Search

Stosowanie środków ochrony indywidualnej (ŚOI; PPE, z ang. personal protective equipment) jest najpopularniejszym sposobem zmniejszenia narażenia pracownika na czynniki szkodliwe występujące w środowisku pracy. Jedną z form ŚOI, niechętnie stosowaną przez pracowników, są środki ochrony układu oddechowego. Ich zadaniem jest ochrona pracownika przed wdychaniem zawieszonego w powietrzu aerozolu. Celem badań było poznanie postaw pracowników wobec obowiązku stosowania ochrony układu oddechowego w trakcie pracy – przed pandemią COVID-19 i w czasie jej trwania. Do realizacji celu badania utworzono autorską ankietę, korzystając z kwestionariusza formularza Google. Ankieta zawierała 25 pytań, w tym pytanie filtrujące, które wykluczało osoby inne niż grupa docelowa. Uzyskane wyniki poddano analizie statystycznej, korzystając z programu Statistica v.12.0. Główną ochroną stosowaną przez pracowników w trakcie pracy jest półmaska. Przed pandemią nie wszyscy pracownicy byli pozytywnie nastawieni do noszenia ŚOI. W grupie osób, które nie miały zdania na temat stosowania ochrony dróg oddechowych, 31,71% wymienia zużyte lub uszkodzone ŚOI na nowe, co potwierdzono statystycznie. Pracownicy zwracają dużą uwagę na wygodę noszenia ŚOI.

Background The study assessed the effect of smectites (bentonite and zeolite) used as natural sorbents in the diet of pigs on feed digestibility, health parameters, the severity of anatomo-histological changes in organs, and the accumulation of volatile pollutants in organs. Material and methods The study was conducted using fattening pigs (crossbreds from multiple breeds) assigned to three groups – a control (C) and two experimental groups (A and B), with 240 pigs in each group (3 replicates × 80). The animals in group C received a standard complete diet, while groups A and B received diets with 1.5% composed smectite sorbents. The feed and faeces were analysed for content of dry matter, crude ash, crude protein, ether extract, and crude fibre. The content of P was determined using a Helios Alpha UV–VIS spectrophotometer. Whole blood was analysed for haematological parameters and serum for biochemical parameters. Tissue samples were collected for analysis of volatile substances and histological analysis. After slaughter, samples of the lungs, liver, kidneys and jejunum were collected for morphological evaluation, and samples of the perirenal fat, liver, kidneys, lungs and brain for headspace gas chromatography (GC) to determine the levels of volatile toxic substances. Results A statistical increase in the digestibility of crude fibre and an increase in that of P were observed in both experimental groups (A and B) in comparison to the control. The whole blood and serum of the pigs from the control group had statistically significantly higher levels of creatinine, urea, and Mg and a higher WBC count compared to both experimental groups (A and B). Conclusions The feed additives were not shown to have a negative effect on the health parameters analysed or on accumulation of pollutants in selected tissues. No significant effect on the digestibility of most nutrients was observed; only an increase in the digestibility of crude fibre and a decrease in P digestibility were noted in the experimental groups.

The article reports on an action research study which uses reformulation as its key instrument. The aim of the study was to identify the individual characteristics of acquisition of complex structures in Polish (native language) and English (foreign language) by children with speech and language deficits, learning in an inclusive environment at the upper primary level. The analysis of the gathered data focuses on Polish and English structures used by special needs students and mainstream students in their inclusive educational environment, and on the students’ ability to build/reconstruct a narrative structure – according to the unique qualities of the input text. The observed trends help to plan and organise the teaching process, which also includes the rehabilitation of speech and language in a foreign language lesson.

Introduction Incidences of chronic myeloid leukaemia (CML) after treatment of Hodgkin lymphoma (HL) are well described. Here, we report a case of secondary HL in a patient with CML treated with dasatinib as a third-line treatment. Patient information A 64-year-old male was diagnosed with CML and initially treated with imatinib and then with nilotinib due to resistance. Finally, the patient experienced cardiovascular complications, and dasatinib was introduced. After 19 months of treatment, the patient experienced enlargement of lymph nodes that formed packs on the neck. Interventions Based on histopathological examination of the lymph nodes, a diagnosis of classical Hodgkin lymphoma - mixed cellularity was established. The patient was successfully treated with 4 cycles of AVD (adriamycin, vinblastine, dacarbazine) chemotherapy. Outcomes Complete metabolic remission of Hodgkin lymphoma is currently sustained, and the molecular response to dasatinib at a reduced dose of 50 mg daily corresponds with a deep molecular response. Conclusion In this report, we demonstrate the efficacy and safety of the combination of dasatinib and AVD regimens in coexisting CML and HL. This case report emphasizes the importance of insightful evaluation and differential diagnosis in cases of lymphadenopathy during CML treatment.

