Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item MRI Findings of Lumbosacral Metastasis from Occult Follicular Thyroid Cancer: Report of A Case(2014) Coban, Gokcen; Yildirim, Erkan; Gemici, Kazim; Erinanc, Hilal; https://orcid.org/0000-0002-9057-722X; https://orcid.org/0000-0003-1401-6356; 23129029; P-7533-2014; ABI-3856-2020; AAL-1268-2021A 63-year-old female was admitted to our hospital with bowel and bladder incontinence. Magnetic resonance imaging (MRI) showed a 13 x 12 x 12 cm mass invading the posterior regions of the L4, L5, S1 and S2 vertebrae with broad paravertebral soft tissue invasion. A Tru-cut biopsy of the mass was performed. The histopathological examination revealed metastatic follicular carcinoma of the thyroid. Thyroid functional tests were within the normal limits. Thyroid sonography revealed a heterogeneous, ill-defined, 14 x 9 mm hypoechoic solid nodule in the right lobe of the thyroid gland. On thyroid scintigraphy, an area of focal hyperactivity was detected in the right lobe at the nodule localization. Total thyroidectomy was performed, and the primary tumor pathology was determined to be follicular thyroid cancer. To our knowledge, only a few cases of lumbosacral cord compression as the initial manifestation of follicular thyroid carcinoma have been reported in the literature. We aimed to discuss the MRI findings of tumors in this age group with lumbosacral localization.Item Lung Metastasis of Fatty Hepatocellular Carcinoma After Liver Transplant: A Case Report(2014) Tepeoglu, Merih; Ozdemir, B. Handan; Atilgan, Alev Ok; Akdur, Aydincan; Haberal, Mehmet; https://orcid.org/0000-0002-9894-8005; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0001-8595-8880; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0002-3462-7632; 24635803; AAK-5222-2021; X-8540-2019; AAK-3333-2021; AAA-3068-2021; AAJ-8097-2021Hepatocellular carcinoma with prominent fatty change is rare, and to date only a few cases have been reported. In this article, we present a 57-year-old woman who underwent a liver transplant for hepatocellular carcinoma. Ten months after liver transplant, she presented with a persistent cough. Computed tomography of the chest was performed, revealing a solid lung mass that measured 1 Chi 0.9 cm in the right inferior lobe. Right inferior lobectomy was performed, and the final diagnosis was noted as hepatocellular carcinoma with prominent fatty change. Fatty change was extensive in the tumor; therefore, lipoid pneumonia was the first condition that was considered in the differential diagnosis during examination of the lobectomy material. For the differential diagnosis, the immunohistochemistry panel was studied to show the hepatocellular nature of the tumor. Although metastasis of hepatocellular carcinoma to the lungs is expected, hepatocellular carcinoma with prominent fatty change can cause diagnostic difficulties, such as lipoid pneumonia, especially in small lung biopsies.Item Metachronous Prostate Metastasis of Renal Cell Carcinoma: Case Report and Review of the Literature(2016) Guler, Ozan Cem; Bal, Nebil; Onal, Cem; https://orcid.org/0000-0001-6908-3412; https://orcid.org/0000-0002-2742-9021; 26739102; AAC-5654-2020; HOC-5611-2023Secondary tumors of the prostate are very rare, and only a few reports of prostate metastasis originating from renal cell carcinoma (RCC) have been published. The reported 5-year survival rate has been approximately 35% for patients who underwent nephrectomy and surgical resection of a solitary metastasis. Immunohistochemical analysis showed that CD10 and vimentin positivity were helpful for distinguishing clear cell RCC from other renal tumors. We report a case with delayed metachronous metastasis of RCC to the prostate, which clinically mimicked benign prostatic hyperplasia or prostate cancer, treated with transurethral resection and palliative radiotherapy. (C) 2016 Elsevier Inc. All rights reserved.Item Risk Factors for Lymph Node Metastasis among Lymphovascular Space Invasion-Positive Women with Endometrioid Endometrial Cancer Clinically Confined to the Uterus(2018) Sari, Mustafa Erkan; Meydanli, Mehmet Mutlu; Yalcin, Ibrahim; Sahin, Hanifi; Coban, Gonca; Celik, Husnu; Kuscu, Esra; Gungor, Tayfun; Ayhan, Ali; 0000-0002-3285-5519; 0000-0002-0992-6980; 30419557; AAD-8494-2019; AAI-9974-2021; AAL-1923-2021; AAI-8792-2021; AAJ-5802-2021Introduction: We aimed to assess risk factors for lymph node (LN) metastasis among lymphovascular space invasion(LVSI)-positive women with pure endometrioid endometrial cancer (EC) clinically confined to the uterus. Methods: Medical records of women who underwent primary surgery for EC between 2007 and 2016 at either of 2 gynecological oncology centers were retrospectively reviewed. Patient data were analyzed with respect to LN involvement, and predictive factors for LN