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Cancer Statistics
Population in 2012: 3.2m
People newly diagnosed with cancer (excluding NMSC) / yr: 7,100
Age-standardised rate, incidence per 100,000 people/yr: 178.3
Risk of getting cancer before age 75:18.4%
People dying from cancer /yr: 4,800
Data from IARC GlobalCan (2012)
Albania Cancer Organisations and Resources
Latest Research Publications Related to Albania

Albania Cancer Organisations and Resources (4 links)

Latest Research Publications Related to Albania

Bilaj F, Rroji A, Enesi E, et al.
Cerebral proliferative angiopathy with tumor-like hemorrhage: A case report and literature review.
Neuroradiol J. 2016; 29(5):336-9 [PubMed] Article available free on PMC after 01/10/2017 Related Publications
Cerebral proliferative angiopathy (CPA) is defined as a rare vascular disorder, characterized by diffuse arterial proliferation and distinctive angiogenetic features. Complication with hemorrhage is exceedingly rare, but once the bleeding occurs, the chance of re-bleeding is increased. Here we report a case of a patient with CPA complicated with bleeding and re-bleeding, and imaging findings mimicking a brain tumor, which has not been reported in the literature so far.

Kajo E, Prifti E, Knuti A, et al.
Surgical treatment of a calcified, amorphous tumor of the right ventricle complicated with thrombosis of the right pulmonary artery in an adult male: a case report.
J Med Case Rep. 2016; 10:90 [PubMed] Article available free on PMC after 01/10/2017 Related Publications
BACKGROUND: A calcified amorphous tumor of the heart is an extremely rare cardiac mass.
CASE PRESENTATION: A 32-year-old Albanian man presented to our hospital with fatigue, shortness of breath, progressive dyspnea, and right congestive heart failure. Echocardiography and chest computed tomography revealed a giant, calcified right ventricular mass that originated between the papillary muscles and the trabeculae and extended to the pulmonary valve. The patient underwent surgery with excision of the mass, replacement of the pulmonary valve with a biological one, and repair of the tricuspid valve. His histopathological examination revealed that the mass was a calcified, amorphous tumor. His postoperative course was uneventful.
CONCLUSIONS: The clinical presentation of the calcified amorphous tumor is similar to that of other cardiac tumors, so surgical excision is mandatory. Histopathological examination remains the gold standard for an accurate diagnosis.

Kamberi F, Theodhosi G, Ndreu V, et al.
Nurses, Healthy Women and Preventive Gynecological Examinations--Vlora City Scenario, Albania.
Asian Pac J Cancer Prev. 2016; 17(1):311-4 [PubMed] Related Publications
BACKGROUND: Nurses play an important role in preventive medicine because they represent the largest sector of health professionals. This role is very crucial in developing countries, which are going through rapid societal and economic changes, associated with a rising burden of cancers due to different risk factors. The current study aimed to compare health awareness between nurses and healthy women regarding preventive gynecological examinations and to answer the question - can nurses make a difference in women's health?
MATERIALS AND METHODS: This cross sectional research included a total of 150 women, 70 nurses and 80 healthy women, randomly selected. Data were collected in 2014 in Vlora city through a self-administered questionnaire that assessed different variables about preventive gynecological examinations.
RESULTS: Cervical screening rates were 20.3% and 41.8%, respectively, for nurses and healthy women, despite the former having a statistical significant greater knowledge of risk factors and symptoms.
CONCLUSIONS: Even if the health awareness of nurse participants can be considered good, they need themselves to increase participation rates in cervical screening if they are to provide role models for health education/promotion addressing misconceptions and barriers.

De Angelis B, Gentile P, Tati E, et al.
One-Stage Reconstruction of Scalp after Full-Thickness Oncologic Defects Using a Dermal Regeneration Template (Integra).
Biomed Res Int. 2015; 2015:698385 [PubMed] Article available free on PMC after 01/10/2017 Related Publications
The use of Dermal Regeneration Template (DRT) can be a valid alternative for scalp reconstruction, especially in elderly patients where a rapid procedure with an acceptable aesthetic and reliable functional outcome is required. We reviewed the surgical outcome of 20 patients, 14 (70%) males and 6 (30%) females, who underwent application of DRT for scalp reconstruction for small defects (group A: mean defect size of 12.51 cm(2)) and for large defects (group B: mean defect size of 28.7 cm(2)) after wide excision of scalp neoplasm (basal cell carcinoma and squamous cell carcinoma). In group A, the excisions were performed to the galeal layer avoiding pericranium, and in group B the excisions were performed including pericranium layer with subsequent coverage of the exposed bone with local pericranial flap. In both the groups (A and B) after the excision of the tumor, the wound bed was covered with Dermal Regeneration Template. In 3 weeks we observed the complete healing of the wound bed by secondary intention with acceptable cosmetic results and stable scars. Scalp reconstruction using a DRT is a valid coverage technique for minor and major scalp defects and it can be conducted with good results in elderly patients with multiple comorbidities.

