Asli Cakir

Meningiomas are the most common primary central nervous system tumors and their biological behavior is closely related to histopathological grade and proliferative activity. This study investigated the associations between World Health Organization (WHO) grade, tumor location, mitotic activity, and Ki-67 labeling index in previously untreated meningiomas. We retrospectively analyzed 298 surgically treated primary meningiomas diagnosed between 2013 and 2025, re-evaluated according to the 2021 WHO Classification of Central Nervous System Tumors. Mitotic counts and Ki-67 labeling indices were assessed in hotspot areas. Associations between proliferation markers, grade, and anatomical location were analyzed statistically, and receiver operating characteristic (ROC) analyses determined optimal cut-off values. Of the tumors, 55.0% were WHO Grade 1, 41.6% Grade 2, and 3.4% Grade 3. Both markers increased significantly with grade and showed a strong positive correlation (ρ = 0.79, P < .001). Convexity meningiomas were associated with higher grades and increased proliferative activity, whereas skull base and spinal tumors predominantly exhibited lower grades and lower proliferation indices. ROC analyses demonstrated comparable discriminatory performance for Ki-67 and mitotic counts across WHO grades. In summary, proliferation markers strongly correlate with WHO grade and vary by tumor location, supporting their combined value in meningioma risk stratification.

Objective: Chondroblastoma (CB) is a benign but locally aggressive bone tumor that may present histopathologic diagnostic challenges, particularly in atypical locations and limited biopsy specimens. Recent studies have identified recurrent mutations in the H3F3B and, less frequently, H3F3A genes, suggesting their potential diagnostic value. This study aimed to evaluate the prevalence and diagnostic utility of H3F3A and H3F3B mutations in a multicenter cohort of CB patients. Methods: Forty-three patients with histopathologically confirmed CB were included in a retrospective analysis. All cases were re-evaluated by 2 pathologists, and mutation analysis of H3F3A and H3F3B genes was performed using polymerase chain reaction–based Sanger sequencing. Results: H3F3B mutations were detected in 41 cases (95.3%), all corresponding to the Lys36Met substitution. One case (2.3%) harbored an H3F3A Gly34Trp mutation, whereas 1 case (2.3%) showed no detectable mutation. No significant histopathological differences were observed between mutation-positive and mutation-negative cases. A notable case involved a 72-year-old patient with frontal bone involvement, highlighting the diagnostic difficulty in unusual locations and older age groups. Conclusion: The findings demonstrate that H3F3B mutation analysis is an extremely sensitive and reliable molecular tool for confirming the diagnosis of CB. It is particularly valuable in challenging cases and especially in small biopsy samples where pathognomonic findings, such as chicken-wire calcification and chondroid matrix are not visible. Incorporation of molecular testing into targeted diagnostic workflows may improve diagnostic accuracy and assist in distinguishing CB from its histological mimics. Cite this article as: Tosun I, Yilmaz I, Cakir A, et al. H3F3B gene mutation in chondroblastomas: a multicenter study. Acta Orthop Traumatol Turc.,2026; 60(4), 0277, doi: 10.5152/j.aott.2026.25277.

Objective: To evaluate the Tumor-Immune-Proliferation-Inflammation (TIPI) score as a composite biomarker for predicting pathological complete response (pCR) in human epidermal growth factor receptor 2 (HER2)-positive breast cancer treated with neoadjuvant therapy. Methods: This retrospective single-center study included 75 patients with HER2-positive invasive breast cancer treated with neoadjuvant chemotherapy plus dual anti-HER2 blockade (trastuzumab and pertuzumab). The association between the TIPI score and pCR was assessed using receiver operating characteristic (ROC) analysis and logistic regression. Results: pCR was achieved in 34 patients (45.3%). The optimal TIPI cut-off was 11.41. Patients with high TIPI scores had a higher pCR rate than those with low TIPI scores (56.3% vs. 25.9%, p = 0.016). However, the discriminative performance of the score was modest (AUC 0.598, 95% CI: 0.467–0.730; p = 0.145). In the adjusted analysis, hormone receptor negativity remained the most consistent factor associated with pCR. Conclusions: The TIPI score was developed as a preliminary composite model integrating selected tumor- and host-related biological variables and showed an exploratory association with pCR in this single-center HER2-positive cohort. Given the modest discriminative performance and lack of external validation, these findings should be interpreted cautiously. Further validation in larger independent cohorts is required before the score can be considered for clinical stratification or implementation.

