Karcinom štitne žlijezde

Zloćudni tumori štitnjače mogu se podijeliti prema vrstama, pri čemu su najčešći papilarni i folikularni karcinom, dok se medularni, anaplastični karcinom, Hürtlov karcinom, primarni limfom i primarni sarkom štitnjače javljaju izrazito rijetko.

Papilarni karcinom:
- Čini oko 80% svih karcinoma štitnjače.
- Najčešće se javlja između 30. i 40. godine života.
- Razvija se sporo, s najboljom prognozom.
- Ponekad se javlja i u obiteljskom obliku.
- Metastazira u limfne čvorove vrata i udaljene dijelove tijela (5% – 10% slučajeva).
Folikularni karcinom:
- Čini oko 10% slučajeva raka štitnjače.
- Obično se javlja iza 40. godine života.
- Karakterizira ga veća učestalost metastatskog širenja u usporedbi s papilarnim karcinomom.
- Podvrsta je karcinoma Hürtlovih stanica.
Medularni karcinom:
- Čini oko 5% zloćudnih tumora štitnjače.
- Karakteriziran je prekomjernom proizvodnjom hormona kalcitonina.
- Može se javiti sporadično ili nasljedno kao dio sindroma multiple endokrine neoplazije-2 (MEN2).
Anaplastični karcinom:
- Obuhvaća 1% – 2% svih zloćudnih tumora štitnjače.
- Javlja se skoro isključivo u starijoj životnoj dobi.
- Karakterizira ga agresivan klinički tijek, brz rast i širenje, lokalno i udaljeno.

Operacija karcinoma štitnjače tradicionalno se povezuje s većom stopom komplikacija, uključujući povredu rekurentnog (povratnog) živca koji inervira grkljan, u usporedbi s kirurškim zahvatima kod dobroćudnih oboljenja štitnjače.

Naši kirurzi, s ekspertizom u tehnici kirurgije glave, temeljitim znanjem anatomije rekurentnog laringealnog živca, štitne žlijezde i okolnih limfnih čvorova, su dobro pripremljeni za zahtjevne slučajeve. Veliko iskustvo i korištenje monitoringa rekurentnog laringealnog živca omogućuju nam izvođenje ovih složenih postupaka uz minimalni rizik od komplikacija.

Neposredna suradnja s endokrinologom prije i nakon operacije omogućuje koordiniranu brigu o pacijentu.

U slučaju potvrđenog karcinoma štitnjače, kirurški zahvat obično uključuje uklanjanje cijele štitne žlijezde, ponekad i limfnih čvorova. Budući da je ovo opsežna kirurška procedura koja može trajati od dva do četiri sata, pacijent obično prenoći u bolnici.

Nakon operacije, bol je obično kontrolirana analgeticima, a pacijenti brzo vraćaju normalne funkcije govora, prehrane i disanja.

Liječnik će nakon operacije pregledati patološki nalaz i surađivati s endokrinologom kako bi preporučio daljnji tretman, uključujući terapiju radioaktivnim jodom prema uputama endokrinologa. Ova terapija obično ima ograničen trajanje i rijetko uzrokuje nuspojave nakon završetka.

Standardne terapije poput zračenja i kemoterapije rijetko su potrebne, obično samo u agresivnijim oblicima karcinoma. Naši stručnjaci ne samo da su iskusni u kirurškom liječenju karcinoma štitnjače, već i u postoperativnom tretmanu. Pružit ćemo podršku i vođenje kroz ovaj period, surađujući prema potrebi s drugim specijalistima.

Iako su prognoze za većinu karcinoma štitnjače izuzetno dobre, dugoročno je potrebno redovito praćenje kod kirurga i endokrinologa.

J.Lj.