Prifti E, Ademaj F, Ikonomi M, Demiraj A
Unusual localization of a primary pleomorphic malignant fibrous histiocytoma on the mitral valve: a case report and review of the literature.
J Med Case Rep. 2015; 9:246 [PubMed] Article available free on PMC after 01/10/2017 Related Publications
INTRODUCTION: It has been reported that cardiac malignant fibrous histiocytomas occur more frequently in the left side of the heart, especially in the left atrium, but rarely invade the mitral valve. We present a case with a giant malignant fibrous histiocytoma with an unusual localization involving almost the entire left atrium, mitral valve, and left superior pulmonary vein.
CASE PRESENTATION: We describe the case of a 54-year-old woman from Kosovo admitted to our emergency department with dyspnea. A transthoracic echocardiography demonstrated a giant mass localized on her left atrium. Our patient underwent emergent total surgical removal of the mass. The mass extended between her left superior pulmonary vein, and extended to her left atrium and the posterior mitral valve leaflet. We formulated a surgical plan for total separation of the mass from the endocardium. Total removal was performed and her left side pulmonary veins were entirely freed from the mass. We then performed a mitral valve replacement. The differential diagnosis included other masses of the left atrium, including thrombi, vegetations, and cardiac tumors. Postsurgical histopathologic results showed a pleomorphic malignant fibrous histiocytoma. Six monthly follow-up cardiac and abdominal sonographic examinations revealed no tumor recidivism.
CONCLUSION: We reviewed 90 cases with malignant fibrous histiocytoma reported in the literature. Our case was especially unusual because of the primary location in the mitral valve, the pleomorphic variant, and the dimensions and extension. Complete surgical resection is mandatory to ameliorate symptoms and to obtain histologic information.

Prifti E, Veshti A, Ikonomi M, Demiraj A
Primary Cardiac Synovial Sarcoma Originating From the Mitral Valve Causing Left Ventricular Outflow Tract Obstruction.
World J Pediatr Congenit Heart Surg. 2015; 6(4):650-3 [PubMed] Related Publications
An 11-year-old boy was admitted with complaints of syncope and convulsion. Echocardiogram revealed a mass measuring 2 × 4 cm related to the mitral subvalvular apparatus. The mass, which appeared to be attached to the anterolateral papillary muscle, protruded into the left ventricular outflow tract causing intermittent obstruction. The patient underwent surgical excision of the mass. Pathology confirmed the diagnosis of primary synovial sarcoma. At six months following the operation, a small mass measuring 1 × 1 cm was detected in the left ventricle. The patient underwent reoperation consisting of radical resection of the subvalvular apparatus and mitral valve replacement. Histology confirmed that the mass was cardiac synovial sarcoma. One year after surgery, the patient is doing well.

Marku E, Maltese PE, Koni M, et al.
Polymorphism of UGT1A1*28 (TA)7 and liver damage in hepatitis B virus-positive patients in Albania.
Genet Mol Res. 2015; 14(2):5221-8 [PubMed] Related Publications
Hepatitis B virus (HBV) is the infectious agent of both acute and chronic hepatitis. HBV exists in multiple genotypic variants that differ in their capacity to become persistent chronic infections and in their clinical manifestations, including hepatocellular carcinoma. The 8 genotypes (A-H) of HBV show a specific worldwide geographic distribution and are correlated with different disease course, severity, and response to therapy. We isolated DNA from 75 HBV-positive blood donors, chosen randomly from the database of the National Blood Bank in Tirana, to specifically analyze the UGT1A1 polymorphism to determine its correlations with bilirubin levels and liver function. The large number of subjects who were HBV-positive carriers of heterozygosis or homozygosis for the UGT1A1*28 (TA)7 polymorphism suggests that these individuals may be more susceptible to cancer and should follow a strict regime of prevention.

Kaloshi G, Roci E, Rroji A, et al.
Kinetic evaluation of low-grade gliomas in adults before and after treatment with CCNU alone.
J Neurosurg. 2015; 123(5):1244-6 [PubMed] Related Publications
OBJECT: The aim of this study was to evaluate the impact of CCNU chemotherapy alone on low-grade glioma (LGG) growth dynamics.
METHODS: The authors measured the evolution of the mean tumor diameter (MTD) in adult patients with LGG before (n=28 patients) and after (n=38 patients) CCNU administration.
RESULTS: Natural (spontaneous) growth of LGG in the present study was 4.3 mm/year (range 2.1-6.6 mm/year). The median MTD decrease after CCNU was 5.1 mm/year (range 1-8.9 mm/year). MTD decrease was noted in 30 patients (late decrease in 4 patients, and ongoing decrease in 24 patients with oligodendroglial tumors and 2 with astrocytic tumors). The median duration it took for the MTD to decrease after initiation of CCNU treatment was 619 days (1038 days for oligodendroglial tumors vs 377 days for astrocytic tumors; p=0.003).
CONCLUSIONS: These results show that CCNU as a single agent has a significant impact on LGG tumor growth. The impact of CCNU seems to be comparable to the previously reported impact of temozolomide therapy and of combined procarbazine, CCNU, and vincristine chemotherapy.