metastasis were investigated. Results: 280 patients with surgically staged endometrioid-type EC with LVSI were identified. LN involvement was detected in 88 patients (31.4%) with a systematic LN dissection. In multivariate analysis, elevated baseline serum CA 125 levels, deep myometrial invasion (MMI), adnexal involvement and positive peritoneal cytology were found to be independent risk factors for LN metastasis. In women without deep MMI and elevated baseline serum CA 125 levels, the rate of LN metastasis was 19%. The presence of solely deep MMI increased this probability up to 29.1%. The rate of LN metastasis was found to be 46.8% for women with both deep MMI and elevated baseline serum CA 125 levels. Conclusion: These findings may be useful in the decision- making process for LVSI-positive women who are unstaged. (c) 2018 S. Karger GmbH, FreiburgItem Spinal anesthesia in surgical treatment of lumbar spine tumors(2020) Ogrenc, Ahmet; Akar, Ezgi; Koban, Orkun; Isik, Semra; Sener, Mesut; Yilmaz, Mesut; Dalbayrak, Sedat; 32619901Objective: This study aims to show the feasibility of spinal anesthesia in lumbar spinal tumor surgery; share our data and experience. Patients and methods: : A retrospective review of 14 patients with high risk for general anesthesia due to severe comorbidities was carried out. Patients who underwent surgeries under spinal anesthesia for lumbar vertebral column or spinal cord tumors at a single center between 2007-2019 were evaluated. The final pathological diagnosis, operation time, and surgical procedures were analyzed. Also, preoperative and postoperative ad-vantages and disadvantages were determined. A comparison was performed with other 184 patients who were operated for spinal tumors in the same period under general anesthesia. Results: Maximum operation time was found 220 min, and the average operation time was 166 min. The most primary diagnosis was vertebral column metastasis. The mean age was 65.5 years. None of the patients required general anesthesia during surgery; however, two patients needed additional spinal anesthesia preoperatively, which was performed by the surgeon. Lumbar decompression and fusion were the most performed procedures. Conclusion: Spinal anesthesia is a feasible and useful method of anesthesia in lumbar spinal tumor surgery for especially elderly patients with American Society of Anesthesiologists (ASA) 3 or 4 score and high risk of general anesthesia.Item Para-aortic lymph node involvement revisited in the light of the revised 2018 FIGO staging system for cervical cancer(2019) Ayhan, Ali; Aslan, Koray; Oz, Murat; Tohma, Yusuf Aytac; Kuscu, Esra; Meydanli, Mehmet Mutlu; 0000-0001-9418-4733; 31263988Objective This dual-institutional, retrospective study aimed to determine the clinicopathological risk factors for para-aortic lymph node (LN) metastasis among women who underwent radical hysterectomy with systematic pelvic and para-aortic lymphadenectomy for 2009 FIGO stage IB1-IIA2 cervical cancer. Methods Institutional cervical cancer databases of two high-volume gynecologic cancer centers in Ankara, Turkey were retrospectively analyzed. Women with 2009 FIGO stage IB1-IIA2 cervical cancer that had undergone radical hysterectomy with pelvic and para-aortic lymphadenectomy between January 2006 and December 2018 were included in the study. Patient data were analyzed with respect to para-aortic LN involvement and all potential clinicopathological risk factors for para-aortic LN metastasis were investigated. Results A total of 522 women met the inclusion criteria. Pelvic LN metastasis was detected in 190 patients (36.4%), para-aortic LN metastasis in 48 patients (9.2%), isolated para-aortic LN metastasis in 4 (0.8%), and both pelvic and para-aortic LN metastasis in 44 (8.4%) women, respectively. The independent risk factors identified for para-aortic LN involvement included parametrial invasion (odds ratio [OR]: 3.57, 95% confidence interval [CI]: 1.65-7.72; p = 0.001), metastasized pelvic LN size > 1 cm (OR: 4.51, 95% CI: 1.75-11.64; p = 0.002), multiple pelvic LN metastases (OR: 3.83, 95% CI: 1.46-10.01; p = 0.006), and common iliac LN metastasis (OR: 2.97, 95% CI: 1.01-8.68; p = 0.04). A total of 196 (37.5%) patients exhibited at least one risk factor for para-aortic nodal disease. Conclusion Parametrial invasion, metastasized pelvic LN size > 1 cm, multiple pelvic LN metastases, and common iliac LN metastasis seem to be independent predictors of para-aortic LN involvement.Item Outcome of loco-regional radiotherapy in metastatic castration-resistant prostate cancer patients treated with abiraterone acetate(2019) Yildirim, Berna Akkus; Onal, Cem; Kose, Fatih; Oymak, Ezgi; Sedef, Ali Murat; Besen, Ali Ayberk; Aksoy, Sercan; Guler, Ozan Cem; Sumbul, Ahmet Taner; Mualloglu, Sadik; Mertsoylu, Huseyin; Ozyigit, Gokhan; 