Prognostic significance of omental disease and the role of omentectomy in non-endometrioid endometrial cancer

Objectives: Non-endometrioid endometrial cancers (non-EEC) have different management from endometrioid endometrial cancers. The purpose of this study was to investigate the prognostic significance of omental disease and the role of omentectomy in non-endometrioid endometrial cancer and discuss the current literature with the findings. Material and methods: The study included two hundred-three patients with non-EEC who underwent surgical treatment and follow-up between January 1996 and December 2018 in a University Hospital Gynecologic Oncology Center. The patients were divided into three groups according to whether omentectomy was performed and the presence of omental metastasis. The patient’s demographics, clinical characteristics such as stage, grade, histopathologic type, lymphovascular space invasion (LVSI), myometrial invasion, lymph node involvement, and survival outcomes were compared between the groups. Results: The study included 203 patients. Twenty-five patients (12%) had omental metastases. LVSI was reported in 57.3%, 88.0%, and 43.2% of the non-omentectomy, no-omental metastasis, and omental metastatic groups, respectively (p = 0.001). The 5-year disease-free survival (DFS) and overall survival (OS) rates according to the tumor grade, peritoneal cytology, and lymphadenectomy were also compared and were found to be statistically similar. The five-year OS rates were 70.6% for the group without omental metastases and 16.2% for the group with omental metastases, respectively (p = 0.001). In the group of omentectomy, the five-year DFS rates were 62.2% in cases without omental metastasis and 13.0% in cases with omental metastasis (p = 0.001). The five-year OS rates of 86.3% and DFS rates of 80.0% in the group without omentectomy. Conclusions: In non-endometrioid tumors, the survival rate was better in the group that did not undergo omentectomy. Based on these results, we can say that omentectomy may not be necessary for non-endometrioid tumors whose omentum is found to be normal in intraoperative visual examination

Malign mezotelyoma: mineralojik analiz, elektron mikroskobi, histokimya ve immünohistokimyanın tanı ve ayırıcı tanıdaki rolü

TEZ2952Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 1998.Kaynakça (s. 61-67) var.vii, 69 s. ; res. ; 30 cm.

Exceptional giant intestinal leiomyoma which is originated from intestinal mesenteric root ( Report of a case and review of the literature )

İnce bağırsak leiomyomaları oldukça nadir görülen tümörlerdir. 3 aylık karın ağrısı, diyare, karında şişlik şikayetleri ile müracaat eden 32 yaşında bir olgu takdim edildi. Preoperatif peritonoskopik biyopsi bulguları ile leiomyoma tanısı konuldu. 29x21x8 santimetrelik mezenterden kaynaklanan distal ileum leiomyoması cerrahi olarak çıkarıldı. Yaptığımız literatür araştırmasında bu kadar genç yaşta, ishalle seyreden, mezenter kökünden orijinini alan 10 santimetreden büyük ve peritonoskopi ile preoperatif tanı konulan başka bir leiomyoma vakası bulunamadı. 9 aylık takip süresinde klinik ve radyolojik nüks bulgularına rastlanmadı.Leiomyomas of small bowel are extremely rare lesions. A unique case is reported of 32 years old male patient who complains of abdominal swelling, pain and diarrhea for 3 months. 29x21x8 cms. leiomyoma of the mesenterium was excised surgically . Preoperative laparoscopic biopsy confirmed a tissue diagnosis of leiomyoma of distal ileum. A literature review showed the only case of ileal mesenteric root leiomyoma that had presented with diarrhea in this young age and also diameter more than 10 cms. No clinical and radiological evi- dence of recurrence was detected during a 9 month follow-up period

Paravertebral mass in a patient with thalassemia intermedia

Toraks içi ekstramedüller hematopoezis genellikle asemptomatik olan ve ender görülen bir tablodur. ?-talasemi intermedia’lı 31 yaşında erkek hasta, tesadüfen çekilen akciğer grafisinde sağ hiler bölgede, bilgisayarlı tomografisinde bilateral paravertebral kitle lezyonu tespit edildi. Uygulanan ince iğne aspirasyonunun sitolojik incelemesi sonucunda ekstramedüller hematopoezis tanısı konuldu. fiikâyeti olmayan hastaya herhangi bir tedavi uygulanmadı ve hasta düzenli aralıklarla izlemimizde tutulmaktadır.Intrathoracic extramedullary hematopoiesis is a rare and usually asypmtomatic disease. In a 31-year-old man with B-thalassemia intermedia was incidentally found to have right hilar mass. In computerized tomography paravertebral mass lesions were detected. Cytological analysis of fine needle aspiration revealed diagnosis of extramedullary hematopoiesis. The patient did not receive any therapy because he was asymptomatic and he is on our follow up