Kraja B, Muka T, Ruiter R, et al.
Dietary Fiber Intake Modifies the Positive Association between n-3 PUFA Intake and Colorectal Cancer Risk in a Caucasian Population.
J Nutr. 2015; 145(8):1709-16 [PubMed] Related Publications
BACKGROUND: The association between dietary fat intake and the risk of colorectal cancer (CRC) is still unclear.
OBJECTIVES: We analyzed whether intakes of dietary polyunsaturated fatty acids (PUFAs) and saturated fatty acids (SFAs) were associated with CRC risk and whether these associations were modified by dietary fiber (DF) intake.
METHODS: This study was embedded in the Rotterdam Study, a prospective cohort study among subjects aged ≥55 y (n = 4967). At baseline, diet was measured by a food-frequency questionnaire. CRC events were diagnosed on the basis of pathology data and medical records. Multivariable adjusted HRs were calculated using Cox regression models.
RESULTS: During a mean follow-up period of 14.6 y, we identified 222 incident cases of CRC. There was no association between total PUFA, n-6 (ω-6) PUFA, or SFA intake and CRC risk. n-3 PUFA intake was associated with an increased risk of CRC [tertile 3 vs. tertile 1: HR = 1.44 (95% CI: 1.02, 2.04), P-trend = 0.04]. When data were analyzed by food sources, only n-3 PUFAs from nonmarine sources were associated with an increased risk of CRC. A significant interaction between n-3 PUFA and DF intakes was found (P-interaction = 0.02). After stratification by median DF intake, an increased risk of CRC caused by n-3 PUFA intake was observed in participants with a DF intake less than the median [tertile 3 vs. tertile 1: HR = 1.96 (95% CI: 1.20, 3.19), P-trend = 0.01]. No association was observed in subjects with DF intake equal to or higher than the median.
CONCLUSIONS: This study suggests that intake of n-3 PUFAs by adults is associated with an increased risk of CRC, which may be driven mainly by sources other than fish. Moreover, a complex interaction with DF intake may be present.

Vara-Messler M, Buccellati C, Pustina L, et al.
A potential role of PUFAs and COXIBs in cancer chemoprevention.
Prostaglandins Other Lipid Mediat. 2015; 120:97-102 [PubMed] Related Publications
Polyunsaturated fatty acids (PUFAs), particularly the ω-3 PUFAs and COXIBs have been associated with decreased inflammation and the prevention of tumorigenesis. ω-3 PUFAs have shown to display multiple antitumour actions, while ω-6 PUFAs and its derived eicosanoids promote the effects in cancer cell growth, angiogenesis, and invasion. ω-3 PUFAs may act by suppressing the metabolism of arachidonic acid to form proinflammatory mediators or as a precursors of novel lipid mediators with pro-resolving activity, while COXIBs are able to modulate inflammatory response by inhibiting cyclooxygenase 2 (COX-2), an inducible prostaglandin synthase overexpressed in several human cancers. As recently has been postulated, the anti-inflammation and pro-resolution processes are not equivalent. A family of lipid mediators from ω-3 PUFAs can act as agonist promoting resolution, while antinflammatory agents such as COXIBs may act as antagonists limiting the inflammatory response. The present paper reviews the current knowledge about the role of PUFAs and its derivatives (metabolites), as well as the COXIBs activity in cancer process as a sinergic therapeutic alternative for cancer treatment.

Prifti E, Ademaj F, Kajo E, Baboci A
A giant myxoma originating from the aortic valve causing severe left ventricular tract obstruction: a case report and literature review.
World J Surg Oncol. 2015; 13:151 [PubMed] Article available free on PMC after 01/10/2017 Related Publications
INTRODUCTION: The left ventricular localization of a myxoma is very rare, usually arising from the interventricular septum close to the left ventricular outflow tract, the mitral valve, the ventricular wall and extremely rarely the aortic valve.
CASE PRESENTATION: A 13-year-old male was admitted due to dyspnea and angina. Transesophageal echocardiography revealed left ventricular outflow tract obstruction with a mean gradient of 58 mmHg, and a mobile mass measuring 65×25 mm originating from the ventricular surface of the aortic valve was identified. The patient underwent urgent surgical excision and aortic valve replacement. Histopathological examination of the mass confirmed the diagnosis of a myxoma.
CONCLUSION: In conclusion, a myxoma originating from the aortic valve remains a very rare localization. Total resection associated with aortic valve replacement seems to offer an excellent outcome.

