Browsing by Author "Nursal, Gul Nihal"

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A Case of a Man With Isolated Breast Metastasis From Lung Adenocarcinoma Incidentally Detected by FDG PET/CT
(2016) Erhamamci, Seval; Reyhan, Mehmet; Canpolat, Tuba; Nursal, Gul Nihal; Yapar, Ali Fuat; https://orcid.org/0000-0001-8550-3368; https://orcid.org/0000-0002-5302-4386; https://orcid.org/0000-0003-1715-4180; 26562574; AAJ-5242-2021; AAK-8107-2021; R-3735-2016; AAI-8973-2021
Breast metastases from an extramammary primary tumor are very rare, particularly in men. In this study, we present a case of a 74-year-old man with isolated breast metastasis from lung adenocarcinoma as an incidental finding on PET/CT and diagnosed concomitantly with the primary tumor. Detection of isolated incidental metastatic lesions in the breast on PET/CT imaging has a significant clinical impact on patients with known malignant disease due to change of disease stage, management, and also treatment method.
Demonstration of Cerebrospinal Fluid Leakage on Radionuclide Cisternography by SPECT/CT
(2015) Nursal, Gul Nihal; Yapar, Ali Fuat; 0000-0002-5302-4386; 0000-0003-1715-4180; 25072925; R-3735-2016; AAI-8973-2021
The Effects of Cinacalcet Treatment on Bone Mineral Metabolism, Anemia Parameters, Left Ventricular Mass Index and Parathyroid Gland Volume in Hemodialysis Patients with Severe Secondary Hyperparathyroidism
(2016) Torun, Dilek; Yildiz, Ismail; Micozkadioglu, Hasan; Nursal, Gul Nihal; Yiğit, Fatma; Ozelsancak, Ruya; 26787561
The aim of this study was to investigate the effects of cinacalcet therapy on anemia parameters, bone mineral metabolism, left ventricular mass index (LVMI) and parathyroid gland volume in hemodialysis (HD) patients with secondary hyperparathyroidism. Twenty-five HD patients (M/F: 11/14, mean age: 45.2 +/- 17.9 years, mean HD duration: 96.4 +/- 32.7 months) were included in this prospective pilot study. The indication to start calcimimetic therapy was persistent serum levels of parathyroid hormone (PTH) > 1000 pg/mL, refractory to intravenous (i.v.) vitamin D and phosphate-binding therapy. The initial and one-year results of adjusted serum calcium (Ca+2), phosphate (P), Ca x P product, PTH, hemoglobin (Hb) and ferritin levels, transferrin saturation index (TSAT), median weekly erythropoietin (EPO) dose, LVMI, and parathyroid volume by parathyroid ultrasonography were determined. There were no differences between pre-and posttreatment levels of serum Ca+2 (P = 0.853), P (P = 0.447), Ca x P product (P = 0.587), PTH (P = 0.273), ferritin (P = 0.153) and TSAT (P = 0.104). After 1 year of calcimimetic therapy, the Hb levels were significantly higher than the initial levels (P = 0.048). The weekly dose of EPO decreased with no statistical significance. The dose of cinacalcet was increased from 32.4 +/- 12.0 to 60.0 +/- 24.4 mg/day (P = 0.01). There were no differences between the pre-and post-treatment results regarding weekly vitamin D dose, parenteral iron dose, LVMI and parathyroid volume. The results of our study suggest that cinacalcet therapy might have an additional benefit in the control anemia in HD patients.
Elastofibroma Dorsi Incidentally Detected by 18F-FDG PET/CT Imaging
(2015) Erhamamci, Seval; Reyhan, Mehmet; Nursal, Gul Nihal; Torun, Nese; Yapar, Ali Fuat; Findikcioglu, Alper; Canpolat, Tuba; 0000-0003-1715-4180; 0000-0002-5597-676X; 0000-0002-5302-4386; 0000-0001-8550-3368; 25666569; AAI-8973-2021; AAE-2718-2021; R-3735-2016; AFT-2303-2022; AAK-8107-2021; AAJ-5242-2021
Elastofibroma dorsi (ED) is a rare pseudotumor of the soft tissues that can also show 18F-fluorodeoxyglucose (F-18-FDG) uptake on positron emission tomography combined with computed tomography (PET/CT) imaging. The aim of this retrospectively study was to describe the metabolic characteristics of ED incidentally detected by F-18-FDG PET/CT imaging. Between November 2009 and August 2013 at our institution, 10,350 consecutive PET/CT examinations were retrospectively investigated. In 176 of these patients, ED was recorded as an incidental finding. Fifty-five of 176 patients also had follow-up scans after chemoradiotherapy. A total of 231 scans with ED in 176 patients were identified. To determine the metabolic activity of ED, the maximum standardized uptake value (SUVmax) was calculated semiquantitatively. For measurement size of ED, the longest axis of transaxial CT images was used. Seven of the 176 patients underwent surgery due to suspected metastases and/or invasion of primary malignancy and/or symptoms or incidental during surgery. The prevalence of ED in our series was 1.7 %. The lesions were located in the subscapular region in all patients, except in one case with a lesion in the infrascapular region. A total of 419 ED lesions in 231 scan of 176 patients were evaluated. Mean +/- A SD SUVmax and long axis values for these 419 lesions were 2.31 +/- A 0.61 (range 1.0-4.30) and 56.78 +/- A 17.01 mm (range 19-112 mm), respectively. Of these 176 patients, 141 (80.1 %) had bilateral lesions and 35 (19.9 %) had unilateral lesions. There were statistically significant differences in the SUVmax and long axis values between the right and left side in the bilateral lesions (p = 0.001). No significant differences in the SUVmax and long axis values of the lesion were found between pre- and posttreatment in the patients with follow-up scans. Elastofibroma dorsi located in the scapular region is usually bilateral, asymmetric and with mild or moderate metabolic activity on PET/CT imaging. In addition, the metabolic activity and size of ED remained stable after chemoradiotherapy. Awareness of these metabolic characteristics of ED is important for preventing misinterpretation during F-18-FDG PET/CT studies.
