Browsing by Author "Kilic, Dalokay"

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Biphasic Pulmonary Blastoma Associated with Cerebral Metastasis
(2016) Kilic, Dalokay; Yilmaz, Cem; Tepeoglu, Merih; Vural, Cigdem; Caner, Hakan; 26768884
Pulmonary blastoma is a very rare malignant tumor of the lungs. A biphasic pulmonary blastoma was histologically diagnosed by a characteristic finding as it was mainly constituted of immature tumor tissue that had both epithelial and mesenchymal components. We present a case of a 68-year-old man with biphasic pulmonary blastoma. The patient underwent cranial metastatectomy and left lung upper lobectomy. Although the tumor was resected, there was rapid metastasis to the cranial, liver, kidney and multiple bones. Although radiotherapy and chemotherapy were administrated, the patient died about 6 months postoperatively. Close follow-up and aggressive chemotherapy should be considered for such tumours. In the light of this case, the authors review the pathologic, clinical, radiological and therapeutic features of this very rare malignant lung tumor.
Chest Wall Implantation Metastasis Caused by Percutaneous Radiofrequency Ablation for Hepatic Tumor
(2015) Kilic, Dalokay; Uysal, Cagri; Akdur, Aydincan; Kayipmaz, Cagri; Tepeoglu, Merih; Boyvat, Fatih; 0000-0002-9894-8005; 0000-0002-8726-3369; 0000-0001-6236-0050; 25742838; H-7700-2019; F-4230-2011; AAK-5222-2021; AAA-3068-2021
We report a very rare case of a 55-year-old man with chest wall metastatic tumor caused by seeding of hepatocellular carcinoma after percutaneous radiofrequency ablation (RFA) for hepatic tumor 42 months after the initial operation. The patient was managed with aggressive full-thickness chest wall resection and reconstruction with a Prolene (Ethicon, Somerville, NJ) and methyl methacrylate sandwich graft and subsequent musculocutaneous free-flap transposition. (C) 2015 by The Society of Thoracic Surgeons
Chondromyxoid Fibroma of the Sternum in a 63-Year-Old Woman
(2015) Kilic, Dalokay; Findikcioglu, Alper; Tepeoglu, Merih; Vural, Cigdem; 26413029
Primary chondromyxoid fibroma is a benign bone tumor. Its localization in the sternum is quite rare; we found only 6 relevant reports. We report our diagnosis and treatment of a chondromyxoid fibroma in the sternum of a 63-year-old woman. The patient underwent subtotal sternectomy and chest-wall reconstruction with use of a titanium rib bridge system and Prolene mesh. The patient's clinical course was uneventful, and she had no local recurrence 41 months postoperatively. Our review herein of the 6 previous cases reveals that our patient is the oldest thus far to have been diagnosed with a sternal chondromyxoid fibroma.
Dual-Energy Computed Tomography Pulmonary Angiography With Ultra-Low Dose Contrast Administration: Comparison Of Image Quality With Standard Computed Tomography Pulmonary Angiography
(2022) Celtikci, Pinar; Hekimoglu, Koray; Kahraman, Gokhan; Haberal, Kemal Murat; Kilic, Dalokay
Background: This study aims to compare quantitative and qualitative image quality between standard computed tomography pulmonary angiography and dual-energy computed tomography pulmonary angiography protocols. Methods: Between September 2017 and August 2018, a total of 91 consecutive patients (34 males, 57 females; mean age: 65.9 +/- 15 years; range, 37 to 91 years) who were referred for computed tomography pulmonary angiography were randomly imaged with either a standard or dual-energy protocol. Standard protocol (n=49) was acquired with a 64-slice multidetector computed tomography scanner using 60 mL contrast media (18 g iodine). A third-generation dual-energy computed tomography scanner was utilized to acquire dual-energy computed tomography pulmonary angiography and simultaneous lung perfusion imaging (n=42), which required 40 mL contrast media (12 g iodine). Two radiologists reviewed images separately to determine interobserver variability. Attenuation and noise in three central and two segmental pulmonary arteries were measured; signal-to-noise ratio and contrast-to-noise ratio were calculated. A five-point scale was utilized to evaluate image quality and image noise qualitatively. Results: The standard protocol required a significantly higher amount of iodine. Comparison of two groups employing quantitative measurements (attenuation value in five pulmonary arteries, mean attenuation value, mean background noise, signal-to-noise ratio, and contrast-to-noise ratio) and employing qualitative measurements (five-point scale scores of image quality and image noise) revealed no significant difference between dual-energy and standard groups (p>0.05). Qualitative and quantitative evaluations demonstrated low interobserver variability. Conclusion: Dual-energy computed tomography pulmonary angiography protocol delivers image quality equal to standard protocol, while requiring less amount of iodinated contrast medium and providing simultaneous lung perfusion imaging to contribute the diagnosis of pulmonary embolism.
A Fine Line Between A Major Surgery and Medical Therapy: The Diagnosis of Sternal Tuberculosis
(2014) Yesilkaya, Aysegul; Azap, Ozlem Kurt; Kilic, Dalokay; Arslan, Hande; Uner, Halit; https://orcid.org/0000-0003-0225-6416; https://orcid.org/0000-0002-3171-8926; https://orcid.org/0000-0002-5708-7915; https://orcid.org/0000-0002-5388-4183; A-8902-2013; AAK-4089-2021; H-7700-2019; ABG-7034-2021; HOH-1335-2023
Tuberculosis involving the sternum is rare. The most common symptoms at the early stage are chest pain and palpable masses on the sternum. Cutaneous fistulas, spontaneous fracture of sternum and extrasternal spread may develop in cases with late diagnosis. In this article, we report a 53-year-old male case admitted with a one-month history of chest pain and two palpable masses on his lower sternal part of chest in whom the diagnosis of sternal tuberculosis was confirmed by histopathologically and rnicrobiologically. The masses were reduced in size with two-month anti-tubercular therapy. The nine-month duration of the therapy produced satisfactory results without any adverse reactions.
