Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Urachal Adenocarcinoma: A Case Report with 4-Year Follow-up(2023) Kayra, Mehmet Vehbi; Kahraman, Oguzhan; Egilmez, Mehmet Tulga; Hasbay, Bermal; 0000-0003-3691-8617; 0000-0002-7349-9952; AAC-8630-2022; AAK-8372-2021The urachus is an embryological remnant that lies between the bladder and umbilicus as a fibrous band that attaches the cloaca to the allantois in the intrauterine period. Urachal adenocarcinoma is a rare tumor and more aggressive in behavior than primary bladder tumors. In this case report, we present a 37 years old female patient with urachal adenocarcinoma in whom transurethral resection of the bladder revealed a signet ring adenocarcinoma of the bladder with invasion of the muscularis propria. The patient had left manubrium sterni and bone marrow infiltration. Partial cystectomy and sternal resection were performed, followed by radiotherapy and chemotherapy. There was no recurrence or new metastasis at the 4-year follow-up. In conclusion, a combination of surgery, chemotherapy, and radiotherapy is a suitable approach for the treatment of oligo-metastatic urachal carcinoma.Item 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-8973-2021Purpose 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.Item Meckel Diverticulum in Children: Evaluation of Macroscopic Appearance for Guidance in Subsequent Surgery(2016) Gezer, Hasan Ozkan; Temiz, Abdulkerim; Ince, Emine; Ezer, Semire Serin; Hasbay, Bermal; Hicsonmez, Akgun; 0000-0002-4635-2613; 0000-0001-8789-6003; 0000-0002-9597-3264; 26435520; J-3197-2013; A-4719-2018; AAJ-9529-2021Background: The treatment of incidentally encountered asymptomatic Meckel diverticulum(MD) is controversial. We evaluated whether the macroscopic appearance correlates with clinical features, histopathological findings, future complications, and management decisions. Methods: Patients who underwent MD resection at a single institution from 2000 to 2012 were retrospectively analyzed in terms of age, sex, clinical features, laboratory data, perioperative findings (diverticulum length, diameter, depth, thickening, and height-to diameter ratio [HDR]), pathology, and postoperative follow-up. Results: Fifty children were enrolled. Sixteen percent of the resected MDs were found incidentally. Of 42 complicated MDs, 17 (40%) were long (HDR >= 2), 14 (33%) were thickened, and 29 (70%) exhibited base widening. Histopathologically, ectopic mucosa was found in 32 (64%) of all MDs and in 5 (62%) of incidentally removed MDs. There was no statistical difference between the macroscopic appearance and clinical signs, sex, or presence of ectopic tissue based on palpation. Conclusion: The macroscopic appearance of MD does not indicate the presence or absence of HGM and cannot be used to guide subsequent surgery. Additionally, 40% of symptomatic patients in our study had life-threatening complications requiring prompt fluid resuscitation. We consider that incidentally detected MD should be removed regardless of its macroscopic appearance. (C) 2016 Elsevier Inc. All rights reserved.Item Pathology, Classification, Clinical Manifestations and Prognosis of Langerhan's Cell Histiocytosis: A Single Center Experience(2022) Hasbay, Bermal; Kocer, Nazim Emrah; Kayaselcuk, Fazilet; Canpolat, Emine Tuba; Buyukkurt, Nurhilal; Erbay, AyseObjective: The aim of the study is to raise awareness about clinical features, histopathological and radiological analyzes and treatment details of this rare disease. Methods: A total of 55 Langerhans cell histiocytosis patients, diagnosed between the year 2006 and October 2020 in our department were included in the study. The patients were evaluated in terms of age, gender, tumor localization, risk groups, treatment modalities, recurrence, and outcome of the disease. Results: Twenty-three out of 55 patients were children and 32 were adults. The ages of the patients were between 7 months and 72 years. Thirty-seven of the cases were male and 18 were female. The most common clinical complaint in both groups was pain and swelling. The duration between the onset of the patient complaints and admission to the hospital varies between 7 days-12 months in children, and 10 days-23 years in adults. Forty-three of the cases had single organ involvement and 12 had multiorgan involvement. The most frequently affected organ in both groups was bone. Forty of the 55 patients had follow-up data and the treatment modalities are as follows: Nine patients radiotherapy, 8 patients chemotherapy+steroid, 7 patients chemotherapy, 2 patients chemotherapy+radiotherapy+steroid, 1 patient steroid, 2 patients chemotherapy+radiotherapy. Eleven patients were followed up without additional treatment after surgery. Median follow-up from the time of biopsy was 45.9 months in children and 41.9 months in adults. Conclusions: As a result, diagnosis requires a high degree of suspicion and final diagnosis is based on the