Fazilet Kayaselcuk

Amaç: Apendiks tümörleri gastrointestinal sistemin nadir görülen tümörlerindendir. Apendiksin epitelyal tümörlerinin üçte birini müsinöz neoplazmlar oluşturur. Çalışmada apendiks müsinöz neoplazi hastalarındaki klinik yaklaşımımız ve tedavi sonuçlarımızı literatüre sunmayı amaçladık. Gereç ve Yöntemler: Ocak 2012 - Ocak 2022 yılları arasında apendektomi yapılan 1028 hastanın dosyası geriye dönük olarak incelendi. Histopatolojik tanısı apendiks müsinöz neoplazisi olan hastalar çalışmaya dahil edildi. Hastaların yaş ve cinsiyet verileri, başvuru semptomları, tümör marker değerleri (CEA, CA125, CA19-9), bilgisayarlı tomografi bulguları, ameliyatı yapan cerrahi branş, uygulanan cerrahi yöntemler, frozen verileri, histopatolojik tanıları ve sağ kalım bilgileri kaydedildi. Bulgular: Histopatolojik tanısı müsinöz neoplazm olan 35 (%3.4) hasta vardı. Hastalarımızın 28 (%80)’i kadın, 7 (%20)’si erkekti ve yaş ortalaması 57,5 ± 11.68 yıldı. Karın ağrısı şikayeti ile başvuran 21 (%60), şişkinlik ve ele gelen kitle ile başvuran 9 (%25.7), şikayeti olmayan 5 (%14.2) hasta vardı. Hastaların 7 (%20)’sinde CA125 yüksekliği vardı. Bilgisayarlı tomografide 9 (%25.7) hastada akut apandisit bulgusu mevcuttu. Hastaların 28 (%80)’ine sadece apendektomi, 5 (%14.2)’ine sağ hemikolektomi, 2’sine de apendektomi sonrası sitoredüksiyon + hipertermik intraperitoneal kemoterapi yapılmıştı. Mortalite sayımız 4 (%11.4)’tü. Sonuç: Pelvik kaynaklı kitlesel lezyonlarda anatomik komşuluk nedeniyle apendiks müsinöz neoplazileri akılda tutulmalı, hastalar multidisipliner değerlendirilmeli ve gereğinde ameliyat anında yapılacak frozen incelemelerle tedavi şekillendirilmelidir.

Objective: The aim of the study is to raise awareness about clinical features, histopathological and radiological analyzes and treatment details of this rare disease. Methods: A total of 55 Langerhans cell histiocytosis patients, diagnosed between the year 2006 and October 2020 in our department were included in the study. The patients were evaluated in terms of age, gender, tumor localization, risk groups, treatment modalities, recurrence, and outcome of the disease. Results: Twenty-three out of 55 patients were children and 32 were adults. The ages of the patients were between 7 months and 72 years. Thirty-seven of the cases were male and 18 were female. The most common clinical complaint in both groups was pain and swelling. The duration between the onset of the patient complaints and admission to the hospital varies between 7 days-12 months in children, and 10 days-23 years in adults. Forty-three of the cases had single organ involvement and 12 had multiorgan involvement. The most frequently affected organ in both groups was bone. Forty of the 55 patients had follow-up data and the treatment modalities are as follows: Nine patients radiotherapy, 8 patients chemotherapy+steroid, 7 patients chemotherapy, 2 patients chemotherapy+radiotherapy+steroid, 1 patient steroid, 2 patients chemotherapy+radiotherapy. Eleven patients were followed up without additional treatment after surgery. Median follow-up from the time of biopsy was 45.9 months in children and 41.9 months in adults. Conclusions: As a result, diagnosis requires a high degree of suspicion and final diagnosis is based on the histological examination of the lesions and biopsies.