Background: Mast cells are integral components of the tumor microenvironment and have been implicated in the regulation of tumor progression in various malignancies. The association between inflammation and colorectal cancer (CRC) development has become increasingly recognized. Depending on the tumor microenvironment, mast cells may exert either pro-tumorigenic or antitumorigenic functions. Objective: This study aimed to evaluate the relationship between stromal mast cell density and prognostic factors in patients with CRC. Methods: In this retrospective cohort study, 81 patients who underwent curative surgical resection for CRC were analyzed. Immunohistochemical staining for mast cell tryptase (MCT) was performed on paraffin-embedded tumor specimens. Mast cells were quantified in regions of hot spots within the tumor stroma. Patients were categorized as high mast cell density (MCC-H, ≥22 cells/HPF) or low mast cell density (MCC-L, p = 0.033) and macroscopic tumor perforation (HR: 0.15, 95% CI: 0.04–0.55, p = 0.004) as independent predictors of PFS. High MCC (≥22) independently predicted improved OS (HR: 0.07, 95% CI: 0.006–0.87, p = 0.039). A significant association was observed between OS, MCC, and lymph node stage. Conclusions: Stromal mast cell count is an independent prognostic factor for overall survival in patients with CRC. Our findings suggest that MCC may serve as a reliable prognostic biomarker following surgical resection and could aid in postoperative risk stratification.

Purpose Craniopharyngiomas (CP) present with both solid and cystic structures in magnetic resonance imaging (MRI) studies. Contrary to MRI appearance, components described as cysts are not infrequently found as non-fluent structures during surgery. This study aims to address the discrepancy between radiology and surgery regarding the nature of these lesions and to evaluate them for their preoperative predictability. Materials and methods Preoperative MRI images of 24 CP patients were analyzed. The cystic components of the tumors were assessed in terms of quantitative and qualitative signal properties and contrast enhancement on conventional pulse sequences, and analyzed based on their macroscopic appearances. Results Thirteen of 31 lesions (42%) that suggested cyst on MRI were solid during surgery, with none showing contrast uptake. MRI demonstrated 100% sensitivity and negative predictive value (NPV), 71.7% specificity, and 58% positive predictive value (PPV) in identifying true cysts. Most lesions resembling cysts were hyperintense on FLAIR and T1WI and isointense on ADC maps, suggesting high protein content. However, surgically confirmed fluid-filled cysts exhibited similar signal characteristics in a comparable proportion. The only significant imaging indicator was a hypointense appearance on T2WI, with a mean intensity ratio close to that of the basal ganglia. Conclusion Accurate identification of solid and cystic components in craniopharyngiomas is critical for effective treatment planning. Although MRI is traditionally considered reliable for this purpose, 42% of lesions that appeared cystic without contrast enhancement were ultimately confirmed as non-fluid or solid during surgery. This study was unable to establish definitive MRI characteristics to reliably differentiate between cystic and solid components. Further research with larger cohorts is warranted to validate potential imaging markers and improve diagnostic accuracy.