Kraków: Impuls, 2018, 406 s.

In this article the relation between the discourse production dynamic and the linguistic competence development is discussed. This problem is considered with regard to two types of language activities based on reformulation tasks: 1) written reconstruction of a story heard, 2) written production of the end of the story. The analysis of experimental data shows that in the second case the approach to the discourse is more complete which positively influences application of complex morphosyntactic structures in students production.

The article presents ‘didactic dialogue’ against the background of other interactive forms of remediation in foreign language learning. Drawing on the works of Antoine de La Garanderie, Reuven Feuierstein and Pierre Vermersch, three didactic approaches have been analyzed. Theoretical considerations have been illustrated with conclusions formulated on the basis of own studies on the use of dialogues in different educational contexts, which included: the diagnosis and remediation of language deficits of special educational needs students, remediation in the case of school failure in foreign language learning, and an interview after completing a task of retelling a story.

Adapting foreign language teaching to the requirements of studentswith special educational needs requires prior diagnosis of the developmentalpotential of the pupils concerned. Because of the educationaland rehabilitative character of foreign language learning in studentswith language and speech deficiencies, the diagnosis addresses thepossibilities of using foreign language learning in developing generaland linguistic competencies in both languages (native and foreign). Thearticle presents the aims of diagnosing linguistic communicative competenciesin the context of foreign language teaching. The differencesbetween speech diagnosis and diagnosis performed for the needs of foreignlanguage teaching are discussed, based on cases of pupils with deficienciesin their native language (Polish). The evaluation of the students’competencies involved reformulation as an instrument of linguistic diagnosis;learning strategies were also considered in the assessment.

Not required for Clinical Vignette.

This article is about a task which required learners to reformulate a story which they had listened to in writing. In the context of foreign language learning, the original text provides a discourse model, whereas the way it is rephrased reflects students’ skill to use the new information in their own words. Retelling can also be treated as language practice focused on learning and practising new vocabulary and sentence structures. The research concentrated on fragments of text that were an extension of the original text that was retold by an elementary group of students of French philology (A2 level according to The Common European Framework of Reference for Languages, 2003) in Polish and French (the foreign language). Comparison of speech produced in the two languages made it possible to consider the nature and function of the learners’ discourse competence which, depending on the students’ personal goals and communicative experience, differed in the two cases. The data collected can serve as a starting point for planning further steps to develop students’ metadiscoursal awareness with the use of the retelling of a story as a learning strategy.

The subject of this article is the use of reformulation, the instrument of language acquisition research, in studies on language teaching and learning. Incorporating reformulation into the methodological repertoire of language education research requires a clear definition of differences in the subject-matter and in objectives of research between the two disciplines, in order to clearly capture the potential and limitations of this tool. This article will consider the innovative potential of reformulation at both the research level and the didactic level, at various stages of development of communicative competencies in a foreign language.

Almost one million new cases of gastric cancer (GC) were estimated globally in 2012, (i.e. 952,000, representing 6.8% of the total cancer burden), making it the fifth most common malignancy in the world. GC represents a biologically and genetically diverse group of tumours with multifactorial aetiologies; both environmental and genetic. The vast majority of GCs are adenocarcinomas, which can be further subdivided into intestinal and diffuse histological subtypes according to the Lauren classification published in 1965. The molecular classification of GC according to the Cancer Genome Atlas (TCGA) divides GC into four subtypes: tumours positive for the EBV virus (9%), microsatellite unstable tumours (22%), genomically stable tumours (20%) and tumours with chromosomal instability (CIN) at 50%. Most GCs are sporadic by nature, where approximately 10% appear to possess a familial predisposition of which around half can be attributed to hereditary germline mutations i.e. those of the E-cadherin ( CDH1 ) or mismatch repair ( MMR ) genes. Histopathological characteristics of the tumour type and analysis of potential genetic changes have substantial cli­nical significance, as they determine the choice of treatment. In this review, we consider the molecular pathogenesis, phenotype and testing of GC placing particular emphasis on microsatellite instability (MSI) and the CDH1 mutation.

