[Diagnostic dilemmas in surgical pathology]

In the majority of presented cases persisted certain diagnostic perplexities even after the careful investigations were performed, which required surgical exploration. For example, carcinomatous pericarditis as the sequel of metastasis from occult thyroid carcinoma and two cases of double malignity (papillary carcinoma and Hodgkin's lymphoma of the thyroid), retroperitoneal leiomyosarcoma and the clear cells renal carcinoma. All the cases were not successfully solved until the application of highly sophisticated and precise methods of immunohistochemical staining, which without a mistake confirmed our assumed histopathologic diagnosis. Metastatic lesion of folicular thyroid carcinoma in the adrenal gland should be mentioned because of the long remission period of 15 years following total thyroidectomy and neck irradiation during the primary therapy of thyroid carcinoma. It is very significant to point out that pathologic disorders such as undifferentiated neoplasm, strange inflammatory conditions, endocrine proliferative lesions deserve special attention because in certain cases consultative approach is necessary for obtaining the definite finding that can in some degree histoprognostically predict the outcome of pathologic process.