Focal 99mTc-DMSA Uptake in Lung Parenchyma Without Structural Alterations on SPECT/CT
(2015) Nursal, Gul Nihal; Reyhan, Mehmet; Yapar, Ali Fuat; 0000-0003-1715-4180; 0000-0001-8550-3368; 0000-0002-5302-4386; 26053717; AAI-8973-2021; AAJ-5242-2021; R-3735-2016
Static renal scintigraphy with Tc-99m-DMSA is commonly used for the evaluation of renal morphology and function. Extrarenal uptake of Tc-99m-DMSA is a rare finding described previously on sites such as bone metastasis, hemangioma, and splenic amyloidosis. We report a case with Tc-99m-DMSA activity in the lungs.
Is PET/CT Necessary in the Management of Early Breast Cancer?
(2016) Nursal, Gul Nihal; Nursal, Tarik Zafer; Aytac, Huseyin Ozgur; Hasbay, Bermal; Torun, Nese; Reyhan, Mehmet; Yapar, Ali Fuat; https://orcid.org/0000-0002-5302-4386; https://orcid.org/0000-0002-3583-9282; https://orcid.org/0000-0002-5597-676X; https://orcid.org/0000-0001-8550-3368; https://orcid.org/0000-0003-1715-4180; 26914560; R-3735-2016; IQV-1169-2023; AAJ-7913-2021; AAE-2718-2021; AAJ-5242-2021; AAI-8973-2021
Purpose Advanced imaging methods in early breast cancers are not recommended before surgery. In contrast to the accepted guidelines, some recent studies have shown some benefits with the use of PET/CT in early-stage breast cancer. In this study, we aimed to document the efficacy of PET/CT in detection of distant metastasis as well as other primary cancers. Patients and Methods In this retrospective study, we reviewed the records of all women patients diagnosed with early breast cancer between March 2012 and December 2014. Besides demographics, we recorded the clinical TNM stage, histology of the tumor, and hormone receptor status. As PET/CT imaging is a routine procedure in our center for early breast cancer, tumor size, lymph node status, distant metastasis, and possible other primary malignancies detected by PET/CT were also recorded. Results Of the 419 women included in the study, 24.8% were clinically staged as stage I while the rest were stage II. Distant metastases were detected in 42 patients (10%). The yield of PET/CT in detecting metastasis was significant in stage II patients compared with stage I patients (12.4% vs 2.9%). In subgroup analysis of stage II patients, the performance of PET/CT in detecting metastasis was still evident in stage IIA patients (9.5%). In logistic regression analysis of the significant and near-significant factors (as detected by univariate analysis) effecting PET/CT detected distant metastasis, only nodal status (P = 0.053) was found to be significant. Conclusions We suggest the use of PET/CT in investigating metastasis in axilla positive and clinically stage II early breast cancer patients.
Isolated jejunal metastasis in a patient with cervical cancer: A case report
(2015) Onal, Cem; Nursal, Gul Nihal; Torer, Nurkan; Kayaselcuk, Fazilet; 25949229
Background: In approximately 8% of cervical carcinoma patients, gastrointestinal tract is involved, most commonly the rectosigmoid portion, because of local extension. Isolated metastases to small bowel are exceedingly rare. Case report: We present a case of a 63-year-old woman with cervical cancer who developed isolated jejunal metastasis 8 months after postoperative chemoradiotherapy. The patient was alive with no evidence of disease 6 months after resection of metastasis. Very few cases have been reported concerning squamous cell carcinoma of the cervix with documented metastases to the small bowel. There is only one published case report of cervical cancer with multiple metastases to the small intestine and jejunum. To our knowledge, this is the first case of cervical cancer with isolated jejunal metastasis, which was initially demonstrated with positron emission tomography and confirmed histopathologically. Conclusion: Although the exact mechanism underlying the isolated metastasis is unknown, hematogenous spread or tumor seeding during surgery may play a role. (C) 2015 Greater Poland Cancer Centre. Published by Elsevier Sp. z o.o. All rights reserved.