Xhumari A, Rroji A, Enesi E, et al.
Glioblastoma after AVM radiosurgery. Case report and review of the literature.
Acta Neurochir (Wien). 2015; 157(5):889-95 [PubMed] Related Publications
BACKGROUND: Stereotactic radiosurgery (SRS) is considered to be a relatively safe procedure in cerebral arteriovenous malformation management. There are very few reported cases of SRS-associated/induced malignancies.
METHODS: We show the case of a 21-year-old female who presented with a 21-mm(3) ruptured AVM in the right mesial frontocallosal region. Embolization and/or radiosurgery was proposed. She preferred radiosurgery. The AVM was treated with CyberKnife(®) SRS.
RESULTS: She presented behavior changes 6 years after SRS. MRI showed a right subcortical frontal lesion with increased perfusion, more consistent with high-grade glioma. The lesion's center was within the irradiated region of the previous SRS, having received an estimated radiation dose of 4 Gy. Pathological examination noted a hypercellular tumor showing astrocytic tumor cells with moderate pleomorphism in a fibrillary background, endothelial proliferation, and tumor necrosis surrounded by perinecrotic pseudopalisades. Numerous mitotic figures were seen. The appearances were those of glioblastoma, WHO grade IV, with neuronal differentiation. SRS-associated/-induced GBM after treatment of a large AM is exceptional. SRS-associated/-induced malignancies are mostly GBMs and occur on average after a latency of 9.4 years, within very low-dose peripheral regions as well as the full-dose regions; 33.3 % of patients were under 20 years at the time of SRS, and in 66 % the lesion treated was a vascular pathology.
CONCLUSION: Although it is unlikely that the risk of radiation-induced cancer will change the current standard of practice, patients must be warned of this potential possibility before treatment.

Kaloshi G, Diamandi P, Cakani B, et al.
The added value of bevacizumab concomitantly administered with carboplatin versus carboplatin alone in patients with recurrent glioblastomas.
Tumori. 2015 Jan-Feb; 101(1):41-5 [PubMed] Related Publications
AIMS AND BACKGROUND: Carboplatin (CBDCA) and bevacizumab (BEV) are active in glioblastoma (GBM) with different profiles of toxicity. To date, no study has compared the value of the addition of BEV to historical or traditional cytotoxic chemotherapy. We sought to determine the relative value of BEV in combination with CBDCA versus CBDCA alone in patients with recurrent GBM.
METHODS AND STUDY DESIGN: Eligible patients with progressive GBM following surgery, radiotherapy and temozolomide received CBDCA either alone (group 1, n = 25) or in combination with BEV (group 2, n = 23) at 5 mg/kg once every 3 weeks between June 2010 and December 2013. Baseline characteristics and outcomes after treatment were recorded. The primary end points of this retrospective analysis were progression-free survival (PFS) and objective response rate. Secondary end points included safety and overall survival (OS).
RESULTS: Forty-eight patients were enrolled. The median number of cycles was 4 in group 1 and 6 in group 2. No toxicities or intracerebral bleeding were observed. The objective response rate was higher in group 2 than group 1, 66% vs 24% (p = 0.003). The estimated median PFS and OS were 3.1 vs 6.7 months (p<0.0001) and 6.1 vs 8.6 months (p = 0.09) in group 1 vs group 2, respectively.
CONCLUSIONS: The combination of BEV and CBDCA is associated with improved response rates and survival compared with CBDCA alone. These results highlight the value of BEV in recurrent GBM. However, the clinical benefit of this interesting approach needs validation in a larger patient cohort.

Martinetti D, Costanzo R, Kadare S, et al.
KRAS and BRAF mutational status in colon cancer from Albanian patients.
Diagn Pathol. 2014; 9:187 [PubMed] Article available free on PMC after 01/10/2017 Related Publications
BACKGROUND: Numerous clinical studies have shown that anti-EGFR therapies are effective only in a subset of patients with colorectal cancer. Mutations in the KRAS and BRAF genes have been confirmed as negative predictors of the response to EGFR-targeted therapies.In this study we evaluated KRAS and BRAF status in 159 colorectal cancer samples obtained from the University of Tirana.
METHODS: We evaluated KRAS mutations in codons 12, 13, 61, 146 and in codon 600 of BRAF by direct sequencing. 90 patients were male (57%) and 69 female (43%); the patients' ages ranged from 17 to 85 (median 61.7). 24 patient were stage I, 36 stage II, 84 stage III and 15 stage IV.
RESULTS: Out of the 159 cases, 28 (17,6%) showed KRAS mutation (13 G12D, 4 G12C, 4 G12V, 3 G12A, 2 G13 D, 1 G12S and 1 A146T), and 10 (6,3%) showed BRAF mutation (all V600E). No significant correlations between KRAS and BRAF mutations and various clinicopathological parameters was found.This is the first report of KRAS and BRAF status in Albanian patients with colorectal carcinoma (CRC) and though the relatively small sample size might not provide enough statistics power.
CONCLUSIONS: The results of KRAS and BRAF mutation analysis could be used in the selection of patients for anti-EGFR therapy.
VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_187.