Fine needle aspiration biopsy in head and neck lesions

1994-1996 döneminde ince iğne aspirasyonu (İİA) polikliniğinde bizzat patolog tarafından gerçekleştirilen 1000 İİA olgusundan 584'ü baş -boyun lezyonlarına aittir. 560 olguda (% 95,89) İİA ile tanı için yeterli materyal elde edilmiştir. Seride 383 tiroid 115 lenf nodulu, 51 cilt-cilt altı ve 35 tükrük bezi lezyonu yer almaktadır. Hastalarda İİA'na bağlı komplikasyon olmamıştır. İİA'nu takiben biyopsi uygulanan 89 olgu gözönünde bulundurulduğunda sensitivite % 78, spesifite %94'tür.Baş boyun lezyonlarında İİA sitolojisi kolay, hızlı, ekonomik ve güvenilirliği yüksek bir tanı yöntemidir, işlemin patolog tarafından gerçekleştirilmiş olması yeterli tanısal materyal elde edilme oranını, doğru sitolojik yaklaşım ve tanıya varılmasını olumlu yönde etkilemekte; gerek hasta, gereke patolog ve klinisyenler açısından çeşitli avantajlar sağlamaktadır.During a period between 1994-1996,1000 fine needle aspirations ,(FNA) were performed by the pathologist in our FNA policlinic, 584 of these cases were located in, the region of head-neck. In 560 (95,89%) of the cases adequate materials were obtained: The distribution of the cases is 383 thyroid, 115 lymphnode, 51 cutaneus-subcutaneus and 35 salivary gland. There was no complications in any of the patients. In 89 cases, which performed biopsy followed by FNA, the sensitivity is 78% and specifity is 94%. In head-neck lesions FNA cytology is a simple ,rapid, low-costed and highly reliable diagnostic method. The fact procedure is carried on by a pathologist affect the rate of satisfactory diagnostic material, correct histologic intervention and diagnosis positively, provide numerous advantages for the patient, pathologist and clinicians.

A Unique Case of Merkel Cell Carcinoma with Ovarian Metastasis

Background: Merkel cell carcinoma (MCC) is a rare cutaneous/mucosal malignancy with very aggressive biology and increasing incidence. Ovarian metastasis is an exceptionally rare site for MCC, and only two cases have been reported in the literature. Case Report: We report MCC with ovarian metastasis. A 34 year-old female with previously excised MCC from preauricular skin presented with a pelvic mass 15 months after first diagnosis. Anti-cytokeratin (CK) 20 positivity, LCA (leucocyte common antigen), and TTF-1 (Thyroid transcription factor-1) negativity confirmed metastatic ovarian MCC. There was no evidence of recurrence or metastasis at 12 months after salpingo-oopherectomy. Conclusion: MCC should be considered in the differential diagnosis of primary and metastatic undifferentiated small round cell tumors of the ovary

Congenital Peribronchial Myofibroblastic Tumor: A Case Report and Review of the Literature

Background: Congenital peribronchial myofibroblastic tumor is a rare, solid mesenchymal tumor of the neonate, usually associated with non-immune hydrops fetalis. Case Report: We present a case of congenital peribronchial myofibroblastic tumor, in whom a right lung mass was detected in intrauterine life. 12 days after delivery by caesarean section, right lobectomy was performed. The tumor was limited to the lung, and was composed of spindle cells, proliferating around a bronchial unit. Central necrosis and 4-5 mitoses per 10 high power fields were present. The patient is well 26 months after surgery. Conclusion: We report this rare tumor with clinical, radiological and pathologic findings and a review of the literature.Background: Congenital peribronchial myofibroblastic tumor is a rare, solid mesenchymal tumor of the neonate, usually associated with non-immune hydrops fetalis. Case Report: We present a case of congenital peribronchial myofibroblastic tumor, in whom a right lung mass was detected in intrauterine life. 12 days after delivery by caesarean section, right lobectomy was performed. The tumor was limited to the lung, and was composed of spindle cells, proliferating around a bronchial unit. Central necrosis and 4-5 mitoses per 10 high power fields were present. The patient is well 26 months after surgery. Conclusion: We report this rare tumor with clinical, radiological and pathologic findings and a review of the literature

