RESUMO
OBJECTIVE: The main feature of adult granulosa cell tumors (AGCT) is their capacity to secrete hormones, with nearly all of them capable of synthesizing oestradiol. The primary goal of this study is to identify synchronized endometrial pathologies, particularly endometrial cancer, in AGCT patients who had undergone a hysterectomy. MATERIALS AND METHODS: The study cohort comprised retrospectively of 316 AGCT patients from 10 tertiary gynecological oncology centers. AGCT surgery consisted of bilateral salpingo-oophorectomy, hysterectomy, peritoneal cytology, omentectomy, and the excision of any suspicious lesion. The median tumor size value was used to define the relationship between tumor size and endometrial cancer. The relationship between each value and endometrial cancer was evaluated. RESULTS: Endometrial intraepithelial neoplasia, or hyperplasia with complex atypia, was detected in 7.3% of patients, and endometrial cancer in 3.1% of patients. Age, menopausal status, tumor size, International Federation of Gynecology and Obstetrics stage, ascites, and CA-125 level were not statistically significant factors to predict endometrial cancer. There was no endometrial cancer under the age of 40, and 97.8% of women diagnosed with endometrial hyperplasia were over the age of 40. During the menopausal period, the endometrial cancer risk was 4.5%. Developing endometrial cancer increased to 12.1% from 3.2% when the size of the tumor was >150 mm in menopausal patients (p = 0.036). CONCLUSION: Endometrial hyperplasia, or cancer, occurs in approximately 30% of AGCT patients. Patients diagnosed with AGCT, especially those older than 40 years, should be evaluated for endometrial pathologies. There may be a relationship between tumor size and endometrial cancer, especially in menopausal patients.
Assuntos
Hiperplasia Endometrial , Neoplasias do Endométrio , Tumor de Células da Granulosa , Neoplasias Ovarianas , Adulto , Humanos , Feminino , Tumor de Células da Granulosa/cirurgia , Estudos Retrospectivos , Neoplasias Ovarianas/patologia , Neoplasias do Endométrio/patologiaRESUMO
PURPOSE: Extraoral approaches for open reduction and fixation of condylar fractures in children are associated with serious risks of complications, including facial nerve injury, facial scarring, parotid fistula, and auriculotemporal nerve injury. The purpose of this study was to retrospectively evaluate the outcomes of transoral endoscopic-assisted open reduction and internal fixation of condylar fractures and hardware removal in pediatric patients. MATERIAL AND METHODS: This study was designed as a retrospective case series. The study included pediatric patients admitted with condylar fractures that were indicated for treatment with open reduction and internal fixation. The patients were clinically and radiographically evaluated with regard to occlusion, mouth opening, lateral and protrusive movement of the mandible, pain, chewing and speech difficulties, and bone healing at the fracture site. Computed tomography images were used to assess the reduction of the fractured segment, the stability of fixation and progress of healing of the condylar fracture at follow-up visits. The same surgical treatment approach was applied to all patients. The data from the study were analyzed for a single group without any comparison to other groups. RESULTS: The technique was used for the treatment of 14 condylar fractures in 12 patients between the ages of 3 to 11 years. A total of 28 transoral endoscopic-assisted approaches to the condylar region either for reduction and internal fixation or hardware removal were applied. The mean operating time was 53.1 (±11.3) minutes for the fracture repair and 20 (±2.6) minutes for hardware removal, respectively. The mean follow-up time of the patients was 17.8 (±2.7) months (median: 18) months. All patients regained stable occlusion, satisfactory mandibular motion, stable fixation, and complete bone healing at the fracture site at the end of their follow-up period. There was no transient of permanent facial nerve or trigeminal nerve injury in any of the patients. CONCLUSIONS: Endoscopically assisted transoral approach is a reliable technique for reduction and internal fixation of condylar fracture and hardware removal in pediatric patients. The serious risks of extraoral approaches including facial nerve injury, facial scar, and parotid fistula can be eliminated by using this technique.