Objective: To evaluate the clinical and histopathological advantages of a modified technique—In Saline Coblation Adenoidectomy (ISCA)—over conventional coblation adenoidectomy (CCA) in pediatric patients, with respect to intraoperative efficiency, tissue preservation, and postoperative outcomes.Study Design: This study was designed as a prospective, randomized, single‐blind trial. Patients were randomly assigned to two groups, Group A “CCA” and Group B “ISCA,” each consisting of 25 children. Following the approval of the Medipol University Ethics Committee, patients who underwent adenoidectomy or adenotonsillectomy were included in the study.Setting: In Group A, adenoid tissue was ablated using the coblator's built‐in irrigation system. For Group B, the nasopharynx and, partially, the oral cavity were continuously filled with saline solution delivered via the nasal passage. Excess fluid was aspirated from the mouth using a dedicated suction tip. This ensured that the endoscope and coblator tip remained immersed in saline throughout the procedure.Methods: A prospective, randomized, single‐blind study was conducted involving 50 pediatric patients who underwent either conventional coblation (Group A, n = 25) or ISCA (Group B, n = 25). Operative time, intraoperative blood loss, postoperative pain scores, and wand‐related issues were recorded. Histopathological analysis of adenoid specimens was performed to assess tissue integrity and thermal injury. Patients were followed for 6 to 18 months postoperatively for recurrence and complications.Results: ISCA significantly reduced operative time compared to CCA (24 ± 5.8 minutes vs 33 ± 8.5 minutes; P < .05). Wand tip clogging and secondary wand use were observed only in Group A. Histopathological analysis revealed greater epithelial preservation and reduced carbonization in Group B (92% vs 0%; P < .001). Postoperative complications such as transient velopharyngeal insufficiency and localized infection occurred exclusively in Group A, whereas no statistically significant difference in recurrence or residual tissue was noted between the groups.Conclusion: The ISCA technique offers clear clinical advantages over conventional coblation by improving procedural efficiency, minimizing collateral thermal injury, and eliminating wand‐related delays. These findings support its wider adoption in high‐volume pediatric otolaryngology settings.

Amaç: Kardiyak kitleler nadirdir, neoplastik ve nonneoplastik olarak ayrılmaktadır. Bu makalenin amacı kardiyak kitlelere genel bir bakış sağlamak ve klinikopatolojik özelliklerini gözden geçirmektir Materyal ve Metodlar: Merkezimizde 2014-2022 yılları arasında kardiyak kitle nedeniyle opere edilen 35 vakayı retrospektif olarak inceledik. Bulgular: Vakaların yaşları 7 ay ile 79 yıl arasında değişmektedir (ortalama yaş 46,2 yıl) ve 25’i kadındır. Serimizin büyük bir kısmını primer benign kalp tümörleri oluşturmaktadır ve en sık görülen tümöral lezyon miksoma olup, bunu sırasıyla fibroelastom, fibroma, rabdomyom ve glomus tümör izlemektedir. İki vaka metastatik karsinom tanılıdır. Non-neoplastik kitle lezyonları da çoğunlukta olup insidansına göre trombüs, kalsifiye kardiyak psödotümör ve infektif endokardit olarak sıralanmaktadır. Sonuç: Bu çalışmada, çeşitli kardiak kitlelerin klinikopatolojik bulgularının bir arada değerlendirildiği geniş bir vaka serisi sunulmaktadır. Anahtar kelimeler: Kardiak kitleler, tümörler, tümör dışı lezyonlar

Introduction: Approximately 90% of testicular tumors originate from germ cells. Tumor size, lymphovascular invasion, spermatic cord invasion, epididymal invasion, tunica vaginalis and hilar soft tissue invasion are important parameters for staging and prognosis in germ cell tumors of the testis and these parameters are related to prognosis. Materials and methods: Therefore, 80 cases diagnosed with testicular germ cell tumors were retrospectively analyzed. The patients’ age, tumor size, invasion characteristics, tumor focus numbers, tumor subtypes and percentage amounts of the components were documented. Results: Of the cases, 40 (50%) were seminoma, 32 (40%) were mixed germ cell tumors, 6 (7,5%) were embryonal carcinomas and 2 (2,5%) were postpubertal type teratomas. Of these 80 cases, 48,75% had rete testicular invasion, 5% had epididymal invasion, 18,75% had hilar soft tissue invasion, 10% had spermatic cord invasion, 52,5% had lymphovascular invasion, 3,75% had tunica vaginalis invasion and 2,5% had spermatic cord surgical margin invasion. A statistically significant correlation was found between tumor size and all invasion sites. The correlation between yolk sac tumor component and epididymis, hilar soft tissue, spermatic cord and lymphovascular invasions was found to be significant. There was also a statistically significant correlation between embryonal carcinoma component and epididymis and spermatic cord invasions. Conclusion: It is important to evaluate macroscopically and microscopically the tumor size and invasion sites is which are determinants of prognosis in germ cell tumors of the testis. Additionally, it should be kept in mind that tumor subtypes may also be a factor determining the extent and site of invasion.