Filipi K, Xhani A
Assessment of cervical cytological data in Albanian females.
Asian Pac J Cancer Prev. 2014; 15(5):2129-32 [PubMed] Related Publications
BACKGROUND: Cervical cancer is one of the most common female malignancies with high mortality rates in developing countries. Our purpose was to determine the prevalence of cervical cytological abnormalities by cervical cytology (CC) and the analysis of risk factors in Albanian population.
MATERIALS AND METHODS: A total of 5,416 conventional pap smear tests collected between January 2009 and January 2012 from Tirana University Hospital Obstetrics-Gynecology "Queen Geraldine" were retrospectively analyzed.
RESULTS: A total of 258 (4.8%) cases had epithelial abnormalities. The numbers and rates were as follows: atypical squamous cell of undetermined significance (ASCUS; n=150 [2.76%]); atypical glandular cells of undetermined significance (AGUS; n=8 [0.14%]); low-grade squamous intraepithelial lesion (LSIL; n=87 [1.6%]); high- grade squamous intraepithelial lesion (HSIL; n=10 [0.18%]); and squamous cell carcinoma (SCC; n=3 [0.05%]).
CONCLUSIONS: The prevalence of cervical cytological abnormality in our study was 4.8%. A larger community-based study may establish the exact prevalence of malignant and premalignant lesions, so as to plan for future screening.

Prifti E, Baboci A, Ikonomi M
A giant cardiac malignant peripheral nerve sheath tumor presenting with total obstruction of the superior vena cava.
Ann Thorac Surg. 2014; 97(1):e7-9 [PubMed] Related Publications
A 16-year-old boy presenting with dyspnea, facial swelling, cyanosis, and fatigue was found to have a tumor involving the heart, causing superior vena cava and brachiocephalic venous trunk total obstruction. This was diagnosed as malignant peripheral nerve sheath tumor, a rare sarcoma of the heart. The patient underwent successful resection of the tumor, and reconstruction of the superior vena cava and right atrium. Immunohistochemistry was utilized to establish the diagnosis. The details of the patient's clinical course and imaging findings with morphologic and immunohistochemistry data are reported.

Poljak M, Seme K, Maver PJ, et al.
Human papillomavirus prevalence and type-distribution, cervical cancer screening practices and current status of vaccination implementation in Central and Eastern Europe.
Vaccine. 2013; 31 Suppl 7:H59-70 [PubMed] Related Publications
We present a review of current cervical cancer screening practices, the implementation status of vaccination against human papillomaviruses (HPV) and available data concerning the burden of HPV infection and HPV type-specific distribution in 16 Central and Eastern European countries: Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Montenegro, Poland, Romania, Serbia, Slovakia, Slovenia and the Former Yugoslav Republic (FYR) of Macedonia. Since published data were relatively scarce, two detailed surveys were conducted during August-October 2011 and in January 2013 to obtain relevant and updated information. The mean prevalence of HPV infection in 8610 women with normal cervical cytology from the region was 12.6%, with HPV16 being the most frequent HPV type. The overall HPV DNA prevalence in women with high-grade cervical lesions was 78.1%. HPV DNA was found in 86.6% of cervical cancers; the combined prevalence of HPV16/18 among HPV positive cases was 87.5%. The overall HPV DNA prevalence in genital warts and laryngeal papillomas was 94.8% and 95.2%, respectively, with HPV6 and HPV11 being the most frequent types. Opportunistic and organized cervical screening, mainly based on conventional cytology, is performed in nine and seven countries in the region, respectively, with the proposed age of the start of screening ranging from 20 to 30 years and the estimated coverage ranging from a few percent to over 70%. At least one of the current HPV prophylactic vaccines is registered in all Central and Eastern European countries except Montenegro. Only Bulgaria, Czech Republic, FYR Macedonia, Latvia, Romania and Slovenia have actually integrated HPV vaccination into their national immunization programme and currently provide routine vaccination free of charge to the primary target population. The key reasons for lack of implementation of HPV vaccination into the national immunization programme are high vaccine cost and negative public perception. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in the Central and Eastern Europe and Central Asia Region" Vaccine Volume 31, Supplement 7, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.

