A small cell carcinoma in the testis associated with testicular teratoma

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Küçük hücreli akciğer kanserinde yıkıcı bir durum: Ektopik cushing sendromu

Ektopik adrenokortikotop (ACTH) salınmasına bağlı Cushing sendromu, küçük hücreli akciğer kanserli hastalarda diğer birçok paraneoplastik sendromlara göre daha sık görülür. Bu hastalarda hücresel bağışıklık sisteminin baskılanması hem hekimler hem de hastalar için önemli bir sorundur. Ek olarak kemoterapi, bu hastalarda şiddetli ve daha yüksek oranda hematolojik toksisiteye neden olmaktadır. Biz ektopik ACTH salınması ile ilişkili Cushing sendromuna bağlı humoral ve hücresel bağışıklık sistemi baskılanmış çok kötü seyirli bir küçük hücreli akciğer vakası sunduk. Ayrıca, bu özel vaka ve literatür ışığında Cushing sendrom olan küçük hücreli akciğerli hastalar için tedavi stratejileri önerdik.Ectopic secretion of adrenocorticotropic hormone (ACTH) related Cushing's syndrome (CS) is more frequently observed than many other paraneoplastic syndromes in patients with small cell lung cancer. Suppression of the cellular immune system in these patients is severe problem for both patients and physicians. In addition, the chemotherapy has been caused to severity and higher rate of hematological toxicity. We present a case of small cell lung cancer having a very poor prognosis, with a compressed humoral and cellular immune system due to an ectopic secretion of ACTH related CS. We report a rare case of combined immunosuppression in a case with small cell lung cancer in this paper. In addition, in the light of this special case and literature, we suggest treatment strategies for small cell lung cancer patients with CS

A case of gastric adenocarcinoma with rectal metastasis in the form of linitis plastica presenting as primary rectum carcinoma

Gastrointestinal sistemde linitis plastika şeklindeki metastazlar nadir olup sıklıkla primer tümörün mide olduğu bildirilmektedir. Biz rektuma linitis plastika şeklinde metastaz yapan mide adenokarsinom olgumuzu ender rastlanması ve primer lokal ileri rektum kanseri şeklinde karşımıza çıkması sebebiyle literatür bilgileri ışığında, gastrik adenokarsinomaların intestinal metastazlarının klinik, radyolojik ve patolojik özelliklerini de tartışarak sunmayı amaçladık.It is often reported that metastases in the form of linitis plastica developed in the gastrointestinal system are rare cases and frequently the primary tumor is located in the stomach. We presented a case of gastric adenocarcinoma developing a metastasis in the rectum in the form of linitis plastica, which appeared as a primary local advanced rectum cancer. We discussed the clinical, radiological, and pathological characteristics of the intestinal metastases of gastric adenocarcinomas

Comparison of the efficiency of carnitine with that of amifostine known to be a standard cytoprotective agent in preventing the damage of kidney tissue due to cisplatin

Tıpta Uzmanlık TeziSisplatin, kanser kemoterapisinde solid tümörlere karşı oldukça etkin ve geniş kullanıma sahip bir kemoterapötik ajan olmasına rağmen, nefrotoksik yan etkileri nedeniyle kullanımını önemli ölçüde kısıtlamaktadır. Buna bağlı olarak da renal toksisiteyi önleyici ajanların kullanımı son zamanlarda önem kazanmıştır. Çalışmamızda; amifostin ve karnitin ardından sisplatin verilen 24 haftalık ratlarda, bu iki ajanın koruyucu etkilerinin saptanması ve karşılaştırılması amaçlanmıştır. Amifostin ardından sisplatin, karnitin ardından sisplatin ve serum fizyolojik ardından sisplatin uygulanan üç deney grubu ile yalnız serum fizyolojik, yalnız amifostin ve yalnız karnitin verilen üç kontrol grubu olmak üzere toplam altı grup oluşturulmuştur. Deney gruplarına sisplatinden 30 dakika önce amifostin 200mg\kg ve karnitin 300mg\kg dozunda intraperitoneal olarak uygulanmıştır. Beş günlük izlem sonunda sakrifikasyon sonrası tüm ratların kan örnekleri biyokimyasal ve böbrekleri de histopatolojik incelemeye alınmıştır. Biyokimyasal ve histopatolojik olarak, sisplatinin böbrek fonksiyonlarını istatistiksel anlamlı olarak bozduğu görülmüştür. Amifostin, beklenilenin aksine, böbrekleri sisplatinin sebep olduğu biyokimyasal ve histopatolojik hasardan koruyamadığı gibi, biyokimyasal sonuçları istatistiksel anlamlı düzeyde olmasa da değersel olarak, glomerüler hasar, tubuler hasar, tubulointerstisyel infiltratlar ve total nefrotoksisite skorunu ise istatistiksel olarak anlamlı düzeyde bozduğu gözlenmiştir. Amifostin ile karnitin karşılaştırıldığında, her ne kadar karnitin sisplatin nefrotoksisitesine karşı istatistiksel olarak anlamlı düzeyde koruyucu bulunmadıysa da, amifostinden daha etkili olduğu saptanmıştır.AbstractEven though cisplatin is a considerably efficient chemotherapeutic agent against solid tumors with a wide range of use in cancer chemotherapy, its use is significantly limited due its to nephrotoxic side effects. The use of agents preventing renal toxicity has thus gained importance recently. The aim of this study is to explore and compare the protective effects of amifostine and carnitine in rats aged 24 weeks to which cisplatin was given following these two agents. Rats were separated into a total of six groups, three of them being experiment groups, and the other three being control groups. Cisplatin following amifostine were given to those in the first experiment group, cisplatin following carnitine to those in the second, and cisplatin following isotonic saline to those in the third one. As for the control groups, amifostine was given to those in the first group, carnitine to those in the second group, and isotonicl saline to those in the third one. In the experiment groups, 200 mg/kg amifostine and 300 mg/kg carnitine were given intraperitoneally 30 minutes before cisplatin. After an observation period of five days, the blood samples of the rats were examined biochemically, and their kidneys histopathologically.We determined that the use of cisplatin significantly causes biochemical and histopahologic damage to kidney functions with a statistic sinificance. It is also observed that, contrary to expectations, amifostine has not protected kidneys from the biochemical and histopathologic damage caused by cisplatin; and that it has affected the biochemical results qualitatively without statistic significance, and increased the glomerular damage, the tubular damage, the tubulointerstitial infiltrats, and the total nephrotoxicity score with a statistic significance. When compared with amifostine, although carnitine is not found protective against cisplatin nephrotoxicity with a statistic significance, it is observed to be more efficient than amifostine