Assuntos
Traumatismos do Nervo Facial , Fraturas Mandibulares , Humanos , Criança , Pré-Escolar , Estudos Retrospectivos , Resultado do Tratamento , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/cirurgia , Côndilo Mandibular/lesões , Fraturas Mandibulares/diagnóstico por imagem , Fraturas Mandibulares/cirurgia , Fixação Interna de Fraturas/métodos , Cicatriz , SeguimentosRESUMO
Only 2% of all breast cancers are metastatic, making them extremely uncommon. They are frequently mistaken for a primary breast tumor. Although it has been observed, metastatic spread from primary uterine cancers is extremely uncommon. In the literature, our case represents the fourth endometroid adenocarcinoma metastasis from the uterus. Clinical, pathological, and immunohistochemical examination and management of metastatic endometrioid adenocarcinoma of the uterus' extragenital organ were described in this 69-year-old patient's case. Immunohistochemical analysis was performed on a breast biopsy taken from the patient who underwent therapy and discovered a breast mass two years later. Metastatic endometrial adenocarcinoma was diagnosed with negative signs pointing to mammaglobin, GCDFP-15 and GATA3 breasts and markers indicating endometroid adenocarcinomas such as p53, PAX8 and VIMENTIN support. As a result, a thorough clinical history is needed, with special attention to diagnoses of concurrent or prior malignancies, along with clinical examination, appropriate radiological evaluation, and immunohistochemistry. This is necessary to prevent unnecessary surgery, to provide appropriate systemic treatment, to ensure correct diagnosis, and to manage treatment.
Assuntos
Adenocarcinoma , Neoplasias da Mama , Carcinoma , Neoplasias do Endométrio , Feminino , Humanos , Idoso , Biomarcadores Tumorais , Adenocarcinoma/patologia , Neoplasias da Mama/diagnósticoRESUMO
ABSTRACT: Fractures involving the orbital floor such as blow-out fractures may cause damage to the infraorbital nerve (ION). The integrity and course of the nerve should be evaluated preoperatively in order to prevent from such nerve injuries. The anatomy of the ION can show variations in significant number of patients, which should be taken into account in treatment planning. In this report, the authors present a patient with an isolated fracture of the orbital floor, who had abnormal anatomy of his both IONs. Our treatment approach for this patient is presented along with relevant literature findings.
Assuntos
Órbita , Fraturas Orbitárias , Variação Anatômica , Humanos , Nervo Maxilar , Órbita/anatomia & histologia , Fraturas Orbitárias/diagnóstico por imagem , Fraturas Orbitárias/cirurgia , Planejamento de Assistência ao PacienteRESUMO
PURPOSE: To analyze the effects of various obstetric and perinatal factors on the severity of retinopathy of prematurity (ROP). METHODS: Infants born at ≤ 32 weeks of gestation, with less than 1500 g gestational weight and having at least stage 1 ROP, were reviewed. Group1A included treatment-requiring ROP (TR-ROP), and group 2A included the remaining patients not requiring treatment. Group 1B included stage 3 ROP cases, and group 2B included the remaining stage 2 or 1 ROP cases. Group 1C included cases with zone III disease, and group 2C the remaining. The control group (group C) was composed of premature infants without ROP. The multiple comparisons were made among groups 1A, 2A, and C; 1B, 2B, and C; 1C, 2C, and C. RESULTS: A total of 311 infants were included. Group 1A included 34 cases, group 1B 60, group 1C 51, and group C 98. Antenatal steroid administration, gestational diabetes mellitus (GDM), gestational weight (GW), gestational age (GA), sepsis, continuous positive airway pressure (CPAP) time, and invasive mechanical ventilation (MV) time were associated with TR-ROP, stage 3 ROP, and zone I, and II disease (p < 0.05). Pregestational diabetes mellitus (DM) was only associated with stage 3 ROP (p = 0.031). Gestational hypertension was only associated with zone I and II disease (p = 0.034). The use of low-molecular-weight heparin may be protective against stage 3 disease (p = 0.031). CONCLUSION: Antenatal steroid administration, GDM, GW, GA, sepsis, CPAP time, and invasive MV time were risk factors for TR-ROP and stage 3 ROP, while pregestational DM was only associated with stage 3 ROP.
