Carcinosarcoma of the breast: a case report

Meme karsinosarkomu, sarkom benzeri bileseni bulunan duktal tip karsinomayı ifade eden, malin epitelyal ve malin mezenkimal elemanların bir arada bulundugu bir malinitedir. Glandüler epitelin glandüler olmayan mezensimal dokuya farklanmasıyla ortaya çıkan ve seyrek görülen metaplastik meme kanserlerinin en seyrek görülen alt tipidir. Tüm meme malinitelerinin %1'inden azını olusturur. Literatürde karsinosarkomun radyolojik özelliklerinin degerlendirildigi sınırlı sayıda çalısma bulunmaktadır. Hastanemiz meme hastalıkları poliklinigine sol memede ele gelen kitle yakınmasıyla basvuran 44 yasında kadın hastada fizik bakı, mamografi ve ultrasonografi bulguları degerlendirildi. Mamografi ve ultrasonografide lobüle, karma solid ve kistik alanlar içeren kitle izlendi. Histopatolojik olarak karsinosarkom tanısı alan olguda parsiyel mastektomi ve aksiller diseksiyon yapıldı. Aksilladan çıkartılan 16 lenf nodunun biri metastatikti ve uzak metastaz saptanmadı. Bizim amacımız, nadir görülen bu tümörlerde radyolojik bulguları tanımlamak ve literatürü gözden geçirmektirCarcinosarcoma of the breast represents a ductal carcinoma which consists sarcoma like component. Both malign epithelial and malign mesenchymal elements exist together in the breast carcinosarcoma. Glandular epithelium differentiates into non-glandular mesenchymal tissue, a process called metaplasia. Metaplastic breast malignancy is a rare type of the breast cancer, moreover carcinosarcoma is the rarest subtype which is less than 1%of the whole breast cancers. There are limited studies and case reports of carcinosarcoma in literature. Fourtyfour aged woman applied to breast diseases polyclinic with palpable mass on her left breast. We evaluated the findings of the physical examination, mammography and ultrasound. On radiological evaluation we determined a lobulated complex mass with solid and cystic components. Histopathological examination resulted as carcinosarcoma. Lumpectomy and axillary dissection were performed. One axillary lymph node was metastatic out of 16 lymph nodes. There were no distant metastases. Our purpose is to define the radiologic findings about this rare tumour and to review the literature

Regional Clinical and Biochemical Differences among Patients with Primary Hyperparathyroidism

This study had been presented at the 6th ESES Biennial Scientific Meeting held in Cardiff (15-17 May 2014).Address for Correspondence: Dr. Özer Makay, Department of General Surgery, Division of Endocrine Surgery, Ege University School of Medicine, İzmir, TurkeyPhone: +90 232 390 50 50 Received: 13 July 2015 e-mail: [email protected]: 27 January 2016 o DOI: Background: Environmental habitat may play a role in clinical disparities of primary hyperparathyroidism (pHPT) patients. Aims: To compare preoperative clinical symptoms and associated conditions and surgical findings in patients with pHPT, living in different geographical regions from the Black Sea, Mediterranean and Anatolia regions. Study Design: Retrospective, clinical-based multicentric study of 694 patients with pHPT.Methods: Patients from 23 centers and 8 different geographical regions were included. Data related to baseline demographics, clinical, pathologic and treatment characteristics of 8 regions were collected and included age, gender, residential data, symptoms, history of fracture, existence of brown tumor, serum total Ca and p levels, serum parathormone (PTH) levels, serum 25-OH vitamin D levels, bone mineral density, size of the resected abnormal parathyroid gland(s), histology, adenoma, and multiple endocrine neoplasia (MEN)- or familial-related disease.Results: The median age was 54. Asymptomatic patient rate was 25%. The median PTH level was 232 pg/mL and serum total Ca was 11.4 mg/dL. Eighty-seven percent of patients had an adenoma and 90% of these had a single adenoma. Hyperplasia was detected in 79 patients and cancer in 9 patients. The median adenoma size was 16 mm. Significant parameters differing between regions were preoperative symptoms, serum Ca and p levels, and adenoma size. All patients from South-East Anatolia were symptomatic, while the lowest p values were reported from East Anatolia and the largest adenoma size, as well as highest Ca levels, were from Bulgaria.Conclusion: Habitat conditions vary between geographical regions. This affects the clinicopathological features of patients with pHPT

