A rarely seen breast tumor: looking over the literature related to intracystic papillary carcinoma

Intracystic papillary carcinoma of the breast is a rarely seen tumor. It is often classified as a variant of in situ ductal carcinoma. Intracystic papillary carcinoma is slow growing and usually surrounded and limited by fibrosis capsule. Presently described is case of a 51-year-old postmenopausal patient. She felt a tumor in her left breast, and after examination, it was diagnosed as intracystic papillary carcinoma. Following adjuvant chemotherapy breast excision, and axillar dissection, patient was given curative external radiotherapy and hormonal treatment. As result of 40-month follow-up, the patient was evaluated as having local recurrence and no distant metastases. Follow-up and treatment protocols should be observed on case-by-case basi

Safra kesesinin intravasküler diffüz büyük hücreli lenfoması

Intravascular large B-cell lymphoma (IVLBCL) is a rare type of extranodal B-cell lymphoma characterized by the growth of lymphoma cells within the lumina of small vessels. Two major patterns of clinical presentation have been recognized: the first is in European countries, with brain and skin involvement, and the second in Asian countries, where patients typically present with multiorgan failure, hepatosplenomegaly, pancytopenia, and hemophagocytic syndrome [1,2,3,4,5]. Primary IVLBCL of the gallbladder is exceedingly rare

Investigation of the Interobserver Variability of the Prostate Imaging for Recurrence Reporting (PI-RR) Score in Evaluating Local Recurrence in Prostate Cancer After Radiotherapy: Are Tumor Size and Prostate-specific Antigen Important?

INTRODUCTION: The aim of the study was to investigate the interobserver variability of the newly developed Prostate Imaging for Relapse Reporting (PI-RR) to assess recurrence in patients with prostate cancer who received radiotherapy. METHODS: A total of 81 patients who underwent multiparametric magnetic resonance imaging (mpMRI) examination between January 2018 and November 2022 due to the suspicion of local recurrence were retrospectively evaluated. All the mpMRI images were independently reviewed by three radiologists. None of the observers were blinded to clinical and pathological data (including primary tumor location). It was examined whether interobserver agreement increased according to the prostate-specific antigen (PSA) cut-off value being taken as 0,5 or 0,6 (µg/L) and the size of the tissue with tumor suspicion being greater than 1 cm or 1,5 cm. RESULTS: The mean age of the patients was 68,3 +- 6,6 years. The mean PSA was 2,32 +- 2,95 (µg/L), and the mean tumor size was 1,23 +- 0,77 (cm). A very high level of agreement was detected between the gold standard and observers 1, 2, and 3 (κ: 0,921 / 0,873 / 0,825, respectively). The agreement between the observers and the gold standard was also increased in the evaluation of patients with a PSA value above 0,5 (µg/L). Furthermore, patients with a tumor size greater than 1 cm had a very high level of agreement between the gold standard and the observers. DISCUSSION AND CONCLUSION: PI-RR detection rate of relapse tissue and interobserver agreement were correlated with PSA level and size of relapse tissue

Original Article Expression of fibroblast growth factor receptor 1, fibroblast growth factor 2, phosphatidyl inositol 3 phosphate kinase and their clinical and prognostic significance in early and advanced stage of squamous cell carcinoma of the lung