Background/Aims: The aim of the present study was to evaluate the histopathological findings of cirrhosis together with clinical and laboratory parameters, and to investigate their relationship with esophageal varices that are portal hypertension findings. Materials and Methods: A total of 67 (42 male and 25 female) patients who were diagnosed with cirrhosis were included in the study. The mean age of the patients was 51.6±19.0 (1-81) years. The biopsy specimens of the patients were graded in terms of fibrosis, nodularity, loss of portal area, central venous loss, inflammation, and steatosis. The spleen sizes were graded ultrasonographically, and the esophageal varices were graded endoscopically. Results: In the multivariate regression analysis, there was a correlation between the advanced disease stage (Child-Pugh score odds ratio (OR): 1.47, 95% confidence interval (CI): 1.018-2.121, p=0.040), presence of micronodularity (OR: 0.318, 95% CI: 0.120-0.842, p=0.021), grade of central venous loss (OR: 5.231, 95% CI: 1.132-24.176, p=0.034), and presence of esophageal varicose veins. Conclusion: Although thrombocytopenia and splenomegaly may predict the presence of large esophageal varices, cirrhosis histopathology is the main factor in the presence of varices. Cite this article as: Coşar AM, Yakar T, Serin E, Özer B, Kayaselçuk F. The relationship between fibrosis and nodule structure and esophageal varices. Turk J Gastroenterol 2019; 30(7): 624-9.

Angiosarcoma is a rare malignancy originating from vascular endothelial cells. Brain metastasis of aniosarcomas are uncommon up to the literature. Penile angiosarcomas are also seldom among all anjiosarcomas. A case with penile angiosarcoma with confirmed brain metastasis is aimed to be reported and contribute to the literature for similar cases.

Eur J Breast Health AVES | Copyright © 2017 Türkiye Meme Hastalıkları Dernekleri Federasyonu |

Summary Pituitary apoplexy (PA) may very rarely present with hiccups. A 32-year-old man with classical acromegaloid features was admitted with headache, nausea, vomiting and stubborn hiccups. Pituitary magnetic resonance imaging (MRI) demonstrated apoplexy of a macroadenoma with suprasellar extension abutting the optic chiasm. Plasma growth hormone (GH) levels exhibited suppression (below Learning points: Patients with pituitary apoplexy may rarely present with hiccups. Stubborn hiccupping may be a sign of generalized infarction of a large tumor irritating the midbrain. Infarction can be so massive that it may cause cessation of hormonal overproduction and result in remission.

This study was aimed to investigate the effects of experimental left varicocele (ELV) repair on hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) expressions and angiogenesis in rat testis. ELVs were surgically created in 26 adult male Sprague-Dawley rats. Thirty days after surgery, ELV repair was performed in 13 of the rats. All rats subsequently underwent orchiectomy 30 days after the last laparotomy. Histology of ELV-repaired testicles was compared to that of the unrepaired (ELV) group. The frequency of positive HIF-1α findings was significantly lower in the ELV-repaired than in the ELV group. The frequency of positive VEGF findings was also lower in the ELV-repaired than in the ELV group, although the difference was not statistically significant (P = 0.238). The mean microvessel density in ELV-repair group was significantly lower than that in the ELV group (P = 0.002). Our study demonstrated that ELV repair may protect tissues from hypoxia and hypoxia-related pathophysiologic events, such as angiogenesis, in rat testis.

Pilocytic astrocytomas (PAs) are World Heath Organization Grade I tumors and are most common in children. PA calcification is not a common finding and has been reported more frequently in the optic nerve, hypothalamic/thalamus and superficially located cerebral tumors. We present a cerebellar PA in a 3-year-old male patient with cystic components and massive calcification areas. The residual tumor grew rapidly after the first operation, and the patient was operated on again. A histopathological examination revealed polar spongioblastoma-like cells. Massive calcification is not a common feature in PAs and can lead to difficulties in radiological and pathological differential diagnoses.

Insulinoma is the most common type of islet cell tumor of the pancreas and its incidence is estimated at four per one million persons per year. Although fasting hypoglycemia is the typical presentation, cases with postprandial hypoglycemia have rarely been reported. A 48-year-old woman was admitted to our department for evaluation of hypoglycemia. Laboratory data suggested a state of postprandial endogenous hyperinsulinemic hypoglycemia. Abdominal computed tomography revealed a mass lesion measuring 20 mm at the distal pancreas. A decision was made to perform an arterial calcium-stimulated venous sampling for excluding nesidioblastosis coexisting with a pancreatic incidental mass. After that the patient was referred to surgery. Pathological examination revealed a low-grade well-differentiated neuroendocrine tumor with regional lymph node metastasis. Herein, we report a case of malignant insulinoma presenting with postprandial hypoglycemia and discuss the differential diagnosis and possible mechanisms of postprandial hypoglycemia in insulinoma cases.