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Öğe Adenomatous hyperplasia of the rete testis: Not a true hyperplasia, just proliferation!(Termedia Publishing House Ltd, 2013) Ozgur, Tumay; Akin, Mehmet Mustafa; Gokce, Hasan; Davarci, MurselThere are several tumor-like lesions and miscellaneous neoplasms of the rete testis. We present a case with adenomatous hyperplasia of the rete testis (AHRT). The patient was 24 years old with undescended testis and was referred to our hospital. There were no clinical or endocrine abnormalities. Cryptorchidism was unilateral and the other testis was normal. Right orchiectomy was performed and sent to the pathology laboratory for examination. Morphologic and immunohistochemistry findings confirmed the diagnosis of AHRT in the case. The patient's post-operative course continues uneventfully. AHRT is a rare lesion and can be confused with malignancy. It is incidentally detected in microscopic investigation. It may present as a very small lesion detected in microscopic examination or a solid cystic mass lesion which is macroscopically evident. Clinical history, localization, histology features and immunohistochemistry are criteria for differentiating these lesions. We present this rare case for both surgeons and pathologists due to its importance as it can be confused with malignancy.Öğe A Case of Asymptomatic Riedel Thyroiditis with Follicular Adenoma in a Patient with a Multinodular Goiter: An Unusual Association(Bioscientifica Ltd, 2012) Ozgur, Tumay; Gokce, Hasan; Ustun, Ihsan; Yaldiz, Mehmet; Akin, Mehmet Mustafa; Gokce, CumaliBackground: Riedel's thyroiditis (RT) is a rare inflammatory disease that results in fibrosis of the thyroid gland and invasion to the surrounding structures of the neck. Follicular adenoma (FA) of the thyroid is the most common benign neoplasm of the gland. Patient Findings: A 42-year-old woman was referred to the outpatient clinic due to a multinodular goiter and thyroiditis. The patient was euthyroid and thyroid function tests were within normal limits. Thyroid antibodies (thyroid peroxidase antibody and thyroglobulin antibody) were high. Thyroid ultrasonography showed multiple iso-hypoechoic nodules and thyroiditis. Fine-needle aspiration cytology was performed, and it was consistent with 'suspicious for a follicular neoplasm' according to the Bethesda system. Due to the clinical findings, which included weight loss and sweating, and the cytological results indicative of a follicular neoplasm, the patient underwent a total thyroidectomy. The histopathological diagnosis was RT associated with FA. The patient was started on thyroid hormone (thyroxine) replacement therapy after surgery and was evaluated for additional fibrosis related to RT. Conclusions: To our knowledge, this is the first case of RT associated with FA in an asymptomatic patient with a multinodular goiter and high thyroid antibodies reported in the literature. Copyright (C) 2012 European Thyroid Association Published by S. Karger AG, BaselÖğe Factors Predicting Non- Sentinel Lymph Node Involvement in Sentinel Node Positive Breast Carcinoma(De Gruyter Open Ltd, 2011) Durak, Merih Guray; Akansu, Bulent; Akin, Mehmet Mustafa; Sevinc, Ali Ibrahim; Kocdor, Mehmet Ali; Saydam, Serdar; Harmancioglu, OmerObjective: In routine practice, axillary lymph node dissection is performed in early invasive breast cancer patients with positive sentinel node biopsy. However, sentinel node is the only involved axillary node in 40-70% of patients, and determining factors that predict axillary non-sentinel node involvement will therefore prevent unnecessary axillary lymph node dissection and decrease morbidity. Material and Method: In this study, 119 invasive breast cancer patients with sentinel node metastasis who underwent axillary lymph node dissection between 1998-2009 at our institution were studied. Primary tumor characteristics and features of the metastatic tumors in sentinel nodes, such as microanatomic location, size of metastasis, and the ratio of metastatic tumor area to the total sentinel node area were evaluated. Student's t-test and multivariate logistic regression were used for statistical analysis. Results: The mean age of the patients was 50.7 years (28-80). Forty-three patients (36%) had invasive ductal and 25 patients (21%) had invasive lobular carcinoma. Most of the patients had either pT1 (44%) or pT2 (54%) tumors. Fifty-four patients (45%) had no further positive nodes in the axilla. The metastatic deposits in the sentinel node were