Abstract: Aim: Non-small cell lung carcinoma is the leading cause of cancer related to death in the world. Squamous cell lung carcinoma (SqCLC) is the second most frequent histological subtype of lung carcinomas. Recently, growth factors, growth factor receptors, and signal transduction system-related gene amplifications and mutations are extensively under investigation to estimate the prognosis and to develop individualized therapies in SqCLC. In this study, besides the signal transduction molecule phosphatidyl inositol-3-phosphate kinase (IP3K) p110α, we explored the expressions of fibroblast growth factor 2 (FGF2) and receptor-1 (FGFR1) in tumor tissue and also their clinical and prognostic significance in patients with early/advanced SqCLC. Materials and methods: From 2005 to 2013, 129 patients (23 early, 106 advanced disease) with a histopathological SqCLC diagnosis were selected from the hospital files of Cukurova University Medical Faculty for this study. Two independent pathologists evaluated FGFR1, FGF2, and PI3K (p110α) expressions in both tumor and stromal tissues from 99 of the patients with sufficient tissue samples, using immunohistochemistry. Considering survival analysis separately for patients with both early and advanced stage diseases, the relationship between the clinical features of the patients and expressions were evaluated by univariate and multivariate analyses. Results: FGFR1 expression was found to be low in 59 (60%) patients and high in 40 (40%) patients. For FGF2; 12 (12%) patients had high, 87 (88%) patients had low expression and for IP3K; 31 (32%) patients had high and 66 (68%) patients had low expressions. In univariate analysis, overall survival (OS) was significantly associated with stage of the disease and the performance status of the patient (P<0.0001 and P<0.001). There was no significant difference in OS of the patients with either low or high expressions of FGFR1, FGF2, and IP3K. When the patients with early or advanced stage disease were separately taken into consideration, the relationship did not differ, either. Any of FGFR1, FGF2 or IP3K expressions was not found predictive for the treatment of early or advanced staged patients. On the other hand, the expressions of both FGFR1 and FGF2 were significantly different with respect to smoking, scar of tuberculosis and scar of radiotherapy (P=0.002; P=0.06 and P=0.05, respectively). Discussion: There has not been identified an effective individualized treatment for SqCLC yet. Therefore, in order to be able to develop such a treatment in the future, it is essential to identify the genetic abnormalities that are responsible for the biological behaviors and carcinogenesis of SqCLC. Although we could not show the prognostic and predictive significance of FGFR1, FGF2 and IP3K expressions in SqCLC, we determined the expression rates of FGFR1, FGF2 and IP3K as a reference for Turkish patients. In conclusion, we want to put some emphasis on the fact that, pulmonary fibrosis which is a late complication of radiotherapy at stage III disease, and the scar of tuberculosis could be associated with FGFR1 and FGF2 expressions

The relationship between ghreline hormone, cytokines swept by chemoradiation and normal organ chemoradiotoxicity due to clinical chemoradiotherapy.

