Uğur Ünlütürk

Congenital dyserythropoietic anemia (CDA) is a rare hereditary disorder marked by ineffective erythropoiesis and distinctive morphological abnormalities of erythroblasts. A hemolytic component is o...

Malignancies arising from adrenal rests are extremely rare. They may occur in locations such as the retroperitoneum, testes/scrotum, ovaries, kidneys, anterior abdominal wall, spinal cord, and liver, in association with embryological development. In this article, we present a patient with ectopic adrenocortical cancer (ACC) located in the pancreas, along with a review of the relevant literature. A 57-year-old female patient was diagnosed with mixed-type breast cancer (lobular and ductal carcinoma). During further diagnostic evaluations, in addition to a malignant-appearing mass in the left breast, imaging revealed a second tumor in the left paraaortic region, located in the pancreas. This mass, measuring 6 cm, was well-circumscribed, partially necrotic, heterogeneous in appearance, and displayed no significant invasion of surrounding tissues. The patient exhibited no signs of hormonal hyperfunction, such as hypertension, electrolyte imbalances, cushingoid appearance, or hyperandrogenism. Following lumpectomy, the mass adjacent to the pancreas was surgically excised. Pathological examination revealed an oncocytic type of ACC, characterized by nuclear abnormalities, a high mitotic index, and high nuclear grade, with positivity for steroidogenic factor 1 (SF-1) (NR5A1) in immunohistochemical staining. Mitotane and glucocorticoid replacement therapy were added to the patient's treatment plan for ACC. At present, there are no signs of recurrence or metastasis. To our knowledge, this is the first reported example of ectopic ACC arising in the pancreas, diagnosed in a 57-year-old patient. ACCs should be considered in the differential diagnosis of tumors arising in nonadrenal regions.

To investigate the efficiency of ultrasound surveillance in detecting recurrences of papillary thyroid cancer (PTC) in patients with an excellent response (ER) to therapy.In a single center, patients diagnosed with PTC between 2000 and 2018 were evaluated, and data from 477 patients followed up with ultrasonography (USG) were included in the analysis. The study cohort was divided into excellent response (ER) and non-excellent response (non-ER) groups. Follow-up ultrasound scans' positive predictive value (PPV) and negative predictive value (NPV) were calculated.The median surveillance time was 76 (36–240) months. Nine recurrences were observed. The recurrence rate was 0.3% in the ER group. The maximum time until recurrence after the initial one-year assessment was 1 year in the ER group, while it extended to 2 years in the non-ER group. Among the 11 patients who underwent fine needle aspiration cytology (FNAC) due to atypical findings in the ER group, one was found to have metastasis (9%). The combined PPV of USG in the ER group was only 1.78%. Since no recurrence was detected in the ER group in later years, the only assessable annual PPV was in the second year after diagnosis. The ER group exhibited an annual PPV of 7.69% and an NPV of 100%. In contrast, the non-ER group had annual PPV and NPV rates of 34.78% and 95.65%, respectively.Patients with an ER in the first year of treatment can be followed up with clinical examination and serum unstimulated thyroglobulin alone starting three years after diagnosis.

Background: Significant advances have been made in detecting RNA markers that may indicate malignancy in fine needle aspiration cytology (FNAC) samples. Objective: To review the roles of protein-coding and non-coding RNAs in differentiating between malignant and benign thyroid nodules. Methods: A comprehensive literature search using PubMed, Science Direct, Web of Science, and SCOPUS databases was performed. We searched up until September 2024 and complemented by manual citation search. Results: A total of 28 full-text articles were reviewed, encompassing 5770 FNAC samples, which included 3489 benign lesions and 2281 malignant lesions. The studies identified 43 messenger RNAs (mRNAs), 16 microRNAs (miRNAs), and 3 long non-coding RNAs (lncRNAs) that have the potential to distinguish malignant nodules. Among the mRNAs, PAPPA, TIMP1, and HMGA2, as well as the miRNAs, miR-146b, miR-375 and miR-222, appear to be the most promising molecules for diagnosis. Conclusion: Numerous RNA markers have been shown to differentiate malignant from benign lesions. However, there is still a lack of patient-specific classification for thyroid cancer subtypes. Additionally, future studies should prioritize using a combination of molecular markers rather than relying on individual ones. Although current research mainly focuses on identifying cancer-specific molecules, it is important for future studies to shift towards a more patient-specific approach.

Lpha cells of the pancreas, secrete glucagon and represent less than 10% of PNETs, with an incidence<of 0.01-0.1 per million population per year. Often metastatic at diagnosis, glucagonomas commonly<present with dermatological symptoms, notably necrolytic migratory erythema (NME), leading to700 ng/mL) confirmed glucagonoma. Imaging revealed multiple hepatic and pancreatic lesions. The treatment included lanreotide, peptide receptor radionuclide therapy (PRRT), distal pancreatectomy, and splenectomy. Despite 6 PRRT cycles and additional chemother apy, recurrent liver metastases necessitated ongoing management and potential liver transplanta tion. This case emphasizes the importance of early NME recognition and a multidisciplinary approach involving dermatology, endocrinology, pathology, radiology, surgery, nuclear medicine, medical oncology, and interventional radiology for effective glucagonoma management. Cite this article as: Yazarkan Y, Ertürk B, Sönmez G, et al. Multidisciplinary approach to glucagonoma: A case report. Endocrinol Res Pract. 2025;29(2):149-152.

