-
[show abstract]
[hide abstract]
ABSTRACT: Warthin-like tumor of the thyroid is a recently described rare variant of thyroid papillary carcinoma. The distinguishing histological feature of this variant is papillary foldings lined by oncocytic neoplastic cells with clear nuclei and nuclear pseudoinclusions, accompanied by prominent lymphocytic infiltrate in the papillary stalks. Its prognosis has been reported to be almost similar to conventional papillary carcinoma. In this case series, we report four cases with Warthin-like papillary carcinoma of the thyroid, diagnosed at Dokuz Eylul University Faculty of Medicine Department of Pathology in 2008 and 2009. Three patients were female. The mean patient age was 39 years (range, 20-56) and the mean tumor size was 1.7 cm (range, 0.9-2.0 cm). All of the cases had lymphocytic thyroiditis in the background. None of the tumors showed lymphovascular invasion. The patients are free of any recurrence and/or distant metastasis with a mean follow-up of 25 months. This rare variant of thyroid papillary carcinoma with distinct histopathological features should be indicated in pathology reports. Further studies and long-term follow-up of patients are needed to highlight the biological behavior of this variant.
Turk Patoloji Dergisi 01/2013; 29(2):150-155.
-
[show abstract]
[hide abstract]
ABSTRACT: Background: The aim of the study was to evaluate the available breast nomograms (MSKCC, Stanford, Tenon) to predict non-sentinel lymph node metastasis (NSLNM) and to determine variables for NSLNM in SLN positive breast cancer patients in our population. Materials and Methods: We retrospectively reviewed 170 patients who underwent completion axillary lymph node dissection between Jul 2008 and Aug 2010 in our hospital. We validated three nomograms (MSKCC, Stanford, Tenon). The likelihood of having positive NSLNM based on various factors was evaluated by use of univariate analysis. Stepwise multivariate analysis was applied to estimate a predictive model for NSLNM. Four factors were found to contribute significantly to the logistic regression model, allowing design of a new formula to predict non-sentinel lymph node metastasis. The AUCs of the ROCs were used to describe the performance of the diagnostic value of MSKCC, Stanford, Tenon nomograms and our new nomogram. Results: After stepwise multiple logistic regression analysis, multifocality, proportion of positive SLN to total SLN, LVI, SLN extracapsular extention were found to be statistically significant. AUC results were MSKCC: 0.713/Tenon: 0.671/Stanford: 0.534/DEU: 0.814. Conclusions: The MSKCC nomogram proved to be a good discriminator of NSLN metastasis in SLN positive BC patients for our population. Stanford and Tenon nomograms were not as predictive of NSLN metastasis. Our newly created formula was the best prediction tool for discriminate of NSLN metastasis in SLN positive BC patients for our population. We recommend that nomograms be validated before use in specific populations, and more than one validated nomogram may be used together while consulting patients.
Asian Pacific journal of cancer prevention: APJCP 01/2012; 13(12):6181-5. · 0.66 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: In routine practice, axillary lymph node dissection is performed in early invasive breast cancer patients with positive sentinel node biopsy. However, sentinel node is the only involved axillary node in 40-70% of patients, and determining factors that predict axillary non-sentinel node involvement will therefore prevent unnecessary axillary lymph node dissection and decrease morbidity.
In this study, 119 invasive breast cancer patients with sentinel node metastasis who underwent axillary lymph node dissection between 1998-2009 at our institution were studied. Primary tumor characteristics and features of the metastatic tumors in sentinel nodes, such as microanatomic location, size of metastasis, and the ratio of metastatic tumor area to the total sentinel node area were evaluated. Student's t-test and multivariate logistic regression were used for statistical analysis.
The mean age of the patients was 50.7 years (28-80). Forty-three patients (36%) had invasive ductal and 25 patients (21%) had invasive lobular carcinoma. Most of the patients had either pT1 (44%) or pT2 (54%) tumors. Fifty-four patients (45%) had no further positive nodes in the axilla. The metastatic deposits in the sentinel node were subcapsular in 16 patients (13%). The percent area of sentinel node occupied by tumor (p < 0.001), number of sentinel nodes (p=0.041), and microanatomic location of metastatic tumor (p=0.002) were significantly associated with non-sentinel node metastasis in univariate analysis. The percent area of sentinel node occupied by tumor (p < 0.001) and number of sentinel nodes (p=0.033) remained significantly associated with non-sentinel node involvement in multivariate analysis.
In patients with invasive breast cancer and positive sentinel node, area percent of sentinel node occupied by tumor, and the number of sentinel nodes removed are independently predictive of non-sentinel node involvement.
Turk Patoloji Dergisi 01/2011; 27(3):189-95.
-
[show abstract]
[hide abstract]
ABSTRACT: Ectopic thyroid gland with no orthotopic thyroid tissue is extremely rare. The authors present a case of a follicular variant of papillary carcinoma developed from an ectopic thyroid gland with no orthotopic thyroid tissue.
American journal of surgery 07/2010; 200(1):e17-8. · 2.36 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Solitary fibrous tumor is an uncommon neoplasm. We present a case of solitary fibrous tumor of the perithyroidal soft tissue mimicking a substernal goiter.
