Utility of Somatostatin Receptors in Gastrointestinal Tract and Pancreas Neuroendocrine Tumors

Aim: Neuroendocrine tumors (NETs) are heterogenous group of tumors. Most of gastroenteropancreatic NETs (GEPNETs) are welldifferentiated low-grade tumors but a subset of them displays aggressive behavior. Somatostatin receptors (SSTR) play an im-portant role in the pathogenesis of GEPNETs, and they display targets for therapy. We aimed to evaluate SSTR2, SSTR3, SSTR5 by immunohistochemistry in GEPNETs and correlate with clinicopathological findings.Materials and Methods: Totally 61 cases were enrolled into this study and evaluated for SSTR2, 3, and 5 by im-munohistochemically.Results: Mostly the patients had low-grade neoplasms and 23% of them had metastatic disease. Total-ly, 73%, 47%, and 26% positivity were found by SSTR2, SSTR3, and SSTR5, respectively. The histopathological grade was increased relative to decreasing expression levels of SSTRs. Among metastatic neoplasms, SSTR2 positivity was found to be greater than a non-metastatic disease.Conclusion:In conclusion, SSTRs are useful to predict the clinical outcomes as well as target of therapy

Signifance of Liver Ductal Plate Malformation in Differential Diagnosis of Autosomal Recessive Polycystic Kidney Disease: An Autopsy Case

WOS: 000360662000005Cystic renal diseases are a group of disorders that cause neonatal deaths. Autosomal recessive polycystic kidney disease (ARPKD) is a rare entity which may be associated with liver disorders. Presenting autopsy case was stillbirth in 31 + 1 gestational week. In postmortem autopsy, viewed through the capsule, the renal surface was filled by innumerable miniature cysts about 1 mm in diameter. istopathological examination revealed multiple cysts of variable size in the renal medulla and tortuosity, elongation of ductal plate of liver. The autopsy was evaluated as ARPKD and ductal plate malformation. This disorder is not usually compatible with life. Some of the other cystic kidney diseases have better clinical outcome and must be distinguished from ARPKD

Small Bowel Volvulus Secondary to Mucinous Cystadenoma of the Appendix: A Case Report

Amaç: Appendikste oluşan kistadenoma appendektomi ameliyatlarının %0.6'sında tespit edilen nadir bir patolojik durumdur. Bu yayının amacı, apendiks kistadenomuna bağlı gelişen ve cerrahi ile başarılı bir şekilde tedavi edilen, nadir görülen ileal volvulus olgusunu sunmaktır. Olgu: Yetmiş altı yaşındaki kadın hasta acil servisimize şiddetli sağ kadran ağrısı ile kabul edildi. Yapılan abdominal bilgisayarlı tomografide (Abdominal BT) ve abdominal direkt grafide bağırsak segmentlerinde yaygın dilatasyon ve periluminal sıvı koleksiyonları izlendi. Yapılan cerrahi operasyonda ince bağırsak bölgesinde volvulus ve appendiks bölgesinde 2 cm'lik kitle lezyonu nedeni ile apendektomi uygulandı. Volvüle olarak izlenen ileal segment parsiyel olarak uç-uca anastamoz yapılarak rezeke edildi. Alınan kitle histopatolojik olarak müsinöz kistadenoma ile uyumlu olarak geldi. Hastamız genel durumu düzeldikten sonra bir haftalık yatış periodu sonrası taburcu edildi. Sonuç: Appendiks lümeninde müsinöz neoplazi ile oluşan obstrüksüyon gastrointestinal sistemin değişik yerlerinden volvulus ile komplike olabilir. Vakamız ileal volvulus ile komplike olan ileri derecede nadir vaka presentasyonu özelliğini göstermektedirObjective: Appendiceal cystadenoma (AC) is a rare pathology diagnosed in 0.6% of all appendectomy operations. The purpose of the report was to present a rare case of ileal volvulus due to appendiceal cystadenoma, which was successfully treated with surgery. Case: A woman aged 76 years was admitted to our emergency service with severe right lower quadrant pain. Abdominal tomography and X-ray showed features of generalized dilatation of bowel segments with periluminal fluid collections. Intraoperatively, we found bowel volvulus and a 2 cm mass at the appendiceal borders and an appendectomy was performed. The volvulated ileal segment was resected and restored with end-to-end anastomosis. Histopathologic examination of the mass revealed mucinous cystadenoma. Our patient was discharged from hospital at postoperative one week with complete clinical recovery.Conclusion: Obstruction of the appendiceal lumen by a mucinous neoplasia can cause appendicitis followed by secondary volvulus in different parts of the gastrointestinal tract. Our case was further complicated by ileal volvulus, which led to an extremely rare presentatio