Adrenal ganglioneuroma with lymph node metastasis: a case report

Ganglionöroma sempatik sinir sisteminin iyi diferansiye bir tümörüdür. Adrenal bezde nadiren görülür. En sık görülen tutulum yerleri posterior mediasten ve retroperitondur. Bu tümörler benign olmasına karsın nadiren bölgesel lenf nodlarına metastaz yaparlar. Genellikle klinik olarak bulgu vermezler ve baska sebepler için yapılan arastırmalarda rastlantı sonucu saptanırlar. Histopatoloji, ganglionöroma tanısını koyma ve ganglionöroblastom ile nöroblastom ayırıcı tanısını koymada en önemli basamaktır. Burada sol adrenalde ganglionöroma saptanan eriskin bir hasta sunulmaktadır. Histopatolojik bakıda adrenalde matür ganglion hücreleri ve Schwannian stromadan olusan tümöral lezyon izlendi. Paraaortik lenf nodlarında benzer tümör dokusu saptandı. Adrenal bezde ganglionöroma nadir görülür ve operasyon öncesinde tanı koymak çok zordur. Histopatolojik inceleme tanı koymada en önemli basamaktır.Ganglioneuroma is a well differentiated neoplasia of sympathetic nervous system. It is rare in the adrenal gland. The most common sites of involvement are the posterior mediastinum and retroperitoneum. These tumors though benign, can very rarely metastasize to regional lymph nodes. They are usually clinically silent and detected during exploration of other unrelated conditions. Histopathology is the only tool to diagnose ganglioneuroma and to differentiate it from ganglioneuroblastoma and neuroblastoma.We present an adult case with ganglioneuroma in her left adrenal. Histopathological examination showed that the tumoral lesion was a ganglioneuroma composed of both mature ganglion cells and Schwannian stroma arising in the adrenal gland. The paraaortic lymph node showed the same tumoral tissue. In conclusion, ganglioneuroma occurs rarely in adrenal gland and pre-operative diagnosis is difficult. Histopathological examination is the crucial step of diagnosis

Paget's disease of the breast: a case report

Our case is a twenty-eight-year-old female lady who admitted to dermatology clinic of our university hospital with itchy lesions on her nipple-areolar complex of her right breast. She had these symptoms and signs for nearly two years and these lesions did not respond to topical treatment. Punch biopsy of the lesion revealed Paget's disease of the breast and the patient was referred to general surgery department. A sharply demarcated erythematous lesion with yellowish crusts were found at the nipple-areolar complex of right breast. No lumps were palpated in both of the breast and axillary examination was normal bilaterally. Mammography of right breast revealed pleomorphic microcalcifications with suspicious features of malignancy in the upper outside quadrant of the breast. Vacuum-assisted biopsy was performed and histopathological examination revealed İntraductal carcinoma. Skin sparing mastectomy and an immediate breast reconstruction with a Becker prosthesis was performed. The incidence of Paget disease below the age of thirty and the clinicopathological features of the disease were discussed in this case report

Problem-solving breast MRI: useful or a source of new problems?

PURPOSE:We aimed to evaluate the findings and results from breast magnetic resonance imaging (MRI) examinations performed for problem-solving purposes due to inconclusive conventional imaging findings.METHODS:Imaging findings, biopsy and follow-up results were retrospectively evaluated for breast MRI performed for problem-solving purposes at our department between January 2011 and December 2016 for cases whose mammography, tomosynthesis, or ultrasonography findings were inconclusive. RESULTS:Lesions were identified in 414 of 986 problem-solving MRI examinations, and 13.3% of these lesions were diagnosed as malignant. A total of 124 lesions were additionally found by MRI, and 9.7% of these lesions were diagnosed as malignant. MRI produced false-negative results in four cases. In cases whose conventional imaging methods yielded indefinite results, the sensitivity, specificity, negative and positive predictive values of MRI were found to be 96.3%, 83%, 99.3%, and 46.5%, respectively. For the additional lesions identified, the sensitivity, specificity, negative and positive predictive values of MRI were found to be 91.7%, 69%, 98.7%, and 24%, respectively.CONCLUSION:Breast MRI is a reliable problem-solving method for excluding malignancy that cannot be confirmed by conventional imaging. In such cases, additional findings from MRI may help identify new cancers that cannot be detected with conventional methods. However, it has moderately low specificity which may cause unnecessary biopsies, follow-ups, and anxiety to patients

Feeding tube displacement (case report)

Beslenme sondası takıldıktan sonra doğru yerleştirildiğini objektif olarak göstermek gereklidir. Beslenme tüpünün yerinin onayı için çekilen kontrol grafisinin önemini vurgulamak amacıyla, iki olgumuzda karşılaştığımız sorunları sunmayı amaçladık.This paper is aimed to express the importance of control x-ray following insertion of a feeding tube, regarding two cases with tube displacement

Co-gasification of oily sludge and chicken manure in a laboratory-scale updraft fixed bed gasifier

The purpose of this study is to obtain recycled beneficial products with the thermal decomposition of petrochemical industry bottom sludges using gasification processes in a laboratory-scale updraft circulation fixed bed reactor. This work as a result of the gasification experiments carried out at 700-800 degrees C in the presence of limited oxygen results in a waste mass decrease within the range of 64-98%. Furthermore, the calorific value obtained using a mixture of waste consisting of petro-chemistry tank bottom sludge (75%) and dry chicken manure (25%) at 700 degrees C, with a dry air flow rate of 0.05 L/min, is at 3872 kcal/m(3). Depending on the varying experimental conditions, the highest values for CH4 and H-2 gas are measured as 30% vol at 700 degrees C with a 0.05 L/min dried air flow. The co-gasification of chicken manure and petroleum oily sludge is a promising method for achieving sustainable waste management and energy recovery in the concept of waste-to-energy