The aim of this study was to assess the: 1) clinicopathologic features of papillary early gastric cancer (PEGC) (13 cases) compared to tubular early gastric cancer (TEGC) (41 cases); 2) efficiency of endoscopic submucosal dissection (ESD) in treatment of PEGC. From January 2007 to February 2016, a total of 54 consecutive patients with early gastric cancer (EGC) underwent ESD at the Department of Gastroenterology of the Pomeranian Medical University in Poland. The histologic type of carcinoma was assessed according to the WHO histological classification of GC. The extension of GC into the submucosa was measured using the Aperio Scan Scope image analysis system tools. PEGCs were diagnosed in 24.1% of the cases of EGC. PEGCs were significantly more elevated in macroscopic examination and better demarcated tumors than TEGC. There were no significant differences between gender, tumor location, ulceration, tumor size, depth of invasion (T), presence of intestinal metaplasia and lymphocytic infiltrate. Curative resection was achieved in 87.1% of patients with EGCs treated with ESD. The lower rate of curative resection (R0) observed in PEGC (76.9%) vs TEGC (90.2%) was not statistically significant. Further studies will be necessary to confirm the clinical and morphological presentation of PEGCs.

BACKGROUND AND AIMS: The diagnosis of gastric premalignant conditions (GPCs) relies on endoscopy with mucosal sampling. We hypothesized that the endoscopist biopsy rate (EBR) might constitute a quality indicator for EGD, and we have analyzed its association with GPC detection and the rate of missed gastric cancers (GCs). METHODS: We analyzed EGD databases from 2 high-volume outpatient units. EBR values, defined as the proportion of EGDs with ≥1 biopsy to all examinations were calculated for each endoscopist in Unit A (derivation cohort) and divided by the quartile values into 4 groups. Detection of GPC was calculated for each group and compared using multivariate clustered logistic regression models. Unit B database was used for validation. All patients were followed in the Cancer Registry for missed GCs diagnosed between 1 month and 3 years after EGDs with negative results. RESULTS: Sixteen endoscopists in Unit A performed 17,490 EGDs of which 15,340 (87.7%) were analyzed. EBR quartile values were 22.4% to 36.7% (low EBR), 36.8% to 43.7% (moderate), 43.8% to 51.6% (high), and 51.7% and 65.8% (very-high); median value 43.8%. The odds ratios for the moderate, high, and very-high EBR groups of detecting GPC were 1.6 (95% confidence interval [CI], 1.3-1.9), 2.0 (95% CI, 1.7-2.4), and 2.5 (95% CI, 2.1-2.9), respectively, compared with the low EBR group (P < .001). This association was confirmed with the same thresholds in the validation cohort. Endoscopists with higher EBR (≥43.8%) had a lower risk of missed cancer compared with those in the lower EBR group (odds ratio, 0.44; 95% CI, 0.20-1.00; P = .049). CONCLUSIONS: The EBR parameter is highly variable among endoscopists and is associated with efficacy in GPC detection and the rate of missed GCs.

BACKGROUND Mutations in DNA of mismatch repair (MMR) genes result in failure to repair errors that occur during DNA replication in microsatellites, resulting in accumulation of frameshift mutations in these genes and leading to DNA mismatch replication errors and microsatellite instability. Gastric cancers (GCs) with high MSI (MSI-H) are a well-defined subset of carcinomas showing distinctive clinicopathological features. In this study we investigated the rate of MSI and the correlation between MSI status and clinicopathological features of GC. MATERIAL AND METHODS The study included 107 patients with GCs: 61 with advanced gastric cancers (AGC) and 46 with early gastric cancer (EGC). MSI deficiency in GCs was assessed by the immunohistochemical analysis of expression of MMR proteins - MLH1, MSH2, MSH6, and PMS2 - using formalin-fixed and paraffin-embedded tissue. RESULTS A total of 6 (5.6%) MSI-H were observed. The loss of MMR proteins expression was associated with the intestinal type of GC in Lauren classification, and tubular and papillary architecture in WHO classification. There was no statistically significant association between negative MMR expression and other selected clinical parameters: age, sex, tumor location, depth of invasion (EGC and AGC), lymph nodes status, presence of the ulceration, and lymphocytic infiltrate. CONCLUSIONS In the present era of personalized medicine, the histological type of GC and MMR proteins status in cancer cells are very important for the proper surveillance of patients with familial GC and sporadic GCs, as well as for selecting the proper follow-up and treatment. Larger collaborative studies are needed to verify the features of MSI-H GCs in Poland.