Morphologic evaluation of the effect of denosumab on giant cell tumors of bone and a new grading scheme

Giant cell tumor (GCT) is a rare, usually benign but locally aggressive neoplasm. Recent studies suggest new approaches in light of the elucidation of molecular pathways in bone. The osteolytic nature of GCT is caused by the receptor for activating nuclear factor-kB ligand (RANKL) associated osteoclasts. Denosumab is a monoclonal antibody that affects GCT through RANKL and it prevents normal and neoplastic osteolysis. The aim of this study is to evaluate the histopathologic alterations due to denosumab treatment and the efficiency of this drug in GCT therapy. Ten patients had been treated with denosumab and were included in the study. Pretreatment biopsies were interpreted as conventional GCTs and posttreatment biopsies of the ten patients’ GCTs were classified in accordance with the grading system. Only one patient had tumor remaining after treatment. There is limited data on histopathologic alterations that follow denosumab treatment. The bone pathologist should keep these changes in mind because they mimic different types of bone tumors. Furthermore, there is no widely accepted grading system to evaluate the effect of denosumab in GCT. Our study suggested a scheme that would be helpful to evaluate the efficiency of denosumab treatment in GCT

Therapy-Induced Neural Differentiation in Ewing's Sarcoma: A Case Report and Review of the Literature

WOS: 000466572300008PubMed ID: 28272685Ewing's sarcoma (ES) is a small round cell tumor of adolescents or young adults that usually arises in the deep soft tissues of the extremities. The tumor cells have uniform round nuclei, fine powdery chromatin and indistinct nucleoli. CD99 (O13) is a product of the MIC 2 gene that is highly sensitive to ES but not specific. A panel of markers should be used for the differential diagnosis of small round cell tumors because nearly all others, on occasion, show membranous staining for CD99. One of the defining feature of ES is the presence of 22q12 gene rearrangement. The presented case is a 6 year-old boy complaining of swelling on his right leg. The biopsy was compatible with classic ES in terms of histopathological, immunohistochemical and cytogenetic criteria. Wide surgical resection was performed after chemotherapy. The posttreatment specimen was composed of uniformly small round cells mixed with areas of ganglion cells embedded in neurophil-like fibrillary background. Immunohistochemically, neoplastic cells revealed strong CD99 (O13) and NSE staining and the tumor had EWSR1 gene rearrangement. Morphologic alterations due to treatment are commonly seen in pediatric tumors. Single case reports have defined neural differentiation in ES but to the best of our knowledge this is the first report of ES in the literature with all histopathological, immunohistochemical, and cytogenetic criteria evaluated in both pretreatment and posttreatment specimens

AN UNUSUAL PRESENTATION OF INTRAHEPATIC ARTERIOPORTAL FISTULA WITH MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS

WOS: 000391179400012Arterioportal fistula (APF) is a rare disorder of the mesenteric vasculature Patients with arterioportal fistula may present with complications, including portal hypertension (gastrointestinal bleeding and ascites), heart failure or intestinal ischemia. Furthermore, membranoproliferative glomerulonephritis (MPGN) subsequent to portosystemic shunts have been reported. In this paper, we report on a case of arterioportal fistula complicated with membranoproliferative glomerulonephritis and treated with an endovascular embolization procedure. A rapid improvement and complete resolution of ascites were observed following the treatment

Evaluation of epidermal growth factor receptor in odontogenic tumors and rare soft tissue tumors by immunohistochemical and fluorescence in situ hybridization methods

Purpose: The aim of this study is to investigate the role of epidermal growth factor receptor (EGFR) in odontogenic tumors and rare soft tissue tumors. Material and Methods: This study includes 28 cases (11 cases of odontogenic tumors and 17 cases of soft tissue tumors) which were diagnosed at Cukurova University Medical Faculty, Department of Pathology between 2002 and 2010. They were evaluated for immunohistochemical staining of EGFR and the presence of genetic abnormality by FISH method. Results: Eleven cases were positively stained by immunohistochemistry. Eight cases had genetic abnormality of EGFR gene by FISH method. Nine of eleven odontogenic tumors (81,8%) showed overexpression of EGFR by immunohistochemical method or FISH method. Conclusion: Our findings highlight that EGFR plays an important role in chordoma pathogenesis in soft tissue tumors. In addition to odontogenic tumors; two cases of vascular neoplasia, composite and retiform hemangioendothelioma, exhibited EGFR gene amplification. Interestingly, there is no avaliable data about EGFR gene status in these tumors. EGFR can be used for diagnostic purposes. Also, it is a target for anti-EGFR therapy. Therefore, EGFR gene status is a valuable marker for therapeutic management. [Cukurova Med J 2016; 41(2.000): 316-325

