Traumatic rupture of a hydatid cyst of the liver presenting with skin lesions

© 2020, Edizioni Luigi Pozzi. All rights reserved.The hydatid cyst is the evolution of a parasitic infection caused by Echinococcus granulosus and is an endemic disease in Turkey. The hydatid cysts of the liver can give origin to several complications and the rupture is one of them. Rupture can occur spontaneously or as a result of external trauma. The presentation with skin lesions is very rare. We present a 20-year-old male patient who presented himself after a car accident, and was diagnosed with a rupture of traumatic hydatid cysts due to hives rash. In the operation, a scolicidal gent was administered to the cyst, the cyst wall was partially excised and the germinative membranes were removed. Medical treatment with albendazole was started. The postoperative period was quiet. The intraperitoneal traumatic rupture of a hydatid cyst is rare, but it can cause severe anaphylactic reactions and biliary peritonitis. Although a rare and broken hydatid cyst due to trauma may present with skin lesions in a patient in an endemic region, it should be considered in the differential diagnosis

Idiopathic Granulomatous Mastitis: Comparison of Wide Local Excision with or without Corticosteroid Therapy

Background: Idiopathic granulomatous mastitis (IGM) is an uncommon chronic inflammatory disease of the breast with uncertain optimal treatment regimen. In this study, our purpose was to report our clinical experience with 74 IGM patients who were treated wide local excision with or without steroid therapy. Patients and Method: 74 cases diagnosed histologically as IGM were identified from surgical and pathological records between January 1995 and January 2012. Group 1 (surgery-only group) comprised 53 patients, and the 21 patients in group 2 were treated with corticosteroids prior to surgical treatment (steroid-and-surgery group). Results: Follow-up data were complete for 67 (91.7%) of the 73 patients. Recurrence developed in 4 (7.5%) patients in the surgery-only group, while there was no recurrence in the steroid-and-surgery group; the difference was not statistically significant (p = 0.19). Conclusion: Systemic steroid therapy with surgical resection is the recommended first-line treatment strategy for IGM

Surgical Trends in Breast Cancer in Turkey: An Increase in Breast-Conserving Surgery

PURPOSEBreast cancer is the most frequent cancer in women, and there is a great variability in surgical practice for treating that cancer in different countries. The aims of this study were to analyze the effect of guidelines from the Turkish Federation of Breast Diseases Societies on academic institutions that have breast centers and to evaluate surgical practice in Turkey in 2018.PATIENTS AND METHODSBetween January and March 2019, a survey was sent to breast surgeons who were working in breast centers in academic institutions. The sampling frame included 24 academic institutions with breast centers in 18 cities in Turkey to evaluate interdisciplinary differences among breast centers and seven regions in Turkey regarding patients' choices, surgical approaches, and academic institutions.RESULTSAll surgeons responded to the survey, and all 4,381 patients were included. Most of the surgeons (73.9%) were working in a breast center. Multidisciplinary tumor boards were performed in 87% of the breast centers. The average time between clinical evaluation and initiation of treatment was 29 days; the longest time was in Southeast Anatolia (66 days). Only 6% of patients had ductal carcinoma in situ. Sentinel lymph node biopsy was available in every region across the country and was performed in 64.5% of the patients. In 2018, the overall breast-conserving surgery rate was 57.3% in Turkey, and it varied from 72.2% in the Black Sea region to 33.5% in Central Anatolia (P < .001). Oncoplastic breast surgery options were available at all breast centers. However, 25% of the breast centers from the Black Sea region and half the breast centers from Eastern Anatolia and the Mediterranean region did not perform this type of surgery.CONCLUSIONIncreasing rates of nonpalpable breast cancer and decreasing rates of locoregional recurrences favored breast-conserving surgery, especially in developed countries. Guidelines from the Turkish Federation of Breast Diseases Societies resulted in more comprehensive breast centers and improved breast health in Turkey