Assuntos
Retinopatia da Prematuridade , Sepse , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Gravidez , Estudos Retrospectivos , Fatores de Risco , EsteroidesRESUMO
The present study aimed to investigate the association between the severity of erectile dysfunction (ED) and serum 25-hydroxy vitamin D. It also sought to determine the cut-off level of serum 25-hydroxy vitamin D for ED. This study included 130 men who had ED between 2018 and 2019. Patients were divided into three groups according to their scores on the international index of erectile function-5 (IIEF-5) Turkish validated short form questionnaire. The serum 25-hydroxy vitamin D results were compared between the groups. The mean age of the patients was 49.28 ± 13.62 years. Groups 1, 2 and 3 included 44 (33.8%) patients with severe ED, 56 (43.1%) patients with moderate ED and 30 (23.1%) patients with mild ED, respectively. Statistical significance was observed between the groups and serum 25-hydroxy vitamin D levels. A positive correlation was detected between the IIEF-5 scores, serum testosterone and serum 25-hydroxy vitamin D levels. A cut-off level for serum 25-hydroxy vitamin D was calculated as 27.32 ng/ml. During multivariate analysis, we found that serum 25-hydroxy vitamin D levels were independent prognostic risk factors for decreased IIEF-5 scores. Decreased serum 25-hydroxy vitamin D levels were associated with decreased IIEF-5 scores. Therefore, vitamin D replacement therapy may improve symptoms.
Assuntos
Disfunção Erétil , Adulto , Calcifediol , Disfunção Erétil/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença , Inquéritos e Questionários , Vitamina DRESUMO
Surgical management of temporomandibular joint (TMJ) ankylosis in children is often challenging and may result in various complications such as facial nerve injury and visible scar. In this clinical report, the authors present minimally invasive management of a 9-year-old boy with bilateral post-traumatic TMJ ankylosis. The ankylotic TMJs were addressed and gap arthoplasties were performed by endoscopically assisted transoral approach. The risk of facial nerve injury is minimized and facial scar was prevented by avoiding extraoral incision. Mandibular movements in 3 directions were satisfactory at 3rd postoperative month.
Assuntos
Anquilose/cirurgia , Artroplastia/métodos , Mandíbula/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Transtornos da Articulação Temporomandibular/cirurgia , Articulação Temporomandibular/cirurgia , Anquilose/diagnóstico , Criança , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Boca , Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
Foot and ankle osteoid osteomas (OOs) are often cancellous or subperiosteal and rarely present with a periosteal reaction. Additionally, the large number of disorders included in the differential diagnosis and the nonspecific findings on radiographs complicate the diagnosis. We performed a manual search of the senior surgeon's hospitals' operating room records for the terms "benign bone tumor," "foot," "ankle," and "osteoid osteoma" from January 2003 until December 2014. Of 87 surgically treated patients with lower extremity OOs, 9 patients (11%) with foot or ankle OOs were included. The mean age at presentation was 21 (range 6 to 30) years; all 9 (11%) patients were male. The patients were evaluated for swelling, pain, trauma history, night pain, response to pain relievers, duration of complaints, and interval to diagnosis. The mean follow-up period was 48 ± 24 months, and no recurrences had developed. The mean American Orthopaedic Foot and Ankle Society scale score was 59.04 ± 11 before surgery and 91.56 ± 6 after surgery. The difference was statistically significant at p ≤ .0003. Most previous studies have been limited to case reports. The need for findings from a case series was an essential determinant of our decision to report our results. Patients usually have been treated conservatively, often for a long period. However, delays in treatment cause social, economic, and psychological damage. In conclusion, the presence of atypical findings on radiographs has resulted in a preference for magnetic resonance imaging instead of computed tomography; however, the diffuse soft tissue edema observed on MRI can lead to the use of long-term immobilization and a delay in the diagnosis.