30701292Purpose To evaluate the potential benefit of curative radiotherapy (RT) to the primary tumor in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone. Materials and methods The clinical parameters of 106 mCRPC patients treated with abiraterone were retrospectively evaluated. Patients were either oligometastatic (<= 5 metastases) at diagnosis or became oligometastatic after the systemic treatment was analyzed. Local RT to the primary tumor and pelvic lymphatics was delivered in 44 patients (41%), and 62 patients (59%) did not have RT to the primary tumor. After propensity match analysis, a total of 92 patients were analyzed. Resultsn Median follow-up time was 14.2 months (range: 2.3-54.9 months). Median overall survival (OS) was higher in patients treated with local RT to the primary tumor than in those treated without local RT with borderline significance (24.1 vs. 21.4 months; p=0.08). Local RT to the prostate and pelvic lymphatics significantly diminished the local recurrence rate (16 patients, 31% vs. 2 patients, 5%; p=0.003). In multivariate analysis, the prostate specific antigen (PSA) response >= 50% of the baseline obtained 3 weeks after abiraterone therapy was the only significant prognostic factor for better OS and progression-free survival (PFS). Patients treated with primary RT to the prostate had significantly less progression under abiraterone and a longer abiraterone period than those treated without local prostate RT. Conclusions Local prostate RT significantly improved OS and local control in mCRPC patients treated with abiraterone. The patients treated with primary RT had significantly less progression under abiraterone and a longer abiraterone period than those treated without local prostate RT.Item Isolated jejunal metastasis in a patient with cervical cancer: A case report(2015) Onal, Cem; Nursal, Gul Nihal; Torer, Nurkan; Kayaselcuk, Fazilet; 25949229Background: 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.Item An Unusual Gastrointestinal Stromal Tumor Presentain: Breast, Liver and Lymph Node Metastasis(2017) Hasbay, Bermal; Aytac, Huseyin Ozgur; Kayaselcuk, Fazilet; Torun, Nese; 000-0002-1180-3840; 0000-0002-5597-676X; 29082381; AAE-2550-2021; AAE-2718-2021Gastrointestinal Stromal Tumors (GIST) are the common mesenchymal tumors of gastrointestinal tract. They can display benign and malignant clinical behavior. The most common metastasis sites of malignant stromal tumor are liver, peritoneum, lung and bones. Metastasis to breast is extremely rare. Here, we present a case of GIST with liver, bone, lymph node and breast metastasis by reviewing the literature.Item Comparison of three different risk-stratification models for predicting lymph node involvement in endometrioid endometrial cancer clinically confined to the uterus(2017) Haberal, Ali; Kocaman, Eda; Dursun, Polat; Ayhan, Ali; Korkmaz, Vakkas; Meydanli, Mehmet Mutlu; Yalcin, Ibrahim; Sari, Mustafa Erkan; Sahin, Hanifi; Gungor, Tayfun; 0000-0002-1741-7035; 0000-0002-1486-7209; 0000-0002-7869-9662; 29027396; AAI-9331-2021; AAJ-5802-2021Objective: To compare the clinical validity of the Gynecologic Oncology Group-99 (GOG-99), the Mayo-modified and the European Society for Medical Oncology (ESMO)-modified criteria for predicting lymph node (LN) involvement in women with endometrioid endometrial cancer (EC) clinically confined to the uterus. Methods: A total of 625 consecutive women who underwent comprehensive surgical staging for endometrioid EC clinically confined to the uterus were divided into low- and high-risk groups according to the GOG-99, the Mayo-modified, and the ESMO-modified criteria. Lymphovascular space invasion is the cornerstone of risk stratification according to the ESMO-modified criteria. These 3 risk stratification models were compared in terms of predicting LN positivity. Results: Systematic LN dissection was achieved in all patients included in the study. LN involvement was detected in 70 (11.2%) patients. LN involvement was correctly estimated in 51 of 70 LN-positive patients according to the GOG-99 criteria (positive likelihood ratio [LR+], 3.3; negative likelihood ratio [LR-], 0.4), 64 of 70 LN-positive patients according to the ESMO-modified criteria (LR+, 2.5; LR-, 0.13) and 69 of the 70 LN-positive patients according to the Mayo-modified criteria (LR+, 2.2; LR-, 0.03). The area under curve of the Mayo-modified, the GOG-99 and the ESMO-modified criteria was 0.763, 0.753, and 0.780, respectively. Conclusion: The ESMO-modified classification seems to be the risk-stratification model that most accurately predicts LN involvement in endometrioid EC clinically confined to the uterus. However, the Mayo-modified classification may be an alternative model to achieve a precise balance between the desire to prevent over-treatment and the ability to diagnose LN involvement.