Early gastric cancer (EGC) is defined as cancer invasion confined to the mucosa or submucosa, irrespective of lymph node metastasis. Recently endoscopic submucosal dissection (ESD) has been widely accepted for the treatment for dysplasia and EGC without lymph node metastases. While the method has been advanced in Far East countries, ESD is still being developed in Europe and has not gained enough popularity although it has been recommended as the treatment of choice for superficial gastric neoplastic lesions by European Society of Gastrointestinal Endoscopy (ESGE) in 2015.The aim of the study was to perform a retrospective analysis of clinical and histomorphologic features of 58 cases of EGCs removed by ESD in a university hospital in Western Pomerania in Poland and to evaluate factors related to the efficiency of ESD resection.With univariate analysis, indications for ESD with the highest R0 rate were found in EGCs limited to mucosa (T1a, small mucosal, M), without muscularis mucosa invasion, localised in the middle/lower part of stomach and intestinal type in histological examination. The R0 complete resection rate was significantly (p 0.0001) lower for T1b than that for T1a tumours (21.4% vs. 100%). Tumours with submucosal involvement were associated with lower efficiency of ESD procedure.Our data showed that in EGCs with favourable histomorphologic characteristics, ESD seemed to be a totally efficient and safe method of treatment in a European small-volume centre. R0 resection rate reached 81.1% of cases and median time of the ESD procedure was 61.5 min.

The phenomenon of cloud voids, i.e., elongated volumes inside a cloud that are devoid of droplets, was observed with laser sheet photography in clouds at a mountain-top station. Two experimental cases, similar in turbulence conditions yet with diverse droplet size distributions and cloud void prevalence, are reported. A theoretical explanation is proposed based on the study of heavy inertial sedimenting particles inside a Burgers vortex. A general conclusion regarding void appearance is drawn from theoretical analysis. Numerical simulations of polydisperse droplet motion with realistic vortex parameters and Mie scattering visual effects accounted for can explain the presence of voids with sizes similar to that of the observed ones. Preferential concentration and sorting effects in a vortex tube are discussed for reasonable cloud conditions.

TWstęp: Ginekomastia pokwitaniowa (GP) jest łagodnym powiększeniem gruczołów piersiowych u mężczyzn, które występuje u ponad połowy chłopców w wieku pokwitaniowym. W niejasnej etiologii ginekomastii nie ma również wyjaśnienia przyczyny przypadków jednostronnej GP. Najczęstszą metodą leczenia przetrwałych przypadków jest zabieg operacyjny, obciążony ryzykiem powikłań.Celem badania było porównanie występowania receptorów estrogenowych (ER) i progesteronowych (PR) w jednostronnej i obustronnej GP z oceną możliwego klinicznego zastosowania wyników.Materiały i metody: Przeprowadzono retrospektywną analizę dokumentacji 30 pacjentów operowanych z powodu GP z wtórną oceną immunohistochemiczną występowania ER i PR w wyciętych preparatach. Porównano przypadki jednostronne (8) z obustronnymi (22).Wyniki: Receptory estrogenowe i progesteronowe były obecne we wszystkich przebadanych preparatach. Stwierdzono statystycznie istotnie wyższy odsetek jąder komórkowych z ER i PR w materiale obustronnych GP niż w przypadkach jednostronnej patologii. Została stwierdzona dodatnia korelacja pomiędzy występowaniem obu typów receptorów. Wiek pacjentów w chwili operacji nie był istotnym czynnikiem.Wnioski: Receptory estrogenowe i progesteronowe mogą odgrywać istotną rolę w etiologii ginekomastii, szczególnie w przypadkach obustronnych. Uzyskane wyniki stanowią punkt wyjścia do dalszych badań nad różnicami pomiędzy jednostronną a obustronną ginekomastią. Randomizowane badania prospektywne oceniające skuteczność terapii GP lekami antyestrogenowymi mogłyby przyczynić się do ustalenia farmakologicznej alternatywny dla leczenia chirurgicznego.