TEZ8816Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2012.Kaynakça (s. 81-92) var.xi, 93 s. : res. ; 29 cm.Aim: The aim of this study is to compare the levels of ghreline hormone, TNF-, IL-1, IL-6 and IL-8 before radiotherapy, at the last week of radiotherapy and 3 months after radiotherapy in 30 patients with stomach, gall bladder and pancreas carcinoma who had concomittant chemoradiotherapy and to evaluate the relationship between these measurements and grade 1-2-3 toxicity. Material and Methods: Stomach, gall ladder and pancreatic carcinoma patients having concomittant chemoradiotherapy who admitted to Çukurova University Medical Faculty, Department of Radiation Oncology between the dates March 2011-May 2012 were run into our study. Before the study, informed consents of all patients were taken and ethics committee approval was taken. All of the patients blood samples (not lower than 5 cc) were taken to measure plasma Ghreline, serum TNF-, IL-1, IL-6 and IL-8 levels before radiotherapy, at the last week of radiotherapy and 3 months after radiotherapy. Blood samples were centrifuged and frozen at -700C. When the control samples were collected, ELISA method was used for measurements. To evaluate the kidney and liver functions of patients, AST, ALT, LDH and creatinine levels were measured before radiotherapy, weekly during radiotherapy and 3 months after radiotherapy. Results: 15 men and 15 women were taken into study. Histopathologically, 25 (86.7 %) were adenocarcinoma, 5 (13.3 %) were squamous cell carcinoma. 16.7 % of patients were stage-1b; 30 % were stage-2a, 53.3 % were stage-3. Ghreline levels at the last week of radiotherapy decreased when compared with its levels before radiotherapy and Ghreline levels increased 3 months after radiotherapy. The changes of Ghreline levels by time were found to be significant (p<0.001). The levels of preinflammatory cytokines TNF-?, IL-1, IL6 and IL-8 increased at the last week of radiotherapy and decreased 3 months after radiotherapy (p<0.001, p<0.001, p<0.001, p<0.001). When the patients were divided into two groups such as stomach group and the other group; the changes of blood Ghreline, TNF-?, IL-1, IL-6, IL-8 levels by time were found to be significant (Ghreline stomach group p<0,001, other group p=0.002, TNF-? stomach group p=0.078, other group p=0.001, IL-1 stomach group p=0.001, other group p=0.022, IL-6 stomach group p<0.001, other group p=0.058, IL-8 stomach group p=0.006, other group p=0.069). There were no significant changes in transaminase and creatinine levels which were measured before radiotherapy, weekly during radiotherapy and 3 months after radiotherapy. At the last week of radiotherapy, between groups who had grade 1-2-3 toxicity, Ghreline and cytokine levels were measured and Ghreline levels decreased; cytokine levels increased due to toxicity at the last week of radiotherapy. Ghreline decrease was distinctly more in the group who had grade 2-3 toxicity when compared with the group who had grade 1 toxicity. Result: In this study, the changes of Ghreline and cytokine levels during chemoradiotherapy and the relationship of chemoradiotherapy toxicity and these measurements were associated. At the last week of therapy, appetite of patients decreased, nausea increased, velocity of weight loss increased. Ghreline levels decreased during radiotherapy parallel to this finding. At the same time, cytokine levels increased as toxicity increased paralel to this finding. After radiotherapy patients gathered up slowly and appetite of patients increased. They started to gain weight parallel to this. So; after radiotherapy Ghreline levels increased and cytokine levels decreased.Amaç: Çalışmamızın amacı eş zamanlı kemoterapi ve radyoterapi gören mide, safra ve pankreas kanserli 30 hastanın, radyoterapiye başlamadan önceki kan grelin, IL- 1, IL-6, IL-8 değerlerinin radyoterapinin son haftasında ve radyoterapinin bitiminden sonraki üçüncü aydaki ölçümleri ile kıyaslamaktır. Bu ölçümlerle grad 1-2-3 toksisite arasındaki ilişkiyi belirlemeye çalışmaktır. Gereç ve yöntem: Çalışmaya Çukurova Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi Anabilimdalı Polikliniğine Mart 2011 ile Mayıs 2012 tarihleri arasında başvuran mide kanseri, pankreas kanseri ve safra kesesi kanseri tanısı almış eş zamanlı kemoradyoterapi gören hastalar alındı. Tüm hastaların kendi onayları ve etik kurul onayı alınarak çalışmaya dahil edildi. Tüm hastaların plazma Grelin ve serum TNF-alfa, IL-1, IL-6, IL-8 değerine bakmak için radyoterapiye başlamadan önce, radyoterapinin son haftasında ve radyoterapi bittikten üç ay sonra, 5cc'den az olmamak kaydıyla kanları alındı. Santrifüj edildikten sonra -700c'de donduruldu. Hastaların kontrol kanları da alınarak tamamlandıktan sonra ELIZA yöntemi ile çalışıldı. Tüm hastaların karaciğer ve böbrek fonksiyonlarına bakmak amacıyla radyoterapiye başlamadan önce, radyoterapinin her haftasında ve radyoterapi bitiminde üç ay sonra kan AST, ALT, LDH ve kreatinin değerlerine bakıldı. Bulgular: Çalışmaya 15 kadın, 15 erkek hasta dahil edilmiştir. Histopatolojik olarak, 25 (% 86.7) adenokarsinom, 5 (% 13.3) skuamöz hücreli karsinomdu. E1-b (% 16.7), E-2a (%30), E-3 (% 53.3) olgu bulunmaktaydı. Radyoterapinin son haftasında Grelin değeri, Radyoterapiye başlamadan önceki değeri ile kıyaslandığında düşmüş olduğu, tedavi bitiminden üç ay sonra ise yeniden yükseldiği görülmüştür. Grelin değerlerinin zaman içindeki değişimi anlamlı bulunmuştur (p<0,001). Preinflamatuar sitokinlerin TNF-alfa, IL-1, IL6, IL-8'in ise radyoterapinin son haftasında yükseldiği, radyoterapi bittikten üç ay sonra ise düştüğü görülmüştür (p<0,001, p<0,001, p<0,001, p<0,001). Hastalar kendi arasında mide kanseri, safra kesesi ve pankreas kanseri olmak üzere ikiye ayrıldığında da kan Grelin, TNF-alfa, IL-1, IL-6, IL-8 değerlerinin zaman içinde değişimi anlamlı bulunmuştur (Grelin mide grunda p<0,001, diğer grupta p=0,002, TNFalfa mide grubunda p=0,078, diğer grupta p=0,001, IL-1 mide grubunda p=0,001, diğer grupta p=0,022, IL-6 mide grubunda p<0,001, diğer grupta p=0,058, IL- 8 mide grubunda p=0,006, diğer grupta p=0,069) olarak bulunmuştur. Transaminaz ve kreatinin değerlerinin radyoterapi öncesi ölçümleri ile radyoterapinin her haftası ve radyoterapiden sonraki üç ay sonraki değeri karşılaştırıldığında anlamlı bir fark görülmemiştir. Radyoterapinin son haftasında Grad-1-2-3 toksisite görülen gruplar arasında Grelin ve sitokin değerlerine bakıldığında Radyoterapinin son haftasında toksisiteye bağlı olarak grelinin azaldığı, sitokinlerin ise arttığı gözlenmiştir. Grad-2-3 toksisite gözlenen gruptaki Grelin düşmesinin Grad-1 toksisite görülen gruptakine oranla daha fazla olduğu saptanmıştır. Sonuç: Bu çalışmada Radyoterapiye bağlı farklanan Grelin ve sitokin değerlerinin arasındaki değişimi, hastaların Radyoterapi sırasındaki toksisiteleri ile ilişkilendirilmiştir. Tedavinin son haftasında iştahları azalmış, mide bulantıları artmış olup kilo verme hızları yükselmiştir. Buna parelel olarak Grelin seviyeleri Radyoterapi gördüğü zaman süresince azalmıştır. Aynı oranda toksisitenin artmasına parelel olarak sitokinlerde de artış saptanmıştır. Radyoterapi sonrasında ise hastalar kendilerini yavaş yavaş toparlamış olup iştahları artmıştır. Bunun parelelinde kilo almaya başlamışlardır. Dolayısı ile hastaların tedavi sonrasındaki ölçülen Grelin değerleri yükselmiş. Sitokin değerleri ise azalmıştır