Assuntos
Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/cirurgia , Fíbula , Ossos do Pé , Osteoma Osteoide/diagnóstico , Osteoma Osteoide/cirurgia , Adolescente , Adulto , Criança , Estudos de Coortes , Humanos , Imageamento por Ressonância Magnética , Masculino , Radiografia , Adulto JovemRESUMO
Osteochondromas are the most common benign tumor of the bones which are cartilage-capped exophytic lesions that arises from the bone cortex. They usually seen in the axial skeleton, especially around the metaphysis of long bone but seldom in the head and neck region. The majority of patients in the head and neck region affect the mandibular area. To our knowledge, this is the first reported patient with an osteochondroma of the temporal bone in the English literature. A patient with temporal bone osteochondroma and its surgical treatment are here described.
Assuntos
Neoplasias de Cabeça e Pescoço/cirurgia , Osteocondroma/cirurgia , Neoplasias Cranianas/cirurgia , Osso Temporal , Feminino , Humanos , Adulto JovemRESUMO
PURPOSE: To evaluate the bone regeneration capacity of bone marrow-derived stem cells (BMSCs) in vertical guided augmentation of bone tissue. MATERIAL AND METHODS: The calvaria of 20 rabbits were vertically augmented with autogenous bone graft (ABG); collagen/beta-tricalcium phosphate (ß-TCP) linked scaffold transplanted with 15 × 10 BMSCs; or scaffold alone (control). The augmentation materials were covered with stainless steel domes. BMSCs were isolated with Ficoll-Paque technique and applied directly without in vitro expansion. The newly formed bone was evaluated using radiodensitometric, histomorphometric, histological, and micro-computed tomographic (micro-CT) analyses after a 12-week healing period. The data excluding micro-CT assessments were compared statistically. RESULTS: Radiodensitometric and bone volume parameters demonstrated increased bone formation in both BMSC group and ABG group compared with control group (P < 0.01), but difference between the BMSC and ABG groups was not significant (P > 0.05). The mean histological scores for the BMSC, ABG, and control groups were 7.44 ± 1.03, 8.44 ± 0.81, and 6.00 ± 1.10, respectively, indicating significant difference among the groups (P < 0.05). CONCLUSION: BMSCs delivered with a collagen/ß-TCP linked scaffold can provide improved new bone formation that is comparable with autogenous bone block graft through vertical guided bone regeneration technique.
Assuntos
Regeneração Óssea , Transplante de Células-Tronco Mesenquimais , Animais , Densidade Óssea , Transplante de Células-Tronco Mesenquimais/métodos , Coelhos , Crânio/anatomia & histologia , Crânio/diagnóstico por imagem , Crânio/crescimento & desenvolvimento , Alicerces Teciduais , Microtomografia por Raio-XRESUMO
OBJECTIVES: The objective of this prospective, controlled clinical study was to determine the outcomes of dental implant therapy with staged guided bone regeneration procedures in patients with type 2 diabetes. PATIENTS AND METHODS: Twenty-four patients were included in the study. Half of the patients were diagnosed with type 2 diabetes mellitus (group 1) while the other half (group 2) of the patients consisted of patients without diabetes. The edentulous maxillary anterior/premolar regions with sufficient vertical height but inadequate horizontal width were treated with staged guided bone regeneration technique and with one or two implant-supported fixed restorations. The patients were followed up at least for 12 months. The parameters that were evaluated were radiographic evaluations on CBCT images and periapical radiographs, histomorphometric analysis, resonance frequency analysis (RFA) and wound-healing parameters. The data were analyzed statistically. RESULTS: A total of 43 implants were placed in 24 patients (22 implants in group 1 and 21 implants in group 2). The survival rates of implants were 100% for both groups. The success rate of implants was 95% for group 1 and 100% for group 2. None of the parameters including CBCT findings, RFA values, success rates and wound-healing scores showed a significant difference between the two groups. CONCLUSION: Staged guided bone regeneration is a feasible augmentation procedure for the treatment of horizontal bone deficiencies of the maxillary anterior/premolar regions in well-controlled type 2 diabetic patients.
