İnsülinoma Tanı Ve Tedavisinde Endoskopik Ve İntraoperatif Ultrasonografinin Birlikte Kullanımının Önemi

Introduction: Insulinoma is a usually benign tumor of pancreas. It is seen rarely and incidence of insulinoma is 1 in 250,000 patient-years. We present a rare case with insulinoma which well diagnosed and treated with aid of endoscopic and intraoperative ultrasonography. Case Report: A patient involving a 39-year-old woman with complaints of cold sweats, weakness, syncope attacks, palpitations was evaluated in polyclinic. She was hospitalized with the diagnosis of pancreatic insulinoma after abdominal computer tomography(CT), magnetic resonance imaging(MRI) endoscopic ultrasonography(EUS), and biochemical parameters. The patient was well treated with enucleation and after imaging aid of endoscopic and intraoperative ultrasound(IOUS). Discussion: In patients with insulinoma, preoperative localization of tumor is most important for diagnosis and treatment. Therefore; CT scanning, MRI, EUS and SPECT / CT are used for diagnosis of insulinoma. Together use of endoscopic and intraoperatively ultrasonography are increasing recently. Enucleation is a curative treatment approach in insulinoma. Conclusion: Together using of preoperative endoscopic and intraoperative ultrasound is quite helpful in the diagnosis and treatment of insulinoma.Giriş: İnsülinoma pankreasın genellikle benign tümörüdür. Yıllık insidansı 250.000’de 1’dir ve nadir görülmektedir. Tanı ve lokalizasyon amaçlı olarak endoskopik ve intraoperatif ultrasonografinin kullanıldığı ve başarılı bir şekilde tedavi edilen insülinomalı hasta sunuldu. Olgu Sunumu: 39 yaşında bayan hasta uzun süre aç kalması sonucu artan, soğuk terleme, halsizlik, bayılma ve çarpıntı şikâyetleriyle poliklinikte değerlendirildi. Batın bilgisayarlı tomografi(BT), manyetik rezonans görüntüleme(MRG), endoskopik ultrasonografi(EUS) ve biyokimyasal parametrelerden sonra hasta insülinoma tanısıyla yatırıldı. Hastaya EUS ve intraoperatifUSG(IOUS) yardımıyla enüklüasyon yapıldı. Tartışma: İnsülinomalı hastalarda ameliyat öncesi kitlenin lokalizasyonu çok önemlidir. Bu yüzden BT tarama, MRG, EUS ve SPECT/BT tanı amaçlı olarak kullanılmaktadır. Son zamanlarda EUS ve IOUS’un birlikte kullanımı artmaktadır. Insülinomada küratif tedavi yöntemi enükleasyondur. Sonuç: İnsülinoma’nın tanı ve tedavisinde, endoskopik ve intraoperatif ultrasonografinin birlikte kullanımı oldukça yararlıdır

Importance of Together Use of Endoscopic and Intraoperative Ultrasonography In The Diagnosis and Treatment of Insulinoma

Introduction:Insulinoma is a usually benign tumor of pancreas. It is seen rarely and incidence of insulinoma is 1 in 250,000 patient-years. We present a rare case with insulinoma which well diagnosed and treated with aid of endoscopic and intraoperative ultrasonography.Case Report:A patient involving a 39-year-old woman with complaints of cold sweats, weakness, syncope attacks, palpitations was evaluated in polyclinic. She was hospitalized with the diagnosis of pancreatic insulinoma after abdominal computer tomography(CT), magnetic resonance imaging(MRI) endoscopic ultrasonography(EUS), and biochemical parameters. The patient was well treated with enucleation and after imaging aid of endoscopic and intraoperative ultrasound(IOUS).Discussion:In patients with insulinoma, preoperative localization of tumor is most important for diagnosis and treatment. Therefore; CT scanning, MRI, EUS and SPECT / CT are used for diagnosis of insulinoma. Together use of endoscopic and intraoperatively ultrasonography are increasing recently. Enucleation is a curative treatment approach in insulinoma.Conclusion:Together using of preoperative endoscopic and intraoperative ultrasound is quite helpful in the diagnosis and treatment of insulinoma

