Serap Akbay

Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Engüri, Ankara, Turkey

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Publications (8)8.52 Total impact

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    ABSTRACT: Purpose The purpose of this multicenter case–control study was to compare the demographic and clinical characteristics of patients with mucinous adenocarcinoma of the endometrium (MAE) and endometrioid endometrial carcinoma (EEC). Methods A retrospective review of two cancer registry databases in Turkey was conducted to identify patients diagnosed with MAE between January 1996 and December 2012. Each patient was matched with a control EEC patient by age and tumor grade. Cases and controls were compared in terms of known risk factors for lymph node metastasis, disease-free survival (DFS), and overall survival (OS). Results The analysis included 112 patients with MAE and 112 with EEC. No significant difference in baseline characteristics was evident between the two groups. Lymphovascular space invasion, deep myometrial invasion, cervical involvement, and tumor diameter did not differ significantly between the mucinous and endometrioid cases. Multivariate analysis confirmed that only mucinous histology (OR 2.2, 95 % CI 1.1–4.5; P = 0.02) was an independent predictor of lymph node involvement. Although the median DFS and OS tended to be better in the endometrioid group, the differences were not statistically significant. Routine appendectomy was performed in 52 (46.2 %) patients with MAE. No mucinous tumor of the appendix was identified. Conclusion Routine appendectomy is not necessary when the appendix is grossly normal at the time of surgery for MAE. Although the DFS and OS of EEC and MAE patients were similar, the risk of nodal metastasis in MAE patients was greater than that in ECC patients, and we thus suggest to perform retroperitoneal lymphadenectomy (both pelvic and para-aortic) for patients with MAE during the initial operation.
    International Journal of Clinical Oncology 11/2014; DOI:10.1007/s10147-014-0767-2 · 2.17 Impact Factor
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    ABSTRACT: Background: To evaluate the clinical significance of atypical squamous cells of undetermined significance (ASCUS) in PAP test in post-menopausal women and compare with reproductive age women. Materials and Methods: A total of 367 patients who referred to our gynecologic oncology clinic were included to the study between September 2012 and August 2013. Data for 164 post-menopausal (group 1) and 203 pre-menopausal (group 2) women with ASCUS cytology were evaluated retrospectively. Immediate colposcopy and endocervical curettage was performed for both groups and conization for all women with a result suggestive of CIN2-3. Histopathological results and demographic features of patients were compared between the two groups. Results: Mean age of the patients was 54.6 +/- 6.5 years in group 1 and 38 +/- 6.6 years in group 2. Some 14 (8.5%) of post-menopausal women and 36 (17.7%) of pre-menopausal women were current smokers (p=011). Totals of 38 (23.2%) post-menopausal and 64 (31.5%) pre-menopausal women were assessed for HPV-DNA. High risk HPV was detected in 7 (4.3%) and 21 (10.3%), respectively (p=0.029). Final histopathological results recorded were normal cervix, low grade cervical intra-epithelial neoplasia (CIN 1), and high grade cervical intra-epithelial neoplasia (CIN2-3). In group 1 results were 84.8%, 12.2% and 1.8%, respectively, and in group 2 were 71.9%, 23.2% and 4.9%. There were no cases of micro invasive or invasive cervical carcinoma in either group. Two cases were detected as endometrial carcinoma in the menopausal group (1.2%). Conclusions: In current study we found that preinvasive lesions were statistically significantly higher in pre-menopausal women than postmenopausal women with ASCUS. Cervicitis was more common in menopausal women. Therefore, we think that in case of ASCUS in a post-menopausal woman there is no need for radical management.
    Asian Pacific journal of cancer prevention: APJCP 08/2014; 15(16):6639-41. DOI:10.7314/APJCP.2014.15.16.6639 · 2.51 Impact Factor
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    ABSTRACT: Uterine leiomyosarcoma is an aggressive malignancy. Spread to the lung, thyroid, liver, brain, pancreas, heart, duodenum, breast, vagina, submandibular gland, and bone has been reported. We describe a case of metastatic uterine leiomyosarcoma to the rectus abdominalis muscle as the first case in the literature. A 39-year-old nulligravid woman presented with a history of pelvic pain. Physical examination discovered about a 6-cm mass in the suprapubic region. She had previously undergone a hysterectomy for uterine leiomyosarcoma. Operative findings had revealed a mass measuring 4×5×6 cm located in the rectus abdominalis muscle. Abnormal mitotic figures and necrosis were evident, and uterine leiomyosarcoma was diagnosed. Uterine leiomyosarcomas are malignancies of the smooth muscle arising from the myometrium. Skeletal muscle is an uncommon site of metastasis by hematogenous spread. In conclusion, we have described a case of skeletal muscle metastasis (first case of rectus abdominalis muscle metastasis) secondary to uterine leiomyosarcoma.
    Journal of the Turkish German Gynecology Association 06/2014; 15(2):122-4. DOI:10.5152/jtgga.2014.53533