Assuntos
Regeneração Óssea , Implantação Dentária Endóssea , Implantes Dentários , Regeneração Tecidual Guiada , Adulto , Idoso , Perda do Osso Alveolar/diagnóstico por imagem , Implantação Dentária Endóssea/métodos , Diabetes Mellitus Tipo 2 , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Pré-Protéticos Bucais , Estudos Prospectivos , Resultado do Tratamento , CicatrizaçãoRESUMO
PURPOSE: The aim of the present prospective, randomized, controlled, clinical study was to compare the outcomes of periradicular surgery of the maxillary first molar tooth using the vestibular approach between 2 preoperative radiologic evaluation methods: cone beam computed tomography (CBCT) and conventional radiography. PATIENTS AND METHODS: Periradicular surgery was applied to the maxillary first molar tooth in 40 patients. The patients were divided into 2 groups. The patients in group 1 underwent examination and preoperative planning with CBCT, and the patients in group 2 underwent examination and preoperative planning with conventional radiography. The outcomes of the treatment were evaluated radiographically and clinically, and the data were analyzed statistically. RESULTS: The mean operative time was significantly shorter in group 1 than in group 2. According to the radiographic and clinical healing criteria used in the present study, the healing of patients in group 1 was rated as a success in 35%, an improvement in 40%, and a failure in 25%. In the group 2 patients, healing was rated as a success in 42.1%, an improvement in 31.6%, and a failure in 26.3%. Sinus membrane elevation was performed in 92.3% of all patients. Sinus membrane perforation occurred in 20% of the patients in group 1 and 36.8% of the patients in group 2. CONCLUSIONS: Periradicular surgery of maxillary first molars using a vestibular approach is a viable treatment method with a low complication rate. Preoperative CBCT examination demonstrated positive contributions to the treatment outcomes.
Assuntos
Maxila/cirurgia , Dente Molar/cirurgia , Raiz Dentária/cirurgia , Abscesso/etiologia , Apicectomia/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Fístula Dentária/etiologia , Edema/etiologia , Feminino , Seguimentos , Humanos , Complicações Intraoperatórias , Masculino , Maxila/diagnóstico por imagem , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/lesões , Dente Molar/diagnóstico por imagem , Mucosa Nasal/lesões , Duração da Cirurgia , Osteotomia/métodos , Medição da Dor , Planejamento de Assistência ao Paciente , Doenças Periapicais/diagnóstico por imagem , Doenças Periapicais/cirurgia , Complicações Pós-Operatórias , Estudos Prospectivos , Obturação Retrógrada/métodos , Preparo de Canal Radicular/métodos , Retalhos Cirúrgicos/cirurgia , Ápice Dentário/diagnóstico por imagem , Ápice Dentário/cirurgia , Raiz Dentária/diagnóstico por imagem , Resultado do Tratamento , Cicatrização/fisiologiaRESUMO
This study aimed to assess the reliability and safety of transoral endoscopic-assisted reduction internal fixation (TERIF) for treating short-segment condylar neck fractures (CNF), including hardware removal. Patients with displaced CNF and short condylar segments treated using TERIF were included in the study. Clinical evaluation covered dental occlusion, range of mouth opening, deviation during mouth opening, protrusion, laterotrusion, pain, and chewing. Radiological evaluation was used to assess fracture displacement, angulation, head dislocation, postoperative reduction, fixation stability, and bone healing. The same technique was used to treat 15 patients with 18 CNF and short condylar segments. Hardware removal was performed for nine fractures in eight patients after fracture healing using the same approach. All patients regained satisfactory, pain-free mouth opening with no deviation and complete bone healing. Computed tomographic images displayed adequate reduction and stable fixation during the follow-up period for all patients. No temporary or permanent facial nerve impairment occurred in any of the patients. TERIF is a reliable and safe treatment for CNF with short condylar segments, even in the presence of head dislocation, medial override, and malunited fractures; hardware can be safely removed after healing using the same approach.