Bray F, Lortet-Tieulent J, Znaor A, et al.
Patterns and trends in human papillomavirus-related diseases in Central and Eastern Europe and Central Asia.
Vaccine. 2013; 31 Suppl 7:H32-45 [PubMed] Related Publications
This article provides an overview of cervical cancer and other human papillomavirus (HPV)-related diseases in Central and Eastern Europe (Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Montenegro, Poland, Romania, Serbia, Slovakia, Slovenia, and the Former Yugoslav Republic [FYR] of Macedonia) and Central Asia (Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Republic of Moldova, the Russian Federation, Tajikistan, Turkmenistan, Ukraine and Uzbekistan). Despite two- to three-fold variations, cervical cancer incidence rates are high in many countries in these two regions relative to other populations on the European and Asian continents. In Central and Eastern Europe, Romania and the FYR of Macedonia had the highest rates in 2008 alongside Bulgaria, Lithuania and Serbia, while in Central Asia, rates are elevated in Kyrgyzstan (the highest rates across the regions), Kazakhstan and Armenia. In each of these countries, at least one woman in 50 develops cervical cancer before the age of 75. The high cervical cancer burden is exacerbated by a lack of effective screening and an increasing risk of death from the disease among young women, as observed in Belarus, Tajikistan, Kyrgyzstan, Armenia, Azerbaijan, Ukraine, the Russian Federation and Kazakhstan. In several countries with longstanding cancer registries of reasonable quality (Belarus, Estonia and the Russian Federation), there are clear birth cohort effects; the risk of onset of cervical cancer is increasing in successive generations of women born from around 1940-50, a general phenomenon indicative of changing sexual behaviour and increasing risk of persistent HPV infection. There are limited data for other HPV-related cancers and other diseases at present in these countries. While options for reducing the HPV-related disease burden are resource-dependent, universal HPV vaccination with enhanced screening would maximally reduce the burden of cervical cancer in the countries within the two regions. It is hoped that the expanded second edition of the European Guidelines will finally kick-start effective interventions in many of these countries that still lack organised programmes. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in the Central and Eastern Europe and Central Asia Region" Vaccine Volume 31, Supplement 7, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.

Baboci A, Prifti E, Xhabija N, Alimehmeti M
Surgical removal of an intravenous leiomyoma with intracardiac extension and pulmonary benign metastases.
Heart Lung Circ. 2014; 23(2):174-6 [PubMed] Related Publications
Intravenous leiomyomatosis (IVL) with right intracardiac extension or pulmonary benign metastases (PBM) is rare. We report a case of 51 year-old woman, who underwent successful extensive double stage surgical removal of the intracardiac IVL extension associated with a pulmonary limited resection where the cystic bullae and PBM were found, and a month later gynaecological operation. To our knowledge this is the first reported case of such a combination.

Kaloshi G, Alikaj V, Rroji A, et al.
Visual and auditory hallucinations revealing cerebellar extraventricular neurocytoma: uncommon presentation for uncommon tumor in uncommon location.
Gen Hosp Psychiatry. 2013 Nov-Dec; 35(6):680.e1-3 [PubMed] Related Publications
OBJECTIVE: Visual and auditory hallucinations in relation to a cerebellar tumor are rarely reported in children. Primary origin of extraventricular neurocytoma (EVN) in the cerebellum is very rare.
CLINICAL PRESENTATION: We report on a case of a cerebellar EVN in a 13-year-old girl with the initial symptoms of psychiatric manifestations for more than 2 months. Magnetic resonance imaging of the brain revealed a patchy enhanced tumor in the paramedian left cerebellar region. No obstructive hydrocephalus was noted.
INTERVENTION: Total surgical removal of the tumor was performed. The tumor was initially diagnosed as an oligodendroglioma. After special immunohistochemical studies, the final definitive diagnosis was an EVN without isocitrate dehydrogenase mutation.
CONCLUSION: EVNs located in the cerebellum are extremely rare. We discuss the clinical symptoms and histological-immunohistochemical features of this rare tumor in that rare location.

Pajenga E, Rexha T, Çeliku S, et al.
Hormonal risk factors for ovarian cancer in the Albanian case-control study.
Bosn J Basic Med Sci. 2013; 13(2):89-93 [PubMed] Article available free on PMC after 01/10/2017 Related Publications
The role of reproductive factors in the aetiology of ovarian cancer had been evaluated in hospital-based case-control study conducted in Albania, providing a total dataset of 283 cases and 1019 controls. Logistic regression models were used to obtain relative risk (OR) estimates. The present results showed that parity had protective effects which increased until the forth birth and the trend in risk was significant (p < 0.01). In each stratum and overall, nulliparous women appeared to be at highly increased risk compared to those who had different number of births (OR=12.5, 95%, CI: 2.4-63.8). Evaluation of early age at menarche and late age at menopause, showed statistically significant increased risk. Furthermore, increased risk was observed between pre-menopausal women and never-married nulliparity women, respectively (OR=1.44 95%, CI: 0.88-2.36; OR=8.98, 95%, CI: 1.44 - 56.14), but ovarian cancer risk was reduced for hysterectomized women. These findings suggest that Albanian women have risk factors similar to women in western countries.