Purpose This study aims to investigate the impact of post-transplant diabetes mellitus (PTDM) on cardiovascular events, graft survival, and mortality and to determine the risk factors involved in developing PTDM. Methods A total of 703 patients who underwent kidney transplantation were included in the study. The total sample was subdivided into three groups: (i) patients with PTDM; (ii) patients who had diabetes before the transplantation (DM); and (iii) patients without diabetes (NoDM). The data on graft failure, cardiovascular events, all-cause mortality, and the potential risk factors that play a role in developing PTDM were recorded and analyzed. Results The patients were followed for a median of 80 (6–300) months after transplantation. Out of all patients, 41 (5.8%) had DM before transplantation, and 101 (14.4%) developed PTDM. Recipient BMI, post-transplant fasting plasma glucose, and hepatitis C seropositivity were independent risk factors for PTDM development. The incidence of cardiovascular events was 6.1% in the NoDM group, 14.9% in the PTDM group, and 29.3% in the DM group (p < 0.001). In PTDM patients, hepatitis C seropositivity and the recipient’s age at transplant were independent predictors of a cardiovascular event. There were no significant differences between the groups regarding the risk of graft loss. PTDM had no significant effect on all-cause mortality. However, the survival rates of DM patients were significantly reduced compared to those with NoDM or PTDM. Conclusions PTDM had no impact on patient survival. Hepatitis C seropositivity and recipient age at transplant predicted cardiovascular events in PTDM patients.

Context The paucity of data on microvascular complications in patients with posttransplant diabetes (PTDM) is an obstacle to developing follow-up algorithms. Objective To evaluate diabetic microvascular complications in patients with long-standing PTDM. Methods In patients with ≥5-year history of PTDM and age-matched renal transplant recipients without PTDM (NDM), diabetic peripheral neuropathy was evaluated using the Michigan Neuropathy Screening Instrument, the CASE IV device, and in vivo corneal confocal microscopy (CCM). Cardiac autonomic neuropathy tests were performed using heart rate variability. Nephropathy screening was assessed using spot urine albumin/creatinine ratio and eGFR calculation. Diabetic retinopathy was evaluated by fundus examination and photography, and optical coherence tomography. Results This study included 41 patients with PTDM and 45 NDM patients. The median follow-up was 107.5 months in the PTDM group. Peripheral neuropathy was significantly higher in the PTDM group than in the NDM group (P = .02). In the PTDM patients with peripheral neuropathy, corneal nerve fiber density examined by CCM was significantly lower than in PTDM patients without neuropathy (P = .001). Parasympathetic involvement was observed in 58.5% of the PTDM group and 22% of the NDM group (P = .001). Sympathetic involvement was present in 65.9% of the PTDM group and 29.3% of the NDM group (P = .001). Retinopathy was observed in 19.5% of patients in the PTDM group and in none of the NDM patients (P < .001). Renal functions were similar between the study groups. Conclusion Cardiac autonomic neuropathy and diabetic retinopathy can affect patients with PTDM at a high rate. Diabetic retinopathy is a threat to the vision of PTDM patients. Diabetic peripheral neuropathy can be detected early in PTDM patients by CCM.

Purpose This study aims to investigate the impact of post-transplant diabetes mellitus (PTDM) on cardiovascular events, graft survival, and mortality and to determine the risk factors involved in developing PTDM. Methods A total of 703 patients who underwent kidney transplantation were included in the study. The total sample was subdivided into three groups: (i) patients with PTDM; (ii) patients who had diabetes before the transplantation (DM); and (iii) patients without diabetes (NoDM). The data on graft failure, cardiovascular events, all-cause mortality, and the potential risk factors that play a role in developing PTDM were recorded and analyzed. Results The patients were followed for a median of 80 (6-300) months after transplantation. Out of all patients, 41 (5.8%) had DM before transplantation, and 101 (14.4%) developed PTDM. Recipient BMI, post-transplant fasting plasma glucose, and hepatitis C seropositivity were independent risk factors for PTDM development. The incidence of cardiovascular events was 6.1% in the NoDM group, 14.9% in the PTDM group, and 29.3% in the DM group (p < 0.001). In PTDM patients, hepatitis C seropositivity and the recipient's age at transplant were independent predictors of a cardiovascular event. There were no significant differences between the groups regarding the risk of graft loss. PTDM had no significant effect on all-cause mortality. However, the survival rates of DM patients were significantly reduced compared to those with NoDM or PTDM. Conclusions PTDM had no impact on patient survival. Hepatitis C seropositivity and recipient age at transplant predicted cardiovascular events in PTDM patients.