Multiple Systems Metastasis Bladder Cancer with Imaging Findings
(2016) Tok, Sermin; Altinkaya, Naime; Nursal, Gul Nihal; 0000-0002-5302-4386; 0000-0003-1348-8167; R-3735-2016; AAM-5169-2021
Predictors Determining the Status of Axilla in Breast Cancer: Where is PET/CT on That?
(2015) Aytac, Huseyin Ozgur; Colacoglu, Tamer; Nursal, Gul Nihal; Nursal, Tarik Zafer; Bolat, Filiz Aka; Yabanoglu, Hakan; Yildirim, Sedat; Moray, Gokhan; 0000-0002-3583-9282; 0000-0003-0268-8999; 0000-0003-2498-7287; 0000-0002-5735-4315; 0000-0002-5302-4386; 0000-0002-3462-7632; 0000-0002-1161-3369; 0000-0003-2031-7374; 26537078; AAJ-7913-2021; AAK-2011-2021; AAE-1041-2021; AAF-4610-2019; R-3735-2016; IQV-1169-2023; AAJ-8097-2021; AAJ-7865-2021; HJZ-1654-2023
Purpose: 18 F-FDG PET/CT has an acceptable specificity but a low sensitivity on the prediction of axillary lymph node (ALN) metastasis in breast cancer. We analyzed the factors that could possibly affect this prediction. Methods: The records of 270 patients with T1-2 invasive breast cancer who underwent surgery, 116 of whom had been evaluated by preoperative 18 F-FDG PET/CT were reviewed. Prediction of ALN status by PET/CT according to tumor stage, estrogen receptor (ER), progesterone receptor (PgR) and HER2 status, histology, age and sentinel node properties was assessed. Results: ALN metastasis was present in 62 of 131 T1 (43.7%) and 106 of 142 T2 tumors (74.6%), 20 of 46 (43.5%) ER(-) and 146 of 222 (65.8%) ER(+) tumors, 38 of 71 (53.5%) PgR(-) and 127 of 200 (63.5%) PgR(+) tumors. On multivariate analysis only the tumor size (>2 cm) independently correlated with ALN metastasis (Odds ratio/OR=3.1). None of the other parameters had statistical significance in terms of ALN prediction on FDG-PET/CT. Conclusion: Though T2 tumors showed increased tendency to metastasize to the axilla, prediction of ALN metastasis in preoperative FDG-PET/CT was not associated with any of the predictive factors.
Simultaneous Occurrence of Medullary and Differentiated Thyroid Carcinomas. Report of 4 Cases and Brief Review of The Literature
(2014) Erhamamci, Seval; Reyhan, Mehmet; Kocer, Nazim Emrah; Nursal, Gul Nihal; Torun, Nese; Yapar, Ali Fuat; https://orcid.org/0000-0001-8550-3368; https://orcid.org/0000-0002-5943-9283; https://orcid.org/0000-0002-5302-4386; https://orcid.org/0000-0002-5597-676X; https://orcid.org/0000-0003-1715-4180; 24997082; AAJ-5242-2021; AAM-5436-2021; R-3735-2016; AAE-2718-2021; AAI-8973-2021
Simultaneous occurence of medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC) in a single patient is an unusual event. The incidence, cell origin, histopathology features and prognosis of these two carcinomas are considered completely different. The aim of this retrospective study was to describe clinical, pathologic characteristics and the prevalence of diagnosing such patients in our clinic. Between October 2003 and December 2013, 1.420 consecutive patients diagnosed by histology as having differentiated thyroid carcinoma (DTC) and treated with radioactive iodide (RAI) were retrospectively investigated. Of these, 4 patients were diagnosed by histology as having simultaneous MTC and PTC. The clinical and pathology characteristics of these patients are described. The prevalence of simultaneous MTC and PTC of these 4 patients in our clinic was 0.28% of all patients with DTC.The age of the 4 patients ranged from 44 to 63 years and were three females and one male.These patients are currently alive without disease from either of the two types of cancer. In two of these patients, MTC was located in the left and PTC in the right thyroid lobe. One patient had MTC in the right lobe and PTC in both lobes. The remaining patient had both cancers in the left lobe as a mixed tumor. We are able to present the pathology of only 2 of these 4 patients. In these 2 patients MTC was located in the left and PTC in the right thyroid lobe, one of them was female and the other was male, aged 44 and 49, respectively. In conclusion, our results suggested that simultaneous occurrence of MTC and PTC had a prevalence in our clinic of 0.28% among 1420 consecutive patients with DTC or 0.14%, if only the 2 patients in whom we are able to present their pathology slides are considered. Our cases suggest that these two tumors are usually independent and coincidental events in patients.
An Unusual Site, Breast Involvement in An Adolescent Girl with Burkitt's Lymphoma
(2015) Yazici, Nalan; Sarialioglu, Faik; Nursal, Gul Nihal; Pourbagher, Aysin; Demir, Senay; Kocer, Nazim Emrah; 0000-0002-8257-810X; 0000-0002-5302-4386; 0000-0002-4209-9075; 0000-0002-5943-9283; AAL-7766-2021; R-3735-2016; AAM-5138-2021; AAK-9310-2021; AAM-5436-2021