Memenin Diffüz Büyük B Hücreli Lenfoması

Primer meme lenfoması, Non Hodgin Lenfomalar içinde nadir görülür. Ancak erken tanı konduğunda, grade ve evresi düşük olan hastalarda tedaviye zaman kaybetmeden başlandığında hastaların sürvisi artmaktadır. 39 yaşındaki bayan hastamız eline kitle gelmesi üzerine başvuruyor. Yapılan tetkikler sonucunda Non Hodkin Lenfoma Diffüz Büyük B Hücreli Lenfoma olarak değerlendiriliyor. Evre-IIE favorabl, B semptomları olmayan hastaya 6 kür CHOP-R kemoterapi sonrasında küratif eksternal radyoterapi uygulanıyor. 48 aylık takipleri sonucunda hastada progresyon, nüks, metaztaz saptanmamış olarak takibe devam edilmektedir.Primary breast lymphoma is rarely encountered in Non-Hodgkin Lymphomas. However, if early diagnosis is made, and treatment is started immediately in patients with low grade and stage, patient survival is increased. 39-year old female patient applied us due to a palpable mass. She was diagnosed with the Non-Hodgkin Lymphoma Diffuse Large B Cell Lymphoma after the investigations. Curative external radiotherapy was applied after 6 courses of CHOP-R chemotherapy to the patient with Stage-IIE favorable, and B symptoms. After 48-month follow up, patient follow up is being continued without any progression, or recurrence or metastasis

IMMUNE MARKERS IN SURGICALLY RESECTED EARLY STAGE NON-SMALL CELL LUNG CANCER PATIENTS

Purpose: Non-small cell lung cancer (NSCLC) is the most common cancer and the leading cause of cancer-related deaths worldwide. Inflammatory markers, such as C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio and platelet-lymphocyte ratio (PLR), serve as indexes for the immune status of the host and the degree of tumor progression. In this study, we evaluated NLR and PLR values in early stage lung cancer patients before and after surgery and its correlation with clinical variables and survival

