Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item A Case of Brain and Leptomeningeal Metastases from Urothelial Carcinoma of The Bladder(2014) Erhamamci, S.; Reyhan, M.; Altinkaya, N.; https://orcid.org/0000-0001-8550-3368; https://orcid.org/0000-0003-1348-8167; 25043771; AAJ-5242-2021; AAM-5169-2021Brain metastases are unusual from urethelial carcinoma of bladder and particularly the occurrence of leptomeningeal metastases is extremely rare, with few cases described in the literature. We present a case of a 45-year-old man with a rare brain metastases as the first metastatic manifestation secondary to urethelial carcinoma of bladder followed by leptomeningeal metastases without any other organ involvement. Eleven months after the diagnosis of high-grade urethelial carcinoma of bladder (T2N0M0), the patient was detected having brain metastases by MRI. FDG PET/CT images for the metastatic evaluation showed no abnormal FDG uptake elsewhere in the body except the brain. Histopathology examination from brain lesion demonstrated the cerebral lesion to be a metastatic urothelial carcinoma. Two months later, the patient was diagnosed to have leptomeningeal metastases by MRI. Our patient's condition gradually worsened, and he died 3 months after the diagnosis of leptomeningeal metastases. (C) 2013 Elsevier Espana, S.L.U. and SEMNIM. All rights reserved.Item Incidental Diagnosis of Tumor Thrombosis on FDG PET/CT Imaging(2015) Erhamamci, S.; Reyhan, M.; Nursal, G. N.; Torun, N.; Yapar, A. F.; 0000-0003-1715-4180; 0000-0002-5597-676X; 0000-0002-5302-4386; 0000-0001-8550-3368; 26025479; AAI-8973-2021; AAE-2718-2021; R-3735-2016; AAJ-5242-2021Objective: Clinical data are presented on patients with tumor thrombosis (TT) incidentally detected on FDG PET/CT imaging, as well as determining its prevalence and metabolic characteristics. Materials and methods: Out of 12,500 consecutive PET/CT examinations of patients with malignancy, the PET/CT images of 15 patients with TT as an incidental finding were retrospectively investigated. A visual and semiquantitative analyses was performed on the PET/CT scans. An evaluation was made of the pattern of FDG uptake in the involved vessel as linear or focal via visual analyses. For the semiquantitative analyses, the metabolic activity was measured using SUVmax by drawing the region of interest at the site of the thrombosis and tumor (if any). Results: The prevalence of occult TT was 0.12%. A total of 15 patients had various malignancies including renal (1 patient), liver (4), pancreas (2), stomach (1), colon (1), non-Hodgkin lymphoma (1), leiomyosarcoma (1), endometrial (1), ovarian (1), malign melanoma (1) and parotid (1). Nineteen vessels with TT were identified in 15 patients; three patients had more than one vessel. Various vessels were affected; the most common was the inferior vena cava (n = 7) followed by the portal (n = 5), renal (n = 3), splenic (n = 1), jugular (n = 1), common iliac (n = 1) and ovarian vein (n = 1). The FDG uptake pattern was linear in 12 and focal in 3 patients. The mean SUVmax values in the TT and primary tumors were 8.40 +/- 4.56 and 13.77 +/- 6.80, respectively. Conclusion: occult TT from various malignancies and locations was found incidentally in 0.12% of patients. Interesting cases with malign melanoma and parotid carcinoma and with TT in ovarian vein were first described by FDG PET/CT. Based on the linear FDG uptake pattern and high SUVmax value, PET/CT may accurately detect occult TT, help with the assessment of treatment response, contribute to correct tumor staging, and provide additional information on the survival rates of oncology patients. (C) 2015 Elsevier Espana, S.L.U. and SEMNIM. All rights reserved.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 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-8973-2021Breast 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.Item A Rare Case of Primary Cardiac Diffuse Large B-cell Lymphoma Imaged with F-18-FDG PET/CT(2022) Erhamamci, Seval; Aslan, Nesrin; 35771036Primary cardiac lymphoma is an extremely rare malignancy. A few reports about the findings of (18)fluorine-fluorodeoxyglucose (F-1(8)-FDG) positron emission tomography/computed tomography (PET/CT) imaging has been presented. We report a rare case of a 70-year-old male with diagnosed primary intracardiac diffuse large B-cell lymphoma referred for