a positive personal and family history of hypothyroidism, one should think in the direction of an unrecognized endocrine disease.

Ectopic thyroid tissue is a rare pathological finding bellow the diaphragm and extremely rare finding is ectopic thyroid tissue in the adrenal gland. Thyroid tissue can be located anywhere along the way of embryological migration pathway of thyroglossal duct. In most cases of ectopic thyroid tissue, it is located in the neck. Pathohistologically ectopic thyroid tissue in all cases was formed of follicular cells that expressed TTF-1, Thyroglobulin, PAX8, and cytokeratin 7, and there was lack expression of calretinin. In the literature we found 15 such cases. Women are much more affected than men (14:1), and it usually presents in the fifth decade (mean age 49). In all cases it was composed of normal follicular cells, and C cells were not found. Review of the literature reveals that adrenal ectopic thyroid tissue is almost always cystic, and has distinctive pathologic features. The most important thing is that ectopic thyroid tissue must be distinguished from metastatic deposits from thyroid gland carcinoma.

Introduction. Parathyroid cysts (PCs) are divided into two categories: functional and nonfunctional. If large enough, both types of PCs can present as a mediastinal or cervical mass in 1-5% of patients. Case report. A retrospective analysis of the data on patients operated on for primary hyperparathyroidism or cervical/mediastinal mass from 2016 to 2021 was conducted. An analysis of the demographic data of the patients, data on preoperative fine needle aspiration biopsy, level of parathyroid hormone in serum pre- and postoperatively, level of serum calcium, as well as on clinical presentation of the disease, was carried out. In this five-year period, a total of 555 patients were operated on, in whom the parathyroid gland was described as a definitive pathohistological finding. Of the total number, PCs were found in seven cases. In five out of the seven cases, PC was nonfunctional. Four female and three male patients were operated on due to PC. The mean age of operated patients was 49.8 years. In one patient, the nonfunctional cyst was represented as a cervical and upper mediastinal mass with a maximal diameter of 10 cm. Conclusion. Although PCs represent about 0.5% of all changes in the parathyroid glands, they can be suspected preoperatively, especially if a water-like liquid is obtained by a fine needle aspiration biopsy. In order to remove the PC completely without making a lesion on the capsule, with the aim of avoiding parathyreomatosis, but to preserve the recurrent laryngeal nerves, the operation should be performed by an experienced endocrine surgeon. [ABSTRACT FROM AUTHOR]

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Copyright of Medical Gazette / Medicinski Glasnik is the property of Specijalna bolnica za bolesti stitaste zlezde i bolesti metabolizma Zlatibor and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)