Maver PJ, Seme K, Korać T, et al.
Cervical cancer screening practices in central and eastern Europe in 2012.
Acta Dermatovenerol Alp Pannonica Adriat. 2013; 22(1):7-19 [PubMed] Related Publications
The burden of cervical cancer in central and eastern Europe is generally higher compared to western or northern Europe due to a history of mostly opportunistic cervical cancer screening practices and due to the strong influence of political and economic changes in post-communist transition. This article describes the current cervical cancer screening practices, organizational plans for the future, and main obstacles that need to be overcome in 16 countries in central and eastern Europe: Albania, Bosnia and Herzegovina, Bulgaria, Croatia, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Montenegro, Poland, Romania, Serbia, Slovakia, Slovenia and The former Yugoslav Republic of Macedonia. Unfortunately, only a few countries have managed to establish an organized and well-functioning cervical cancer screening program in recent years, whereas most countries in the region are still struggling with implementation-related issues of organized cervical cancer screening. Encouragingly, even in the countries where only opportunistic screening is performed, well-prepared plans and strategies have been established for switching to organized screening in the near future.

Vasili E, Savo I, Doci X, et al.
Cutaneous mastocytosis: a case of bullous urticaria pigmentosa.
Cutis. 2013; 91(2):70-2 [PubMed] Related Publications
Mastocytosis is characterized by an increased number of mast cells with abnormal growth and accumulation in 1 or more organs. In children, mastocytosis is commonly cutaneous and patients present with a spectrum of findings, ranging from solitary or multiple mastocytomas to urticaria pigmentosa (UP) or diffuse cutaneous mastocytosis (CM). We present a case of a 4-month-old infant with bullous UP.

Dracini X, Dibra A, Celiku E, et al.
Actual status of preoperative diagnosis of thyroid cancer in Albania.
G Chir. 2013 Jan-Feb; 34(1-2):14-7 [PubMed] Related Publications
INTRODUCTION: Thyroid cancer is the most common endocrine malignancy and accounts for almost 1% of human cancer. It is well known that the majority of cases occur in women in the middle decades of life. Thyroid cancer is a relatively rare disease; on the other hand clinically apparent thyroid nodules are present in 4-7% of the adult population. Most thyroid nodules are not malignant, with reported malignancy rates from 3-12%. It is important for the surgeon to know beforehand the diagnosis of malignancy, in order to perform a more radical operation on the thyroid gland.
PATIENTS AND METHODS: In our study we have analyzed the preoperative clinical data of 84 patients operated in the First Clinic of General Surgery, UHC "Mother Theresa" in Tirana; all with a positive histopathologic diagnosis of thyroid cancer. The data comprised age, sex, age distribution, blood group, time-lapse from the first endocrinologic visit, clinical examination, signs and symptoms, imaging, functional tests, preoperative FNA, admission diagnosis, associated diseases and preoperative treatment.
RESULTS: From the study emerged that only 9,3% of these patients were diagnosed preoperatively as thyroid cancer. Another related problem is the low percentage of preoperative FNA - only 22%. Among the signs and symptoms related to thyroid cancer we found that 40 and 33% of these patient presented dyspnea and dysphagia, respectively. The physical examination revealed apparent nodular growth of the thyroid gland in 81% and nodular hard consistency in 79% of cases. The proper endocrinologist consultation lacked in 23% of cases.
CONCLUSION: In our opinion, close collaboration between endocrinologists and surgeons in a multidisciplinary frame is the key to correct preoperative thyroid cancer diagnosis and optimal treatment.

Boci B, Isufi R, Thomai K
Postlaryngectomy vocal rehabilitation in Albania.
J BUON. 2012 Jul-Sep; 17(3):478-82 [PubMed] Related Publications
PURPOSE: To assess short and midterm results with consistent use of indwelling voice prostheses (Provox 1 and Provox 2 valves) for vocal rehabilitation after total laryngectomy.
METHODS: From May 2008 to June 2010 106 patients (104 men, 2 women, median age 62.32 years) with total laryngectomy underwent vocal prosthesis insertion and replacement procedures as needed. Patients were prosthesized primarily or secondarily and follow-up was performed monthly.
RESULTS: Median patient-device follow-up was 279 days (range 184-995). Leakage through the prosthesis, mainly caused by Candida deposits on the valve, was the most common cause of failure of the Provox valves.
CONCLUSION: Compared to other European countries, like the Netherlands (100 days) and France (150 days) Albania has the longest device half life. This relatively long prosthesis' lifetime in our country is perhaps related with the use of spicy food (a common custom in our country), and the use of antifungal and antacid agents.