F-18-FDG PET/CT imaging for initial staging. The scan revealed an abnormal hypermetabolic gross tumoral lesion involving the right atrium and auricula. After completing three cycles of chemotherapy, post-treatment F-18-FDG PET/CT showed complete response.Item The Promise of Metastasis-Directed Therapy for Oligometastatic Prostate Cancer: Going Beneath the Surface with Molecular Imaging(2022) Sutera, Philip; Phillips, Ryan M.; Deek, Matthew; Ozyigit, Gokhan; Onal, Cem; Tran, Phuoc T.; 35058322Item Comparative Findings Between Ga-68-PSMA and F-18-FDG PET/CT for Hepatocellular Carcinoma(2020) Erhamamci, Seval; Aslan, Nesrin; 0000-0001-5016-4650; 33094578We have reported here the case of a 69-year-old man who presented with spinal cord compression due to bone metastases as the first manifestation of hepatocellular carcinoma (HCC). For the initial staging, the patient underwent F-18-fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) imaging, which demonstrated mild F-18-FDG uptake in the multiple expansile osteolytic bone lesions, but no remarkable atypical F-18-FDG uptake in the liver lesion on low-doses CT. An additional PET/CT scan was performed to evaluate the prostate-specific membrane antigen (PSMA) expression, which has recently been reported to be a potential biological marker in a variety of tumors including HCC. High PSMA uptake was recorded in both the metastatic bone lesions and the primary liver lesion/tumor by the Ga-68-PSMA PET/CT.Item Local control and vertebral compression fractures following stereotactic body radiotherapy for spine metastases(2019) Ozdemir, Yurday; Torun, Nese; Guler, Ozan Cem; Yildirim, Berna Akkus; Besen, Ali A.; Yetisken, Aylin Gunesli; Onal, H. Cem; Topkan, Erkan; 0000-0002-2742-9021; 0000-0001-6908-3412; 0000-0002-2742-9021; 30815342; D-5195-2014; AAC-5654-2020Purpose: We aimed to retrospectively assess the incidence of vertebral compression fractures (VCF), examine clinicopathologic factors potentially associated with VCF, and evaluate treatment response in patients who received stereotactic body radiotherapy (SBRT) for spine metastases (spMets). Methods and Materials: We identified 78 patients with 125 spMets at baseline and subsequent assessments. Patients received SBRT doses of 16 or 18 Gy. Patients with pre-existing VCF and co-existing local progression were excluded. Spine instability neoplastic score (SINS) was used for spMets categorization. Response to SBRT and VCF were assessed according to the Positron Emission tomography Response Criteria In Solid Tumors (PERCIST) and Genant scores, respectively. Kaplan-Meier analyses were used to assess local control of disease and vertebral compression fracture-free survival (FFS). Results: We treated 103 cases with single spMets and 11 cases involving double spMets with SBRT. Progressive disease was reported in 3.2% and 8.2% of the cases in the first and last PET/CT reports, respectively. The distribution of treatment response in the remaining patients was: complete response in 30.6% of patients, partial response in 47.1% of patients, and stable disease in 22.3% of patients in the first PET/CT; complete response in 62.3% of patients, partial response in 16.7% of patients, and stable disease in 21% of patients at the last monitoring. Local failures were observed in 15 (12%) of cases. Median SINS was 5 (range: 1 - 13); majority of patients in our cohort (70.4%) were categorized as stable according to SINS, five (4%) patients had Grade 3 VCF at a median time of 16 months after SBRT (range: 2 - 22 months), and 60% of VCF occurred after an interval of at least 12 months after SBRT. No bisphosphonate usage was significantly associated with VCF (r = -0.204; p = 0.022). Median FFS was 21 months. Univariate analyses indicated that female gender (p < 0.001), bisphosphonate use (p = 0.005), >6 months of bisphosphonates use (p = 0.002), and the lowest vertebral body collapse score (p = 0.023) were associated with higher FFS. Female gender (p = 0.007), >6 months of bisphosphonates usage (p = 0.018), and the lowest vertebral body collapse score (p = 0.044) retained independent significance. Conclusions: This study demonstrated that spine SBRT with doses of 16-18 Gy promises good local control of disease with acceptable VCF rates. Lowest vertebral body collapse score, female gender, and >6 months of bisphosphonate use were significantly associated with longer FFS.