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    Murat ÖZ · Emre ÖZGÜ · Tayfun Güngör · Serap Akbay
    Turkiye Klinikleri Jinekoloji Obstetrik 12/2013; 2014(3):191-4.
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    ABSTRACT: Cervical cancer during pregnancy has an incidence of about 1 to 10 in 10.000 individuals and is one of the most common malignancies occurring during pregnancy. In this report, we aimed to evaluate a pregnant women with cervical cancer underwent radical hysterectomy and pelvic and paraaortic lymphadenectomy at our clinic. A 47 years of pregnant woman (G8, P7) with an intrauterine pregnancy of 4 weeks 6 days of gestation admitted to our high risk pregnancy department with vaginal bleeding complaint. On vaginal examination, we detected a 4 cm of lesion protruding from the cervix. Biopsy of the lesion was proved as microinvasive squamous carcinoma of the cervix. Subsequently radical hysterectomy and pelvic and paraaortic lymphadenectomy was performed. Postoperative pathology was large cell keratinizing squamous cell carcinoma of the cervix. In conclusion, although its rarity, clinicians should suspect of cervical cancer in a pregnant woman complaining of vaginal bleeding.
    Journal of Experimental Therapeutics and Oncology 01/2013; 10(3):235-6.
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    ABSTRACT: Although the majority of metastatic ovarian tumors arise within the female genital tract, squamous cell carcinoma of the cervix is a rare form of metastases to the bilateral ovaries by endometrial and transtubal spreading. A 53-year-old woman was referred to the oncology clinic with postmenopausal bleeding. On vaginal examination, a 3 cm tumor arising from the cervix was inspected. Multiple cervical biopsies and endocervical curettage revealed large cell, non-keratinized squamous cell cervix carcinoma. Radical hysterectomy and bilateral salpingo-oophorectomy were performed. Bilateral pelvic and para-aortic lymph nodes were also removed. The final pathology report revealed endometrial, focal myometrial, bilateral tubal mucosal, fimbrial and bilateral ovarian squamous cell carcinoma involvement. Pelvic and para-aortic nodes were free from metastases. Although the incidence of ovarian metastases of adenocarcinoma of the cervix is significantly higher, squamous cell carcinoma may also metastasize to the ovaries by endometrial and transtubal spreading in the absence of lymph node involvement. Especially in young patients for whom preservation of the ovaries is supposed, gross intraoperative inspection of the radical hysterectomy specimen and endometrium should be done and ovaries should be evaluated carefully.
    Archives of Gynecology 02/2011; 283(2):323-7. DOI:10.1007/s00404-010-1672-1 · 1.28 Impact Factor
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    ABSTRACT: Cystic tumors of ovary, whether benign, borderline, or malignant may be associated with mural nodule of various types, including sarcomas, sarcoma-like mural nodules (SLMN), and foci of anaplastic carcinoma. Cases of serous borderline ovarian tumor with mural nodules of mixed type are very rare. A 54-year-old woman referred with abdominal swelling. Imaging studies revealed a huge mass localized in pelvis and lower abdomen and grade 1-2 left renal hydronephrosis. Preoperative Ca-125 was 798 U/ml. In exploratory laparotomy there was a 16 cm mass adherent to lateral abdominal wall and intestines. Adhesiolysis and de-bulking surgery were performed including bilateral pelvic, para-aortic lymphadenectomy, appendectomy and omentectomy. Left ureter was found to be dilated because of the infiltration of distal part by the tumor, so distal ureteral resection and neoureterocystostomy were performed. Final pathology revealed borderline serous ovarian tumor with mural nodules which were consisted of SLMNs, multiple and sharply demarcated from the adjacent tumor, and sarcomatous nodules showing infiltrative appearance in metastatic regions. Mural nodules showed a positive reaction for vimentin and SMA but were negative for cytokeratin and also necrosis, hemorrhage, and 10-15 mitoses in 10 high power fields were noted. She had postoperative chemotherapy and follow-up is going on without metastases in her first year. The existence of sarcomatous nodules combined with the SLMN necessitates a careful histologic analysis for treatment and the determination of prognosis. However, too few cases of mixed type mural nodules have been published to warrant a conclusion regarding their prognosis.
    Archives of Gynecology 08/2009; 281(3):485-90. DOI:10.1007/s00404-009-1180-3 · 1.28 Impact Factor
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    ABSTRACT: Primary ovarian ectopic pregnancy occurs quite rarely. Primary ovarian ectopic pregnancies usually occur in young, highly fertile, multiparous women using IUD. Two cases, we presented were middle aged, infertility and did not use IUD. The treatment of choice for ovarian pregnancy is usually ovarian wedge resection or oophorectomy, also there is a place for medical treatment of carefully selected patients. In this report, we aimed to present the laparoscopic conservative treatment of spontaneous ovarian ectopic pregnancy in two patients who had primary infertility.
    Archives of Gynecology 12/2008; 280(1):123-5. DOI:10.1007/s00404-008-0832-z · 1.28 Impact Factor