subcapsular in 16 patients (13%). The percent area of sentinel node occupied by tumor (p<0.001), number of sentinel nodes (p=0.041), and microanatomic location of metastatic tumor (p=0.002) were significantly associated with non-sentinel node metastasis in univariate analysis. The percent area of sentinel node occupied by tumor (p<0.001) and number of sentinel nodes (p=0.033) remained significantly associated with non-sentinel node involvement in multivariate analysis. Conclusion: In patients with invasive breast cancer and positive sentinel node, area percent of sentinel node occupied by tumor, and the number of sentinel nodes removed are independently predictive of non-sentinel node involvement.Öğe Funduscopic changes in white coat hypertension(Medi+World Int, 2012) Helvaci, Mehmet Rami; Ozcura, Fatih; Akin, Mehmet MustafaBackground: Diagnosis and management of hypertension is complicated by the fact that blood pressure (BP) varies greatly depending on various stresses. In the doctor's office in particular, measurements are often too high, which is defined as white coat hypertension (WCH). Although already known to have a high prevalence in society, prognostic significance of WCH remains controversial. Methods: We studied consecutive patients with WCH and sustained normotension (NT) at and over the age of 50 years just to catch, if found, the long term effects of WCH on eyes. Funduscopic examination was performed by the same ophthalmologist who was unaware of the patients' subclassification. Keith, Wagener, and Barker's classification of hypertensive retinopathy (HR) was used to define the funduscopic findings. Results: Fifty-six WCH and 51 sustained NT cases were studied. No case of grade III or IV HR was observed in either group. Eight cases of grade I HR (14.2%) were detected in the WCH group, whereas this ratio was 9.8% (five cases) in the sustained NT group (p>0.05). Similarly, although three cases of grade II HR (5.3%) were detected in the WCH group, this ratio was 3.9% (two cases) in the sustained NT group (p>0.05). Conclusion: As a result of nonsignificant differences between WCH and sustained NT groups according to funduscopic findings, and the already known high prevalences of WCH in society even in early decades, WCH should be considered as a response of the body against some metabolic stresses, and its follow up about progression to HT should be performed with regular home BP measurements.Öğe Intracranial Falcine Chondroma: A Case Report and Review of The Literature(Journal Neurological Sciences, 2012) Durak, Merih Guray; Niflioglu, Gulen Gul; Akin, Mehmet Mustafa; Ada, Emel; Acar, Umit; Canda, TulayIntracranial chondromas are rare neoplasms that are most commonly located at the skull base. Localization of this tumor in other areas, such as the convexity, falcine area, brain parenchyma or ventricles is less common. These slow-growing benign tumors have nonspecific symptoms, and variable radiological findings. Complete surgical removal is the treatment of choice, and long-term prognosis is favorable. Herein, we describe a rare case of intracranial falcine chondroma in a 29 year-old female, and review the pertinent literature.Öğe [Ruptured pulmonary hydatid cyst: a case report].(2012) Çelik, Tanju; Akçora, Bülent; Tutanç, Murat; Yetim, Tülin Durgun; Karazincir, Sinem; Akin, Mehmet Mustafa; Çelikkaya, Mehmet EminHydatid cyst (HD), a very common disease in the world, is often transmitted to humans through dog feces. HD is especially common in countries where agriculture and animal husbandry is prevalent. HD is caused by Echinococcus granulosus. The clinic course of HD usually features settling in the liver and lungs. Lung involvement with chest pain, cough, shortness of breath can cause non specific symptoms such as fever and hemoptysis. Diagnostic interventions for HD include chest X-ray tomography, and physical examination. Although the treatment options of HD vary according to the clinical findings of the patients, the primary treatment may be considered as surgery. The most frequently applied methods of surgical treatment are cystectomy and capitonnage. Medical treatment is usually warranted for complicated cases, including the patients with multiple and unresectable lesions, patients who refuse surgery and the patients who cannot tolerate surgery. Treatment with albendazole and its derivatives are used. In this case report, we present a child with primary complaints of cough, chest pain, dyspnea, fatigue and fever who was latterly diagnosed with lung HD.