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I did rhinoplasty along with face tight treatment and the results were more than satisfactory. The guys (Boris and Peter) did everything at the same time, very professionally and in the shortest possible timeframe. I was out of tampons in 2 days, and my bruise recovery does not take longer than 7 days. Very gentle approach. Without unnecessary arrivals, with kind and friendly staff and arranging payments where flexibility was at an enviable level, the impression of service in this clinic is for every recommendation. Of course, I don’t even have to mention that my breathing is better now than before, and my facial skin is smooth and tight without any invasive method. Guys, you are the best. :)

A.P.

I had unwittingly been suffering from hypopnea for nearly a decade. I did some research and I selected this clinic because it was located in a country where I have many friends. I had already been treated for this by a different physician in Canada, a surgery was done in my nose to remove an obstruction and believed it was better, but I was wrong. The Canadian doctor proposed dealing with the problem by CPAP or further surgeries. Their solution was to remove the first obstacle they find, see if that helps, if not, then remove the next obstacle etc. I had been using caffeine to stay awake, but my physical and mental performance was severely impacted by chronic sleep deprivation. At my first meeting, I was surprised to actually meet Dr. Filipovic, I presumed I would be looked after by an associate Doctor. I explained my suspicions and situation and told him, I do not want to go through multiple procedures to find one that worked. He listened, looked into my nose and proposed that I schedule and undergo a general anaesthesia, where he would be able to insert a camera and record what happens when I actually sleep. In addition I took home a wearable monitor for the night. After these diagnotics, it was found that a mandibular advancement device or CPAP would work for me. CPAP is not good for me because my young children would tear it apart. I had to leave Croatia earlier than planned, when I told his team. They moved heaven and earth to rush the casting, production and shipping of the device to me in Canada. Once I arrived here, his dentist responded to my emails to ensure I had proper guidance on how to adjust and use the device. It works wonderfully and with the clarity of thought that comes from regular sleep, I realized I should have a backup mandibular advancement device made, to use if my device is destroyed by my children. His team again did a wonderful job of using the casting I sent back to produce a 2nd set and ship it to Canada. I have tested the second device for a week now and it works as well as the first. I would highly recommend this team for their professional, courteous and effective effort. If, time & money allows and vanity demands, I would go to this team for a rhinoplasty in the future. Thank you all for improving my quality of life and work performance.

M.K.

For so long I was dissatisfied with the breathing and the appearance of my nose. Of course the first step was to google rhinoplasty and read comments on forums of the people who did it in Croatia. That did not help because the amount of negative experiences only scared me. But I also read that the most important thing is to find a great surgeon so I finally went to meet with dr. Filipović. I met him, he explained the procedure and answered all my questions. On that first meeting I felt so confident that I even reserved a date for my surgery. Finally in November 2020 I had septorhinoplasty performed by dr. Filipović. They arranged that I stayed in the clinic for one day after the procedure. That really meant a lot, and I'm grateful for that. Recovery went fast and well, I almost had no bruising at all. I'm quite sensitive, so I felt some pain in the first 3 days after, but nothing too bad. It is now 2 months post-op and I look and feel better than ever. The result looks really natural, and it fits my face perfectly. The only regret that I have is that I didn’t do it sooner. Dr. Filipović is a miracle worker, and I will forever be grateful to him and his team.

M.G.

I've done plasma skin regeneration and skin boosting treatment there. Clinic is beautiful, stuff is very friendly, young and with great knowledge and experience. I would recommend it to anyone who is looking high quality in every aspect. Thank you!

M.S.

Prije mjesec dana bila sam na lip liftu kod dr. Filipovića. Rezultat je fantastičan, kao što je bilo i samo iskustvo konzultacija i operacije. Doktor i sestre profesionalni su i pristupačni i ulijevaju povjerenje. Lip lift je ispao super i izgleda prirodno, ali je dovoljno velika promjena da je utjecala na izgled cijelog lica. Oteknuće je splasnulo nakon otprilike tjedan dana, a ožiljak ispod nosa se mjesec dana poslije vidi, ali nije pretjerano upadljiv.

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