The Prevalence of Human Papillomavirus Genotypes in Women with Abnormal Cervical Cytology

Giriş: Human papillomavirüs (HPV) servikal kanserin majör sebebidir. Servikal kanser kadınlar arasında dünya genelinde ikinci en sık görülen kanser olmakla birlikte, gelişmekte olan ülkelerde kansere bağlı ölümlerin önemli etkenlerinden biridir. Dünyada her yıl yaklaşık 500.000 yeni servikal kanser tanımlanmakta ve bunların yarısına yakınının ölümle sonuçlandığı tahmin edilmektedir. Servikal kanser taramasında yüksek riskli HPV DNA testi ve sitolojik tarama testinin birlikte kullanılmasıyla servikal prekanseröz lezyonların erken tanısı ve tedavisi sonucu servikal kanser büyük oranda önlenebilir bir hastalıktır. Servikal kansere karşı primer koruma sağlayan profilaktik HPV aşılarının 2006 yılından itibaren uygulanmaya başlanmasıyla servikal kanser sıklığı ve mortalitenin azalması amaçlanmıştır. HPV aşısının, yüksek risk (HR) HPV tiplerine karşı immünite gelişmesini sağlayarak prekanseröz lezyonlara karşı korunmada etkin olduğu ispatlanmış ve bu aşı birçok ülkede rutin aşı programına dahil edilmiştir. Bu çalışmada, anormal servikal sitolojili kadınlarda gerçek zamanlı polimeraz zincir reaksiyonu (PCR) testi kullanılarak HPV prevalansı ve genotiplerinin tespiti amaçlanmıştır. Materyal ve Metod: Çalışmaya, 2015-2017 yılları arasında Çukurova Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Polikliniğine başvuran yaşları 30-65 yıl arasında değişen, HPV taraması yapılan, 53’ü anormal servikal sitolojili ve 262’si normal servikal sitolojili toplam 315 kadına ait servikal sürüntü örneği dahil edilmiştir. Servikal sürüntü örneklerden HPV genotiplemesi HPV Genotipleme Testi Bosphore HPV Genotyping High Risk Kit v1 (Anatolia Geneworks, Turkey) kullanılarak gerçek zamanlı PCR testiyle gerçekleştirilmiştir. Bulgular: Anormal sitolojili 53 kadında HPV infeksiyonunun prevalansı %69.8 (n= 37), kontrol grubunda ise %39.7 (n= 104) idi. Anormal sitolojili HPV pozitif 37 kadında en baskın HPV genotipi HPV 16 (%45.9) olup bunu HPV 56 (%18.9), HPV 18 (%16.2), HPV 52 (%13.5), HPV 68 (%13.5), HPV 33 (%10.8), HPV 35 (%10.8), HPV 58 (%10.8), HPV 51 (%8.1), HPV 39 (%5.4), HPV 45 (%5.4) ve HPV 66 (%5.4) izlemiştir. Kontrol grubunda HPV pozitif 104 kadın arasında en yaygın genotiplerin HPV 16 (%52.9), HPV 18 (%27.9), HPV 45 (%13.5), HPV 56 (%13.5), HPV 68 (%12.5) ve HPV 52 (%8.7) olduğu görülmüştür. Sonuç: Servikal prekanseröz lezyonu olan kadınlarda en baskın genotip HPV 16 olup servikal kanser için risk altındaki kadınların tespitinde onkojenik HPV genotiplerinin tanısı gereklidirIntroduction: Human papillomavirus (HPV) is the major cause of cervical cancer, which is the second most common cancer in the world among women and is one of the major causes of cancer-related deaths in developing countries. Approximately 500.000 new cervical cancers are identified each year in the world, and close to half of them are estimated to have resulted in death. Cervical cancer is largely a preventable disease by early detection and treatment of cervical precancerous lesions with the combined use of high risk (HR) HPV DNA testing and cervical cytology test in cervical cancer screening. Prophylactic human papillomavirus vaccines, which provide primary protection against cervical cancer, have been started to be applied since 2006 with the aim of decreasing the incidence of cervical cancer and mortality. HPV vaccine has been proven to be effective in protecting against precancerous lesions by providing immunity against high risk (HR) HPV types and has been included in the routine vaccination program in many countries. The aim of this study was to investigate the prevalence and genotypes of HPV using real-time PCR test in women with abnormal cervical cytology. Materials and Methods: Between 2015-2017, a total of 315 women aged between 30 and 65 years were screened for HPV in the Clinic of Gynecology and Obstetrics, Faculty of Medicine, Cukurova University. Out of the 315 female cervical swabs, a total of 53 had abnormal cervical cytology and 262 had normal cervical cytology. HPV genotyping from cervical swab samples was performed by realtime PCR using Bosphore HPV Genotyping High Risk Kit v1 (Anatolia Geneworks, Turkey). Results: The prevalence of HPV infection in 53 women with abnormal cytology was 69.8% (n= 37) and 39.7% (n= 104) in the control group. The most prevalent HPV genotype among 37 HPV-positive women with abnormal cytology was HPV 16 (45.9%), followed by HPV 56 (18.9%), HPV 18 (16.2%) HPV 52 (13.5%), HPV 68 (13.5%), HPV33 (10.8%), HPV35 (10.8%), HPV 58 (10.8%), HPV 51(8.1%), HPV 39 (5.4%), HPV 45 (5.4%), and HPV 66 (5.4%). Among HPV-positive 104 women as the control group, the most common genotypes were HPV 16 (52.9%), HPV 18 (27.9%), HPV 45 (13.5%), HPV 56 (13.5%), HPV 68 (12.5%,) and HPV 52 (8.7%). Conclusion: The most common genotype was HPV 16 in women with cervical precancerous lesions, and the diagnosis of oncogenic HPV genotypes is necessary to identify women at risk for cervical cancer