Kandolf-Sekulović L, Zivković-Perišić S, Radević T, et al.
Melanoma in South-East Europe: epidemiological data from the central cancer registry and clinicopathological characteristics from the hospital-based registry in Serbia.
Int J Dermatol. 2012; 51(10):1186-94 [PubMed] Related Publications
BACKGROUND: Melanoma in South-East Europe shows varying incidence from 1.7 per 100,000 in Albania to 14.5 per 100,000 in Slovenia, but more detailed data from this region are scarce. In this study, we report epidemiological and clinicopathological characteristics of melanoma in central Serbia.
MATERIALS AND METHODS: Epidemiological data were retrieved from the Cancer Registry of Central Serbia and clinicopathological data from the hospital-based registry.
RESULTS: The ASR(W) incidence rate of melanoma was 4.2/100,000 (males) and 3.9/100,000 (females), and ASR(W) mortality rates were 1.9/100,000 (males) and 1.4/100,000 (females), with recorded rising trends in both of them. Data from the hospital-based registry revealed a total of 266 patients treated from 2005 to 2010, with the median age at diagnosis of 57 (13-86) years. The most frequent histopathological subtype was superficial spreading melanoma (SSM; 63.53%), and ulceration was present in 40.6% of primary tumors. Median Breslow thickness was 3 mm (0.1-25 mm). Primary tumors with thickness of more than 4 mm were found in 31.95% of patients, and in this group statistically significant difference was found for younger age in patients with SSM (55 years vs. 61 years, P = 0.04).
CONCLUSION: Low incidence rates in central Serbia and probably other countries of South-East Europe are accompanied by a large percentage of thick tumors and a significant proportion of younger patients with thick tumors. This points to the urgent need for more effective primary and secondary prevention of melanoma in these countries.

Domi R, Laho H
Management of pheochromocytoma: old ideas and new drugs.
Niger J Clin Pract. 2012 Jul-Sep; 15(3):253-7 [PubMed] Related Publications
Pheochromocytoma presents a challenge to the surgery team because of its clinical features and implications. The patient must be treated before the surgery until a stable hemodynamically state is achieved. The preoperative treatment includes α2-short acting adrenergic blocking and β-blocker agents. The most crucial intraoperative moments are induction of anesthesia and hemodynamic oscillations. An adequate preoperative preparation, modern anesthetic drugs, good collaboration between the surgeons and the anesthesiologists, and postoperative care decrease the rate of complications and improve the outcome. This review aims to discuss all the possible pharmacological strategies of perioperative management of phoechromocytoma, focusing on new drugs and treatments.

Beqiri A, Toci E, Sallaku A, et al.
Breaking bad news in a Southeast European population: a survey among cancer patients in Albania.
J Palliat Med. 2012; 15(10):1100-5 [PubMed] Related Publications
OBJECTIVE: The purpose of this study was to explore the attitudes of cancer patients, their family, and community members in Albania, a post-communist country in Southeast Europe, regarding breaking bad news.
METHODS: One hundred and fifty consecutive cancer patients, 150 respective relatives, and an age-sex-residence matched sample of 150 individuals in Tirana district were interviewed from September 2009-January 2010 about attitudes related to diagnosis disclosure. Logistic regression was used to assess the association of diagnosis disclosure with demographic characteristics.
RESULTS: Community members were the most in favor, whereas the patients' relatives were the least in favor of diagnosis disclosure. Most of the patients, who were aware of their diagnosis, were not satisfied with the disclosure approach employed by the medical staff. The odds of favoring diagnosis disclosure were significantly higher among younger, male, urban, and more educated patients.
CONCLUSION: This survey identified important characteristics of cancer patients, their relatives, and a community-based sample in Albania that could predict the willingness to disclose a fatal diagnosis. Establishment of a formal training of health professionals regarding breaking bad news should be considered in order to ensure a proper approach of communicating diagnosis to cancer patients in transitional Albania.

Lame A, Kaloshi G, Xhumari A, et al.
Insights on the natural history and pathogenesis of multilevel discal cysts.
J Clin Neurosci. 2012; 19(4):617-9 [PubMed] Related Publications
Discal cysts are rare lesions and uncommon causes of low back pain and radiculopathy. Despite growing evidence regarding the clinical, pathological and radiological presentation of these lesions, we do not yet have a detailed understanding of their natural history, etiology or pathogenesis. To our knowledge this is the first report of multiple and multilevel discal cysts, and possible mechanisms of pathogenesis are proposed.

Kasmi G, Andoni R, Mano V, et al.
Streptococcus bovis isolated in haemoculture a signal of malignant lesion of the colon.
Clin Lab. 2011; 57(11-12):1007-9 [PubMed] Related Publications
S. bovis is known for causing bacteremia and endocarditis as well as accompanying malignant diseases of the gastrointestinal tract. Hence, identification of this species and recognition of the clinical characteristics of infections caused are essential for both therapy and prognosis. S. bovis isolated from haemoculture requires an immediate search for gastrointestinal tract lesions.

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