American journal of surgery 06/2010; 199(6):e82-3. · 2.36 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Cutaneous metastases from well-differentiated thyroid carcinomas are rare and usually identified in patients with widely disseminated disease. Fine-needle aspiration biopsy (FNAB) has become an acceptable method for the assessment of thyroid nodules. Very rarely needle track dissemination of tumor cells in the thyroid nodule occurs, but, when this occurs, it is evident many years after the FNAB. We report a patient who appears to have tumor dissemination from an FNAB needle track only 4 months after the procedure.
An 85-year-old female presented with a mass on her neck, skin ulceration, and hemorrhage 4 months after FNAB was performed for a thyroid nodule by another physician. A second FNAB with ultrasound guidance yielded cytology diagnostic of papillary thyroid carcinoma. Papillary thyroid carcinoma was confirmed by surgical dissection of the mass, and a linear array of tumor was noted in skin and muscle was performed again, and the cytological diagnosis revealed papillary carcinoma. After surgical resection, the histopathological diagnosis determined the nodules to be papillary carcinoma. Metastatic deposits appeared in the skin and the muscle. The linear array and the site of metastases implied that seeding most probably resulted from the needle biopsy.
Although FNAB is a useful tool for the diagnosis of thyroid nodules, it is important to consider the risk of tumor cell dissemination.
Thyroid: official journal of the American Thyroid Association 12/2009; 20(1):115-7. · 2.60 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We aimed to determine changes in the expression of the genes CDH1, CDH13, CD44, and TIMP3 to look for any relationship between them, HER2 and ESR1 expression at the RNA level, and the histopathological properties of tumors. We also analyzed the expression properties of double-negative (estrogen receptor [ER] and human epidermal growth factor receptor [HER2] both negative) breast tumors. Expression status was studied in fresh tissue at the mRNA level with quantitative PCR using hydrolysis probes. Sixty-two cancer patients and four normal controls were included in the study. When the tumor group was analyzed as a whole, the correlations of ESR1 with CDH1, CDH13, and TIMP3 were P < 0.05, P < 0.005, and P < 0.005, respectively. In ER-positive tumors, CDH1 and CDH13 were correlated directly (P < 0.005) when HER2 was correlated with CDH1, CDH13, and TIMP3 indirectly (P < 0.005, P < 0.005, and P < 0.05, respectively). CDH1 and CD44 had a strong indirect correlation (P < 0.005) in ER-negative tumors. There were significant differences in the expression levels of the CDH13, TIMP3, and CD44 genes (P < 0.005, P < 0.005, and P < 0.05, respectively) between the ER-positive and -negative groups. All four genes were found to be correlated with invasive properties in both ER-positive and -negative tumors. In double-negative tumor samples, only CD44 had a significant and strong correlation with stage, lymph node involvement, and metastasis (P < 0.05, P < 0.005, and P < 0.05, respectively). As a conclusion, a decrease in CDH1, CDH13, and TIMP3 expression levels with an increase in CD44 can be used as an indicator for invasion in both ER-positive and -negative breast tumors. In double-negative tumor tissues, CD44 can be considered a marker for aggressive properties.
Cancer Science 09/2009; 100(12):2341-5. · 3.33 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Although the negative effects of ischemia on anastomotic healing have been shown in many studies, there is no adequate information on the effects of reperfusion injury. Therefore, in this study, we investigated the effect of ischemia-reperfusion (IR) injury on intestinal anastomosis and the protective efficiency of carnitine in an experimental relatively short intestinal ischemia and long duration reperfusion model.
Animals were divided into three groups (n=14). Each group was separated into two subgroups. In subgroups A, morphologic injury and the number of perfused intestinal muscular microvessels were analyzed to show "no-reflow phenomenon." Intestinal resection and anastomosis were performed in subgroups B. Carnitine group (IRCarG) received 200 mg/kg intravenous carnitine 2 min prior to reperfusion. Malonyldialdehyde, nitric oxide levels in tissue and blood, collagen levels, bursting pressures, and histopathologic evaluation of anastomosis were measured in subgroups B.
Morphologic damage was statistically lower, number of perfused microvessels and epithelial regeneration were statistically higher in IRCarG, compared with ischemia-reperfusion group (P=0.03, P=0.008, P=0.05, respectively).
Carnitine application prior to reperfusion may reduce the severity of the reperfusion injury by preventing the occurrence of no-reflow phenomenon, increase the number of perfused microvessels in the ischemic intestine, and may improve epithelial regeneration in intestinal anastomosis.
Journal of Surgical Research 05/2009; 159(1):603-10. · 2.25 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study is to calculate the exposure of surgical staff during radioguided parathyroidectomy. Two parathyroidectomy operations on patients with parathyroid adenoma were selected. Fifty-centimeter spaced circles were drawn surrounding the operation bed on the floor of the operation room. During the operation, radiation dose was measured according to the drawn circles at distances of 50-200 cm from the side of patient's head, bilateral neck and abdomen while the patient lied on the operation bed. All the operations were recorded throughout with a video camera. Three physicians watched all records. The time spent at each distance for every staff during the operation was recorded. Whole body dose to senior surgeon was calculated as 8.78-11.00 microSv which means that a senior surgeon can perform 91-114 procedures per year to reach the annual International Commission on Radiological Protection (ICRP) radiation dose limit for a member of the public. We concluded that radiation risk to the surgical staff is low from radioguided parathyroidectomy.