Lymphangiomatous Polyp of Tonsil: A Case Report

Lymphangiomatous polyps of the palatine tonsils are uncommon hamartomatous proliferations that could be clinically misdiagnosed as malignant neoplasms. These polyps consist of dilated lymphatic vessels located inside fibrous and/or adipose tissue. In this paper, a 27-year-old man who presented to the outpatient clinic with a complaint of dysphagia is presented. On physical examination, the patient had a smooth, polypoid mass extending from the posterior section of the right palatine tonsil into the oropharynx. The patient underwent right tonsillectomy. histopathological examination of the specimen showed typical features of a lymphangiomatous polyp of the tonsil. The case is reported with the accompanying literature to avoid the possibility of misdiagnosing it as a malignant lesion clinically.Lymphangiomatous polyps of the palatine tonsils are uncommon hamartomatous proliferations that could be clinically misdiagnosed as malignant neoplasms. These polyps consist of dilated lymphatic vessels located inside fibrous and/or adipose tissue. In this paper, a 27-year-old man who presented to the outpatient clinic with a complaint of dysphagia is presented. On physical examination, the patient had a smooth, polypoid mass extending from the posterior section of the right palatine tonsil into the oropharynx. The patient underwent right tonsillectomy. histopathological examination of the specimen showed typical features of a lymphangiomatous polyp of the tonsil. The case is reported with the accompanying literature to avoid the possibility of misdiagnosing it as a malignant lesion clinically

The Value of F-18-FDG PET/CT in Detecting Bone Marrow Involvement in Childhood Cancers

WOS: 000479116100015PubMed ID: 31033787Background: The aim of this study was to assess the utility of F-18-fluoro-2-deoxy-d-glucose (F-18-FDG) positron emission tomography/computed tomography (PET/CT) in assessing bone marrow involvement (BMI) compared with bone marrow biopsy (BMB) in the initial staging of pediatric patients with non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), Ewing sarcoma (ES), and neuroblastoma (NB). Procedure: A total of 94 patients (57 boys, 37 girls, median age 7 y, range 1 to 18 y) with newly diagnosed NHL, HL, ES, and NB between July 2014 and December 2017, who underwent BMB and F-18-FDG PET/CT before chemotherapy were included in this study. There were 36 patients with NHL, 27 HL, 16 ES, and 15 NB. F-18-FDG PET/CT and BMB results were reviewed and compared retrospectively. Findings: Retrospective analysis of data from 94 pediatric patients (57 boys, 37 girls, median age 7 y, range 1 to 18 y) was performed. Of the 94 patients, 29 had BMI on F-18-FDG PET/CT. BMB was positive in 14, negative in 13, and insufficient in 2 of these 29 patients. In 65 patients negative on F-18-FDG PET/CT, BMB was also negative in 54 and insufficient in 7. For the whole group, sensitivity, specificity, and positive and negative predictive values of F-18-FDG PET/CT in detecting bone marrow metastasis at the time of diagnosis were 90.6%, 100%, 100%, and 95.4% and those of BMB were 53.1%, 87.1%, 94.4%, and 80.6%, respectively. Conclusion: Our study demonstrates that F-18-FDG PET/CT predicts BMI better than BMB. F-18-FDG PET/CT may be used at initial staging of pediatric patients with NHL, HL, ES, and NB

Transvers Miyelitle Gelen Bir Primer Spinal Kord Glioblastoma Multiforme Vakası

Primer spinal kord tümörlerine çocukluk çağında nadiren rastlanır. Ependimomlar ve pilositik astrositomlar bunların başında gelir. Spinal glioblastoma multiforme pediatrik intramedüller tümörlerin %1-3\'ünü oluşturan nadir bir antitedir.Bu yazıda sırt ağrısı, paraparezi, yürüme bozukluğu ve sfinkter fonksiyon kaybı ile başvuran ve başlangıçta transvers miyelit olarak değerlendirilen 3 yaş 8 aylık erkek hasta sunulmuştur. Klinisyenlere bu şekilde transvers miyelit bulgularıyla başvuran vakalarda intramedüller tümörlerin de ayırıcı tanıda akılda tutulması gerektiği önerilmiştir.Primary spinal cord tumors are rarely encountered in childhood period. Ependymomas and pilocytic astrocytomas comprise the majority of spinal cord tumors in children. Spinal glioblastoma multiforme (GM) (grade IV astrocytoma) is a rare clinical entity accounting for only 1-3% of all pediatric intramedullary tumors. We report a 3- year-8- month-old male with primary spinal cord GM who presented with back pain, paraparesis, gait disturbance and loss of sphincter control and initially diagnosed as transverse myelitis