Merkel hücreli karsinomun nadir bir presentasyonu

Yetmişbir yaşındaki erkek hastanın sırt ağrısı şikayetiyle hastaneye başvurusu sonrasında yapılan tetkiklerinde sol paravertebral alan ikinci vertebra düzeyinde kitle tespit edilmiş ve kitlenin en blok rezeksiyonu sonrasında histopatolojik olarak Merkel hücreli karsinom tanısı konmuştur. Postoperatif birinci ayında manyetik rezonans incelemede aynı alanda tespit edilen ve inoperabl olarak değerlendirilen kitle hastalığın hızlı ilerlediğini düşündürdü. Hasta radyokemoterapinin 6. gününde pnömoni sonucunda ortaya çıkan solunum yetersizliği nedeniyle hayatını kaybetti. Bu çok nadir görülebilecek bir olgu olmakla birlikte, intratorasik kitlelerin ayırıcı tanısında Merkel hücreli karsinom da düşünülmelidir.We describe a 71-year-old male patient admitted to the hospital with posterior chest pain. Following the detection of a paravetebral mass at the level of the 2nd thoracic vertebra, the patient underwent a surgical en bloc resection of the mass. The histopathologic examination revealed a Merkel cell carcinoma. One month after the operation, magnetic resonance imaging showed an inoperable mass in the same location, which indicated a rapid progression of the tumor. The patient died of progressive respiratory failure due to pneumonia on the 6th day after the onset of radiochemotherapy. Although this appears to be an isolated case, Merkel cell carcinoma must be included in the differential diagnosis of intrathoracic masses

An Unusual Presentation of Merkel Cell Carcinoma

We describe a 71-year-old male patient admitted to the hospital with posterior chest pain. Following the detection of a paravetebral mass at the level of the 2nd thoracic vertebra, the patient underwent a surgical en bloc resection of the mass. The histopathologic examination revealed a Merkel cell carcinoma. One month after the operation, magnetic resonance imaging showed an inoperable mass in the same location, which indicated a rapid progression of the tumor. The patient died of progressive respiratory failure due to pneumonia on the 6th day after the onset of radiochemotherapy. Although this appears to be an isolated case, Merkel cell carcinoma must be included in the differential diagnosis of intrathoracic masses

KRAS Mutation in Small Cell Lung Carcinoma and Extrapulmonary Small Cell Cancer

Background: Lung cancer is one of the most lethal cancers. It is mainly classified into 2 groups: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Extrapulmonary small cell carcinomas (EPSCC) are very rare. The Ras oncogene controls most of the cellular functions in the cell. Overall, 21.6% of human cancers contain a Kirsten Ras (KRAS) mutation. SCLC and EPSCC have several similar features but their clinical course is different. Aims: We investigated the KRAS mutation status in SCLC and EPSCC. Study design: Mutation research. Methods: Thirty-seven SCLC and 15 EPSCC patients were included in the study. The pathological diagnoses were confirmed by a second pathologist. KRAS analysis was performed in our medical genetic department. DNA isolation was performed with primary tumor tissue using the QIAamp DNA FFPE Tissue kit (Qiagen; Hilden, Germany) in all patients. The therascreen KRAS Pyro Kit 24 V1 (Qiagen; Hilden, Germany) was used for KRAS analyses. Results: Thirty-four (91.9%) of the SCLC patients were male, while 11 (73.3%) of the EPSCC l patients were female. SCLC was more common in males, and EPSCC in females (p=0.001). A KRAS mutation was found in 6 (16.2%) if SCLC patients. The most common mutation was Q61R (CAA>CGA). Among the 15 EPSCC patients, 2 had a KRAS mutation (13.3%). When KRAS mutant and wild type patients were compared in the SCLC group, no difference was found for overall survival (p=0.6). Conclusion: In previous studies, the incidence of KRAS mutation in SCLC was 1-3%; however, it was 16.2% in our study. Therefore, there may be ethnic and geographical differences in the KRAS mutations of SCLC. As a result, KRAS mutation should not be excluded in SCLC