Archives of Oto-Rhino-Laryngology 07/2008; 265(12):1545-8. · 1.29 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to evaluate the effects of kinesiophobia, quality of life, and home exercise programs on women with upper extremity lymphedema.
A total of 62 women with lymphedema after breast cancer treatments were provided a protocol of complete decongestive therapy (CDT). This protocol involved manual lymphatic drainage (MLD), compression garments, skin care, and remedial exercises. The women were taken to a 12-week therapy program once per day, 3 days per week. A home program, consisting of compression bandage exercises, skin care and walking was recommended. Absolute volume and percentage of volume of the lymphedema were compared before and after treatment. The kinesiophobia, quality of life, and home-based program were assessed before and after physiotherapy.
Strong correlations were found between the severity of edema and fear of movement. There was a significant negative relationship among the fear of movement, quality of life, and home-based exercises program. Mean initial lymphedema volume was 925 ml, and the percentage of lymphedema was 47.1%. After decongestive physiotherapy, the lymphedema volume and percentage were 510 ml and 21.3% (P < 0.05), respectively. There was also a trend toward improvement in general well-being (P < 0.05).
In upper extremity lymphedema, the use of complex physiotherapy programs (CDP) can decrease edema and fear of activity, and increase the quality of life.
Journal of Surgical Oncology 06/2008; 97(7):572-7. · 2.10 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Breast cancer is the most common malignancy in women. However, metastases to the breast from nonmammary malignant neoplasms are rare and were detected at a rate of 0.28% in our series. Clinical and pathologic findings in 5 cases of metastatic tumors (malign mesenchymal tumor, squamous cell carcinoma of the tongue, non-Hodgkin lymphoma, and Sézary syndrome) in the breast are presented and discussed with respect to the literature. Detailed clinical history and a multidisciplinary approach are useful in establishing correct diagnosis and preventing unnecessary radical surgery.
Clinical Breast Cancer 07/2007; 7(8):638-43. · 2.38 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The purpose of this study was to use comparative genomic hybridization (CGH) to screen breast tumors for copy number changes: 22 ductal, 9 lobular, 7 mixed, 2 micropapillary carcinomas, and 2 ductal carcinoma in situ were studied and various regional genomic imbalances were detected. The majority of the aberrations identified in this study were in line with previous CGH findings. The most frequent DNA sequence copy number changes were 1q, 8q, and 20q gains. The frequency of 16q losses was significantly higher in lobular carcinomas. The nodal involvement was 10 times higher in cases showing losses of 13q than in cases having normal peak profile at this region. Estrogen receptor positivity was significantly higher in cases displaying 20q gains and 16q losses. Unambiguous high-level DNA amplifications have also been detected. These mapped to 4q31, 6q21 approximately q22, 8q21 approximately q24, 8p11.2 approximately p12, 11q13, 15q24 approximately qter, 20q13.1 approximately qter, and 20q12 approximately qter chromosomal locations. Our results highlight several chromosomal regions that may be important in the molecular genetics of distinct clinicopathologic breast cancer subgroups.
Cancer Genetics and Cytogenetics 10/2003; 145(2):108-14. · 1.39 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The carcinoma frequency of clinically and radiologically negative pathologic nipple discharges (PNDs) and the optimum management strategy of these cases are still unclear. In this study, the frequency of cancer and the situation of the classic surgical intervention in patients with PND and invisible mammographic and ultrasonographic results are reviewed. The data pertaining to the cases of sub-areolar exploration and major duct excision in a surgery clinic of university hospital from December 2002 to June 2007 have been examined in detail. In 28 cases with PND, which did not have any findings during conventional radiologic examinations, 21% of cases had malignant, and 7% of cases had atypical ductal hyperplasia. The frequency of invasive or in situ carcinoma is not low in clinically and radiologically negative PNDs. Sub-areolar exploration and major duct excision seems to be an appropriate and definitive diagnostic and therapeutic option in this special patient group.
The Breast Journal 15(3):230-5. · 1.64 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Juvenile hypertrophy of the breast (JHB) is an uncommon, benign disorder and typically occurs in peri-pubertal females. The etiology ofJHB is uncertain. It may represent an end-organ hypersensitivity of the breast to normal levels of sex steroids. Clinically, it is characterized by rapid enlargement of breasts, either unilateral or bilateral. The definitive diagnosis is made by histopathologic examination. Treatment recommendations include surgery and hormonal therapy, although hormonal manipulation is still controversial in pediatric patients. Here we report a 13-year-old girl with unilateral JHB who did not require surgery or medical treatment.
The Turkish journal of pediatrics 50(3):278-81. · 0.44 Impact Factor
-
The Breast Journal 15(4):417-8. · 1.64 Impact Factor