During infancy, skin inflammation is usually treated in basic pediatric care. In this study, we present a case of an 8-month-old girl with a 2-month history of an inflammation of the thigh treated locally by ointments and oral antibiotics in basic and dermatological care. The patient had a history of fever, sweating, and failure to thrive. The lactate dehydrogenase was elevated up to 869 U/L with low C-reactive protein (1.04 mg/L). Magnetic resonance imaging of the thigh reassured the diagnosis of local inflammation. Intravenous antibiotic caused mild local improvement, but the episodes of high fever sustained. The patient was transferred to our pediatric surgery department for treatment and surgical biopsy of the lesion. Histopathological examination confirmed a subcutaneous panniculitis-like T-cell lymphoma, which is a rare cytotoxic T-cell lymphoma representing less than 1% of non-Hodgkin lymphomas, uncommon in children. The patient was introduced to a chemotherapy protocol EURO-LB 2002 with good response. In a skin lesion that is associated with systemic symptoms and responding untypically to antibiotic treatment malignancy should be considered and biopsy not be postponed.

Objective Endoscopic submucosal dissection (ESD) has a high curative resection rate for gastrointestinal mucosal lesions, but is not used widely in Europe because of a high complication rate and a long learning curve. This study analyzed the ESD learning curve at a single European treatment center. Materials and methods ESD and hybrid-ESD (hESD) procedures were used to treat large colonic lesions that could not be resected in one piece by other endoscopic methods. Procedure duration and speed, and en-bloc, complete (R0) resection, and complication rates were analyzed. Results Fifty-three patients underwent ESD (37 pure ESD, 16 hESD), most with rectal lesions (n=34, 64.2%). The mean lesion diameter was 3.7 ± 1.1 cm2 (range 2.0-7.0 cm), the median procedure duration was 70.0 min [interquartile range (IQR) 31.0-113.0 min], and the median treatment speed was 0.086 cm2/min (IQR 0.055-0.152). En-bloc and R0 resection rates were 86.5% (32/37) and 81.1% (30/37), respectively. Procedure speed increased significantly after about 25 cases (P=0.0313). The median hESD procedure treatment speed was 0.159 cm/min (n=16, IQR 0.094-0.193), which was better than with classical ESD (P=0.04). The hESD en-bloc and R0 resection rates were comparable to those of classical ESD (P>0.05). The only complication was bleeding, 5.7% (3/53); no perforation occurred. Recurrence was detected during follow-up (median 30.0 months, IQR 12-48) in one patient (1.7%). Conclusion ESD is useful and safe for resection of large colorectal polyps, and procedure speed increased considerably after 25 procedures. hESD was faster than ESD, with a high therapeutic resection rate.

The correlation of thymidylate synthase (TS) expression in gastric cancers with tumor histology and prognostic or predictive information remains unclear. Most studies have involved Asian populations, with few conducted in European cohorts. Moreover, all published studies analyze TS expression using semi-quantitative methods. This retrospective study evaluated the association of TS expression in tumor cells with gastric carcinoma histological type, with selected clinicopathological parameters, and with the prognosis of patients who underwent surgical treatment. TS expression was detected using immunochemistry and objectively assessed by computerized image analysis of tumor cells in 100 gastric cancers. We found that high TS expression was significantly more common in intestinal than in diffuse type of gastric cancer according to Lauren classification (P=0.0003); in type I carcinomas compared to type IV according to Goseki classification (P=0.002); and in gastric cancers in men than women (P=0.04). Low TS expression was found more often in carcinomas in the middle and lower third of the stomach than in cancers in the upper third of the stomach (P=0.009 and P=0.001, respectively). In the subgroup of 25 patients without lymph node metastases (stage I+II), high TS expression was associated with better DFS (83% for high TS expression versus 38,5% for low TS expression, P=0.03). The results (1) indicate significant correlation between the Lauren and Goseki histopathological classifications of gastric cancer and TS expression in tumor cells, (2) suggest that high TS expression may be a positive prognostic marker with regard to DFS in patients with gastric cancer without involvement of regional lymph nodes who underwent radical surgical treatment and were not treated with preoperative chemotherapy. Prognostic results need confirmation in larger cohorts.