Importance of SUVmax Threshold in Positron Emission Tomography-Computed Tomography Assessment of Mediastinal and Hilar Lymph Nodes in Non-Small Cell Lung Cancer
(2016) Yildiz, Oya; Cangir, Ayten Kayi; Kilic, Dalokay; Yuksel, Cabir; Enon, Serkan; Kutlay, Hakan; Akal, Murat; Ozdemir, Nezih; Kavukcu, Sevket; Okten, Ilker; H-7700-2019
Background: This study aims to determine a new cut-off value for standardized uptake value in positron emission tomography-computed tomography evaluation of mediastinal lymph nodes in non-small cell lung cancer in Turkey. Methods: A total of 207 patients with non-small cell lung cancer who were performed positron emission tomography-computed tomography between November 2006 and February 2010 were prospectively analyzed. Of these patients, 143 patients (125 males, 18 females; mean age 62.1 years; range 39 to 85 years) whose invasive staging was performed after positron emission tomography were included in the study. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates of positron emission tomography were calculated and compared using a maximum standardized uptake value cut-off value of >= 2.5 and the newly determined maximum standardized uptake value cut-off value. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates were 45.3%, 78.9%, 55.8%, 71%, and 66.4%, respectively, when the maximum standardized uptake value cut-off value was considered 2.5 in mediastinal lymph nodes. The new maximum standardized uptake value cut-off value was determined to be 4.8 in metastatic lymph nodes. These values were 39.6%, 91.1%, 72.4%, 71.9% and 72%, respectively, according to the new maximum standardized uptake value cut-off value of 4.8. There was a significant difference only between specificity rates when the two different maximum standardized uptake value cut-off values were used (p=0.022). Conclusion: In this study, the sensitivity of positron emission tomography in the evaluation of mediastinal lymph nodes was lower than those reported in the literature. This situation may be associated with the frequently observed granulomatous infections such as tuberculosis in our country. Results of positron emission tomography should be evaluated according to countries and a new maximum standardized uptake value cut-off value should be calculated particularly for mediastinal lymph node metastasis in multicenter studies in our country.
Is Clipping Superior to Cauterization in the Treatment of Palmar Hyperhidrosis?
(2014) Findikcioglu, Alper; Kilic, Dalokay; Hatipoglu, Ahmet; 23839873
Background Endoscopic thoracic sympathectomy has been accepted as the most effective treatment for palmar hyperhidrosis (PH). However, there is a debate regarding the surgical techniques in terms of effectiveness, recurrence, and reversibility. In this study, sympathetic chain disruptions were compared in terms of whether the clipping or ablation technique had an effect on the long-term outcomes of patients who underwent thoracic sympathectomy for primary PH. Patients and Methods All patients who underwent video-thoracoscopic sympathectomy for PH between May 2008 and October 2011 were included. Single-port bilateral sympathectomy was performed depending on the sweat distribution. As a standard approach, rib-based terminology was used to describe the blockade level of the sympathetic ganglia, and single-level R3 sympathectomy (between R3 and R4) was performed in all patients. The type of sympathectomy was changed. Monopolar electrocautery was first performed and 5-mm clips were then used for nerve disruption. Both techniques were evaluated and compared in terms of effectiveness, reversibility, and recurrence. Results Cauterization of the sympathetic chain was applied in 28 (47%) (Group A) patients and clipping in 32 (53%) patients (Group B). CH was the most common adverse effect and was observed in 43 (71.6%) patients (Group A, 71.4%; Group B, 71.8%; p = 0.8). The success rate was 93% for Group A and 100% for Group B (p = 0.15). The satisfaction rate for Group A was 83% and for Group B was 86% (p = 0.77). In Group A two patients (7%), and in Group B three patients (9%) requested reversibility because of severe compensatory hyperhidrosis. Overly dry hands were the other most common side effect and were identified in 12 (25%) patients. Recurrences were observed in 11 patients in Group A and 4 patients in Group B (19 vs. 6%; p = 0.01). The mean follow-up time was 33 +/- 10.5 months (range, 13-53 months). Conclusion Both clipping and cauterization are highly effective for the treatment of PH. The methods are comparable in terms of effectiveness and side effects despite the fact that the recurrence rate was higher in the cauterization group. Potential reversibility of compensatory sweating was not observed in our series. Identification of ideal candidates for surgery and education of patients about the permanent side effects of sympathectomy might make these techniques more convenient.
Is Clipping the Sympathetic Chain Effective for Palmar Skin Temperature? Reply
(2016) Kilic, Dalokay; H-7700-2019
Textiloma Mimicking Superior Sulcus Tumor: Positron Emission Tomography/Computed Tomography Findings of a Pseudotumor
(2014) Findikcioglu, Alper; Karadayi, Sule; Kilic, Dalokay; Hatipoglu, Ahmet; 23436618; AFT-2303-2022; H-7700-2019
We present an interesting case report of a 52-year-old man with a superior sulcus tumor. To evaluate the suspicious left lung tumor, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) was used. Increased FDG level was indicative of a malignant tumor. Left thoracotomy revealed a textiloma retained during cardiac surgery.