histological examination of the lesions and biopsies.Item Malignant Congenital Orbital Teratoma: Glioblastoma Multiforme With Primitive Neuronal Pattern And Choroid Plexus Papilloma: A Rare Diagnosis At An Unusual Age(2022) Hasbay, Bermal; Kayaselcuk, Fazilet; Kardes, Ozgur; 35435383Childhood orbital teratomas are usually congenital lesions that are most often present at birth with progressive, massive unilateral proptosis. During the routine controls of 27-year-old woman between 26-27th weeks of pregnancy her fetal ultrasonography (USG) revealed a mass in the eye of the fetus, and termination was recommended. The family refused the termination option and in the 37th week of pregnancy, vaginal delivery is performed in an external medical center. The mass in the baby's eye was surgically removed. Microscopic examination revealed disorganized ocular tissues, adipose tissue, microcalcification, nerve plexuses as well as areas of neuronal nodules including hypercellular areas, palisatic necrosis, and microvascular proliferation. The immunprofile- patchy GFAP staining in the areas of cellular epithelioid and spindled cells that also show an focal and sparse expression p53 staining and a high proliferation rate in Ki67 staining-confirmed the hematoxylin-eosin (HE) impression of a teratoma with a component of glioblastoma (GBM). In this unique presentation of a malignant orbital teratoma with a GBM, we have identified three tumor components: (1) GBM component, (2) nodules of neuroglial tissue with mature neurons and BRAF mutation, and (3) papillary proliferation possibly representing a choroid plexus papilloma.Item Clinicopathological Evaluation of Childhood Sacrococcygeal Germ Cell Tumors: A Single-Center Experience(2022) Hasbay, Bermal; Canpolat, Tuba; Aktekin, Elif; Ozkan, Hasan; Kekec, Senay Demir; 35781237Objective: We aimed to evaluate the cases of sacrococcygeal germ cell tumors diagnosed in our hospital between 2006 and June 2021. Materials and Methods::We evaluated 38 sacrococcygeal germ cell tumors cases in our series in terms of age, sex, clinical complaints, localization, macroscopy, tumor size, histopathological diagnosis, surgical, postoperative complications, treatment, recurrence, and prognosis. Results: The cases ranged from 1 day to 16 years of age; 14 cases were diagnosed with routine ultrasonographic examination during prenatal period while the rest of the cases most frequently presented with complaints of constipation. In terms of localization, 6 cases were type 1, 11 cases were type 2, 6 cases were type 3, and 15 cases were type 4. In the pathological evaluation, 25 cases were mature teratoma, 8 cases were immature teratoma, and 5 cases were pure yolk-sac tumor. In terms of complications, temporary colostomy was performed as a result of rupture during birth in 2 cases, disseminated intravascular coagulation at birth in 1 case, and colon injury in 2 cases. There was a recurrence in 2 of our cases. Thirty-seven of our cases were alive and 1 died. Alpha-fetoprotein level was high in 28 of our cases. Conclusion: In our series, type 4 cases were observed more frequently, contrary to the literature. We recommend to use a routine ultrasonography to patients who come to the clinic with complaints of constipation and inability to urinate and if a mass is detected, asking for alphafetoprotein for further follow-up. Sacrococcygeal germ cell tumors are ultimately a disease that can be successfully treated with multidisciplinary approach, accurate diagnosis in the antenatal and postnatal period, appropriate surgical intervention, and regular follow-up.Item Medulloblastoma: Clinicopathological Correlates of SHH, WNT, and Non-WNT/SHH Molecular Subgroups Analysis and Prognostic Significance: Mono-Institutional Series(2022) Hasbay, Bermal; Kayaselcuk, Fazilet; Suner, Halil Ibrahim; Sarialioglu, Faik; https://orcid.org/0000-0002-5957-8611; 000832603900001; AAJ-5381-2021AIM: To reevaluate the medulloblastoma cases according to histomorphological and molecular features, and to investigate the relationship between the prognostic factors of the new WHO classification by applying Beta-catenin, YAP1, GAP1, p53, and INI1 antibodies immunohistochemically. MATERIAL and METHODS: This study includes 41 patients who have been diagnosed with medulloblastoma between 2007-2019 in pathology department. Immunohistochemically, p53, beta-catenin, YAP1, GAP1, and INI1 immune markers were applied, and the relationship between the results and the prognostic parameters was evaluated statistically. RESULTS: When 41 patients were classified into WHO medulloblastoma histological subtype groups according to histomorphological features, 22 (53.7%) patients were classified as classical type, 11 (26.8%) patients as desmoplastic nodular type, and 8 (19.5%) patients as large cell/anaplastic type medulloblastoma. According to their molecular characteristics, 14 (34.1%) patients were in the Non-WNT/SHH group, 