Abdominal extragenital endometriosis: single centre experience

WOS: 000437950900019Purpose: This study aimed to present our clinical experience on symptomatic intaabdominal extragenital endometriosis cases. Materials and Methods: In this study, patients undergoing surgery various indications and for which final histopathologic results reported as endometriosis were evaluated. Demographic characteristics, clinical presentations, localization of disease, surgical procedures and recurrence rates within follow-up period were presented. Results: Histopathologically confirmed 778 endometriosis patients were retrospectively analyzed. Extragenital abdominal endometriosis were present in 32 (4.1%) patients and all cases were symptomatic. The most common symptoms at index admission were mass detected within abdominal wall (n: 13; 40.6%) and chronic recurrence abdominal/pelvic pain (n: 9, 28.1%). 22% (n=7) of patients with abdominal extragenital endometriosis were diagnosed preoperatively. The operations performed were as follows: mass excision from the abdominal wall (n=14, 43.8%), appendectomy (n=5, 15.7%), pelvic mass excision(n=6, 18.8%), anterior resection (n=3, 9.4%), right hemicolectomy (n=2, 6,3%), and laparotomy with urinary stenting (n=2, 6,3%). Recurrence is reported in 6 (18.7%) cases at median follow-up of 42 months. Conclusion: Due to extragenital involvement, endometriosis should be part of differential diagnosis in all women who are reserved for abdominal surgery during reproductive era. Along with the complete excision, wound protector use can potentially decrease recurrence rates in cases diagnosed pre- or intraoperatively as endometriosis

Hypericum perforatum Extract Attennuates Gentamicin Induced Oxidative Stress, Apoptosis and Oedema in Kidney

WOS: 000452553400008Background and Objective: Hypericum perforatum, which have various names locally such as St. John Wort, is a plant which blooms between July and September at farms, borders of roads and woods, top of hills and grasslands, which is regulator of apoptotic mediators are shown in various studies. Also, it is known that gentamicin activates apoptotic mediators and causes necrosis in kidney. Due to this reason, a study was planned to examine the protective effects of Hypericum perforatum on nephrotoxicity caused by gentamicin. Materials and Methods: Mice were divided into three groups; control group, gentamicin group and perforatum extract group. About 100 mg kg(-1 )gentamicin and 70 mg kg(-1) H. perforatum extract are administered to related groups for 9 days. Renal tissue samples and blood samples are obtained for biochemical analysis. caspase-3, bax and bcl-2 proteins are analyzed by using ELISA method. Results: Gentamicin administration increased caspase-3, bax while it decreased bcl-2. H. perforatum administration to mice that are administered gentamicin previously decreased the rate of caspase-3, bax caused by gentamicin while it increased bcl-2. Gentamicin also increased serum BUN, creatinine, TOS and TNF-alpha levels and renal MDA levels significantly and decreased catalase (CAT) and glutathione (GSH) significantly compared to other groups. Gentamicin+perforatum extract treatment reversed these factors compared to the gentamicin group (p<0.05). Conclusion: Histopathologic examination revealed severeedematous damage gentamicin group and reduced edematous damage in the gentamicin+perforatum extract group. Hyperiam perforatum extract provides renal protection against gentamicin-induced nephrotoxicity through its antioxidant and anti-inflammatory effects.Research Fund of Cukurova UniversityCukurova University [TSA-2015-4649]This research was supported by the Research Fund of Cukurova University, Project TSA-2015-4649

A Giant Aggressive Angiomyxoma of the Pelvis Misdiagnosed as Incarcerated Femoral Hernia: A Case Report and Review of the Literature

Aggressive angiomyxoma (AA) is an uncommon mesenchymal tumor that is mostly derived from the female pelvic and perineal regions. AA is a locally infiltrative slow growing tumor with a marked tendency to local recurrence. Painless swelling located around the genitofemoral region is the common symptom; thus, it is often misdiagnosed as a gynecological malignancy or a groin hernia. A 35-year-old female patient who previously underwent surgery for left femoral hernia operation resulting in surgical failure was reoperated for a giant AA located in the pelvis. The tumor was completely excised with free margins. Histopathologic examination revealed an AA. The tumor size was measured as 24 × 12 × 6 cm with a weight of 4.2 kg. Immunohistochemically, the cells show positive staining with vimentin, desmin, estrogen, and progesterone receptor. S100, MUC4, CD34, and SMA were negative in the tumor cells. AA should be considered in the differential diagnosis of any painless swelling located in the genitofemoral region, particularly in women of reproductive age. The principle treatment should be complete surgical excision with tumor-free margins. Long-term follow-up and careful monitoring are essential due to its high tendency of local recurrence in spite of wide excision of the tumor. Adjuvant antihormonal therapy yields promising results for preventing recurrence