Postmenopozal Kadında Az Diferansiye Sertoli-Leydig Hücreli Tümör

Sertoli--Leydig hücreli tümör (SLHT)'lerin %70--75'i 40 yaşın altında, 0/010'dan azı menarştan önce veya postmenopozal dönemde görülmektedir. Bu çalışmada, postmenopozal lekelenme şek-- linde vajinal kanama ile hastanemize başvuran, sağ adneksiyal kitle saptanan 59 yaşındaki kadın olgu sunulmuştur. Olguya batın yıkama sıvısı örneklemesi, total abdominal histerektomi ve bilate-- ral salpingooferektomi yapıldı. İntraoperatif frozen kesitlerin değerlendirilmesinde seks kord stro-- mal tümör düşünüldü. Periton biyopsileri, omentektomi ve pelvik, paraaortik lenf nodu diseksiyonu ile evreleme cerrahisi yapıldı. Solid ve kistik alanlar içeren kitleden hazırlanan kesitlerin histopa-- tolojik incelemesinde; immatür görünümdeki sertoli hücrelerinin tübüller yanı sıra geniş sarko-- matöz dağılım paterni oluşturduğu görüldü. İmmünohistokimyasal çalışmada CD 56 ile kuvvetli, kalretinin, inhibin ile fokal pozitif boyanma görüldü. Histopatolojik ve immünohistokimyasal bul-- gular değerlendirilerek az diferansiye SLHT tanısı verildi. Az diferansiye SLHT nadir görülen, ayı-- rıcı tanısında iğsi hücre komponentli tümörlerin düşünülmesi gereken overin seks kord stromal tümörüdür.70—75% of Sertoli—Leydig cell tumors (SLCT) are diagnosed at before age of 40, and less than 10% takes place before menarche and following menapouse. We report case of right adnexal mass in 59 year—old postmenapousal woman who presented with vaginal bleeding. Sex—cord stro— mal tumor was diagnosed at peroperative frozen section assesment. Staging surgery consisting of peritoneal biopsies, omentectomy and pelvic paraaortic lymph node dissection was performed. ln histopathologic assesment of the slides which were prepared from solid—cyctic areas of the mass, revealed immature sertoli cells forming tubules and wide sarcomatoid differantiation. lmmunhis— tochemically, neoplastic cells stained strongly and diffusely positive with CD 56, focal positive with calretinin and inhibin. Poorly differentiated SLCT was diagnosed with the consideration of both histopathologic and immunhistochemical findings. Poorly differantiated SLCT are unusual sex cord stromal neoplasms of ovary of which differantial diagnosis should include spindle cell neoplasms