Primer Spinal Glioblastoma Multiforme: Bir Vaka Sunumu ve Literatür Derlemesi

Giriş: Primer spinal glioblastoma multiforme yüksek morbidite ve mortalite hızına sahip çok nadir görülen bir hastalıktır. Kesin bir tedavi algoritması yoktur ancak multimodal tedavi rejimleri uygulanmaktadır. Tedavinin amacı kitlenin tama yakın çıkarılması, sonrasında radyoterapi ve kemoterapinin kısa sürede uygulanmasıdır. Metod: 1989'dan itibaren İngilizce yazılmış makaleler, anahtar kelimelerin kullanılması ve derleme makalelerinden referansların ayrıştırılması yoluyla PubMed ve MEDLINE gibi arama motorları taranarak ayrıştırılmıştır. Kullanılan anahtar kelimeler primer, spinal ve glioblastoma multiformedir. Sonuçlar: Alt ekstremitede güçsüzlük ve gayta-üriner inkontinans ile başvuran 4 yaşındaki bir erkek hastada spinal manyetik rezonans görüntülemede (MRI)C2-T8 seviyesinde intramedüller kitle saptandı. Mikrocerrahi metodla kitlesi tama yakın çıkarılan hastada postoperatif dönemde sepsis gelişti. Radyoterapi başlanmasından kısa bir süre sonra klinik durumunda ve nörolojik tablosunda düzelme olan hasta ekstübe edildi. Tedavi sonrası hastanede 3 ay daha izlenmiştir. Literatür bulguları sGBM tedavisinde sekansiyel veya eş zamanlı olarak her üç modalitenin de kullanılabileceğini, kötü prognoza sahip olduğunu, hastaların çoğunluğunun hastalığa bağlı olarak öldüğünü ve semptomların süresinin çok kısa olduğunu göstermektedir. Tartışma: Hastalık nadir görüldüğü için, bu grup hasta popülasyonunda prospektif çalışmalar yapılamamaktadır.Introduction: Primary spinal glioblastoma multiforme is a very rare disease with high morbidity and mortality rates. No definite treatment algorhythm can be constituted, but multimodal treatment regimens have been administered. Aim of the treatment is to excise the mass nearly completely, and then application of radiotherapy and chemotherapy in a short period. Methods: Publications were identified by browsing search engines such as PubMed and MEDLINE for English-language articles since 1989 using a list of keywords; as well as identifying references from review articles. The following keywords were used for searching databases: primary, spinal, glioblastoma multiforme. Results: Intramedullary mass was detected at the levels of C2-T8 in the spinal magnetic resonance imaging (MRI) examination performed in our 4-year old male patient, who applied to us with complaints of weakness in lower extremities and gaita-urine incontinence. Sepsis was developed in postoperative period of the patient, whose mass was gross-totally resected by using microsurgery method. After the patient was started to have radiotherapy, he was extubated with improvements in the clinical state and neurological picture. He has been followed up at the hospital in the three-month monitorization after the treatment. Literature data suggested that all three therapy modalities can be used for sGBM, sequentially or concurrently, it has a poor survival, most of the patients die due to disease and the duration of symptoms are very short. Conclusion: Because the disease is very rare, prospective studies cannot be performed in this patient population

Primary Spinal Glioblastoma Multiforme: A Case Report and Review of The Literature

WOS: 000343369600017Introduction: Primary spinal glioblastoma multiforme is a very rare disease with high morbidity and mortality rates. No definite treatment algorhythm can be constituted, but multimodal treatment regimens have been administered. Aim of the treatment is to excise the mass nearly completely, and then application of radiotherapy and chemotherapy in a short period. Methods: Publications were identified by browsing search engines such as PubMed and MEDLINE for English-language articles since 1989 using a list of keywords; as well as identifying references from review articles. The following keywords were used for searching databases: primary, spinal, glioblastoma multiforme. Results: Intramedullary mass was detected at the levels of C2-T8 in the spinal magnetic resonance imaging (MRI) examination performed in our 4-year old male patient, who applied to us with complaints of weakness in lower extremities and gaita-urine incontinence. Sepsis was developed in postoperative period of the patient, whose mass was gross-totally resected by using microsurgery method. After the patient was started to have radiotherapy, he was extubated with improvements in the clinical state and neurological picture. He has been followed up at the hospital in the three-month monitorization after the treatment. Literature data suggested that all three therapy modalities can be used for sGBM, sequentially or concurrently, it has a poor survival, most of the patients die due to disease and the duration of symptoms are very short. Conclusion: Because the disease is very rare, prospective studies cannot be performed in this patient population