5 (12.2%) patients were SHH mutant, 17 (41.5%) patients were SHH wild, and 5 (12.2%) patients were in the WNT active group. There was no statistically significant correlation between age, gender, tumor size, recurrence, Ki67 proliferation index with molecular types and histopathological types. CONCLUSION: In our study, metastasis at the time of diagnosis, histological large cell anaplastic type, immunohistochemical p53 positivity, molecular SHH mutant type were the statistically significant indicators of worse prognosis and shorter survival time.Item Neuroendocrine Tumors of the Breast: Single-Center Experience(2022) Hasbay, Bermal; Aytac, Huseyin Ozgur; Bolat, Filiz Aka; 35059589Objective: Breast carcinomas with neuroendocrine (NE) differentiation are extremely rare. The aim was to discuss breast cancer cases with NE differentiation in the light of World Health Organization 2019 classification and literature information. Material and Methods: The pathology records of 56 cases diagnosed as neuroendocrine tumor (NET) and/or breast cancers with NE differentiation presenting to a single center between January 2010 and June 2020 were evaluated. The patients were evaluated in terms of age, tumor size, location, histological grade, hormone profiles (ER, PR, HER2), guideline American Joint Committee on Cancer, lymph node status, stage, metastases, progression, survival, radiological features, surgery type and therapy modality. Results: The age of the patients ranged from 34 to 81 years. Average tumor size was 2.3 cm. Median (range) follow up time was 31.5 (1-73 month). Metastatic lymph nodes were found in 20 cases. In our series, NE differentiation mostly accompanied invasive carcinoma of no special type, less frequently solid papillary carcinoma, and mucinous carcinoma. Four patients had a history of neoadjuvant chemotherapy. Response to treatment was very poor in all four cases. Synaptophysin and chromogranin were positive in 38 cases. No correlation was found among tumor size, grade, age, lymph node status, and presence of distant metastasis in our series. Conclusion: Clinical features and morphology may not help to distinguish NET from other subtypes of breast cancer. Therefore, the morphologic findings of a nested or trabecular architecture, nuclear or cytoplasmic features of NE differentiation, mucin production, or solid papillary growth pattern should prompt a pathologist to order NE markers.Item Pancreatic Tumors in Children(2021) Gezer, Hasan Ozkan; Temiz, Abdulkerim; Ezer, Semire; Yazici, Nalan; Demir, Senay; Hasbay, Bermal; Oguzkurt, Pelin; 0000-0002-4635-2613; 0000-0002-4209-9075; 0000-0001-6702-7265; A-4719-2018; AAJ-9529-2021; AAM-5138-2021; AAK-9310-2021Objective: Pancreatic rumors in children are exceedingly rare and hence present diagnostic and therapeutic challenges to pediatric surgeons. In this study, we aimed to present our experiences and treatment outcomes related to these rare tumors. Methods: The clinical data, laboratory investigations, radiological imaging, and the pathology and surgical details of patients with pancreatic tumors who were diagnosed between 2005 and 2019 were retrospectively reviewed. Results: A total of 9 patients (5 men) were included in the study. The most common symptom at the time of presentation was vague abdominal pain. A pancreatic rumor was detected incidentally in 4 patients. All tumors were non-functional primary rumors. Histopathological diagnosis of these tumors were solid-pseudopapillary tumors (n=3), congenital pancreatic cysts (n=3), pancreatoblastoma (n=1), rhabdomyosarcoma (n=1), and an undifferentiated carcinoma (n=1). In addition, 8 patients were treated surgically (through tumor excision, central pancreatectomy + distal pancreaticojejunostomy, distal pancreatectomy, and cystogastrostomy). Two deaths from tumor dissemination were recorded. The patients were followed-up at a mean duration of 72 months (range: 6-120 months). Conclusion: Pediatric pancreatic tumors arc rare and are usually benign in nature. They present symptoms that are often nonspecific. In non-metastatic cases, surgical tumor removal is the preferred method for the treatment. For most tumors, surgical resection is the optimal treatment that may be successfully performed with low morbidity rate when the lesion is either in the body or in the tail of the pancreas. The long-term outcomes with this approach are generally good.Item A Rare Case of Burkitt Lymphoma in a 13-year-girl(2021) Yilmaz, Busra; Somay, Efsun; Hasbay, Bermal; orcid.org/0000-0003-0633-5648; orcid.org/0000-0001-8251-6913Burkitt lymphoma is rare Non-Hodgkin's lymphoma type in childhood. The differential diagnosis includes dental infection and osteomyelitis. Therefore, patients often refer to the dentist first. Early diagnosis has great importance on prognosis. We aimed to broaden the perspective of dentists about this disease and confirm the diagnosis radiographically and clinically.