At present the main purpose of school integration is the pursuit of dialogue and ways of ensuring integration which concerns both disabled learners and the ones who do not exhibit special educational needs. In this paper, the is-sue will be incorporated into the framework of teaching foreign languages to disabled pupils attending public schools. The present author will depict L2 teaching goals in relation to education shared by pupils with and without specific learning difficulties as well as to problems with implementing the idea of integration in foreign language classroom. These questions will be discussed with reference to the opinions of gleaned from public school teachers with experience in working with disabled learners.

The diagnosis of follicular thyroid cancer is based on postoperative histopathology assessment. In its minimally invasive form, the signs of vascular invasion and capsular infiltration may sometimes be seen only in a small tumor fragment; hence, the diagnosis should be based on multiple histopathology specimens. This case study is a report on a 70-year-old female who was diagnosed with spinal metastasis of follicular thyroid cancer. This diagnosis was established 5 years after partial strumectomy due to goiter and there were no signs of thyroid cancer in postoperative histopathology assessment. Based on this case and literature reports, the authors conclude that the diagnosis of follicular thyroid cancer, especially its minimally invasive forms, may pose a diagnostic problem even when based on postoperative histopathology.

The number of nephrons is a multifactorial trait controlled by the interaction of environmental factors and genetic variants that influence the extent of branching nephrogenesis during foetal life. A correlation between renal mass and nephron number in newborns allows the use of the total kidney volume at birth as a surrogate for congenital nephron number. Since the renin–angiotensin system plays an important role in renal development we hypothesized that the common, functional insertion/deletion (I/D) polymorphism in the ACE gene might be responsible for the variation in kidney size amongst healthy individuals. We recruited 210 healthy Polish full-term newborns born to healthy women with uncomplicated pregnancies. The kidney volume was measured sonographically. Total kidney volume (TKV) was calculated as the sum of left kidney volume and right kidney volume. TKV was normalized to body surface area (TKV/BSA). The I and D alleles were identified using polymerase chain reaction. TKV/BSA in newborns carrying at least one insertion ACE allele was significantly reduced by approximately 8% as compared with homozygous newborns for the D allele (DD genotype) (105.1±23.6 vs. 114.2±28.2 cm 3 /m 2 , p

Background Endoscopic submucosal dissection (ESD) is a well-accepted method for removing superficial mucosal tumors; however, there is limited data on the use of this method for removing subepithelial tumors. Objective To investigate the efficacy, safety, and outcome of ESD for gastric subepithelial tumors and determine factors related to treatment success. Design Retrospective analysis of a prospectively maintained database. Setting Single tertiary academic center. Patients and Interventions From April 2007 to November 2010, 37 patients with gastric subepithelial tumors were treated with ESD. Main Outcome Measurements Macroscopically and microscopically complete en block resection rate (R0), complication rate, and endosonographic features predictive of R0 resection. Results The median tumor diameter was 25.0 mm, (range 10-60 mm, IQR 17-37). The overall rate of R0 resections was 81.1% (30/37, 95%CI: 61.8-90.2%), including 100% (15/15, 95%CI: 78.2-100.0%) of tumors from the submucosa and 68.2% (15/22, 95%CI: 45.1-86.1%) of tumors from the muscularis propria. Seventeen patients had a final diagnosis of gastrointestinal stromal tumor. The severe complication (perforation) rate was 5.4% (2/37, 95%CI: 0.0-9.5%). One patient required surgery; the other was treated conservatively. No recurrence was observed in patients with R0 resections at a median follow up of 21.0 months (IQR 11-35). Successful R0 resections were predicted by the observation of no, or only narrow, tumor connections with the underlying muscle layer during EUS (OR=35.0, 95%CI: 3.7-334.4, p=0.001). Limitations Single-center, retrospective analysis, short follow-up. Conclusions ESD is an effective and relatively safe method for removing gastric subepithelial tumors. Endoscopic ultrasonography findings can predict complete tumor resections.

Rhinoscleroma is a chronic inflammatory disease in which granulation tissue with a typical cell content is found. The paper presents the case of a 77-year-old woman with clinically diagnosed nodule in the nasal cavity. The histopathological examination revealed granulation tissue with plasma cells and Mikulicz's cells. The clinical and morphological picture of the case in question is a rare opportunity to bring to mind a disease that used to be common in Poland and which clinically can imitate malignant tumour.