Assuntos
Fixação Interna de Fraturas , Côndilo Mandibular , Fraturas Mandibulares , Humanos , Fraturas Mandibulares/cirurgia , Fraturas Mandibulares/diagnóstico por imagem , Côndilo Mandibular/cirurgia , Côndilo Mandibular/lesões , Côndilo Mandibular/diagnóstico por imagem , Fixação Interna de Fraturas/métodos , Fixação Interna de Fraturas/instrumentação , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Adulto Jovem , Tomografia Computadorizada por Raios X , Endoscopia/métodos , Cirurgia Endoscópica por Orifício Natural/métodos , Resultado do TratamentoRESUMO
OBJECTIVE: We always confirm the diagnosis of syndesmotic injury with a Hook test for all ankle fractures and fixed if necessary. Then, we noticed a discrepancy between preoperative radiology and the Hook test. Moreover, we want to report the reliability of syndesmotic fixation decisions with Hook test and preoperative radiology. METHODS: A total of 37 surgically treated patients with isolated Weber type C ankle fractures were included in the study. In all patients, the syndesmosis joint was injured in preoperative computed tomography and X-ray imaging. However, only patients with (+) Hook tests had undergone a syndesmosis fixation. Patients were divided into two groups: Group A: Hook tests (+) and Group B: Hook test (-). Also, the groups were compared according to clinical outcomes with the Visual Analog Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS), and foot and ankle disability index (FADI) scores. RESULTS: The mean participant age was 39 (19-80) years, and the mean follow-up period was 47.27 (22-68) months. Groups A and B consisted of 17 (45.9%) and 20 (54.1%) patients, respectively. The mean VAS, AOFAS, and FADI scores were 17.7±14.3, 90.32±8.06, and 92.9±6.88, respectively. "Excellent" and "good" results were found in 34 (%91.8) patients according to AOFAS nad FADI. The malreduction rate was 8.1% in all patients, 5% in group A, and 11.8% in group B. No statistically significant differences in final functional scores were found between groups A and B. CONCLUSION: Hook test is reliable and adequate for evaluating the stability and quality of syndesmosis reduction. Weber type C lateral malleolar fractures in the decision of syndesmosis fixation; although syndesmosis injury is diagnosed in preoperative radiology, we recommend that the diagnosis be confirmed with the Hook test.
RESUMO
AIM: The aim of our study is to examine the clinical, surgical, and pathological factors of stage 1C adult granulosa cell tumor (AGCT) patients and to investigate the effects of adjuvant therapy on recurrence and survival rates in this patient group. METHODS: Out of a total of 415 AGCT patients treated by 10 tertiary oncology centers participating in the study, 63 (15.2%) patients with 2014 FIGO stage IC constituted the study group. The FIGO 2014 system was used for staging. Patient group who received adjuvant chemotherapy was compared with patient group who did not receive adjuvant chemotherapy in terms of disease-free survival (DFS), and disease-specific survival. RESULTS: The 5-year DFS of the study cohort was 89%, and the 10-year DFS was 85%. Those who received adjuvant chemotherapy and those who did not were similar in terms of clinical, surgical and pathological factors, except for peritoneal cytology. In the univariate analysis, none of the clinical, surgical or pathological factors were significant for DFS. Adjuvant chemotherapy and type of treatment protocol had no impact on DFS. CONCLUSION: Adjuvant chemotherapy was not associated with improved DFS and overall survival in stage IC AGCT. Multicentric and randomized controlled studies are needed for early stage AGCT in order to confirm these results and reach accurate conclusions.
Assuntos
Tumor de Células da Granulosa , Neoplasias Ovarianas , Adulto , Feminino , Humanos , Tumor de Células da Granulosa/tratamento farmacológico , Tumor de Células da Granulosa/patologia , Estadiamento de Neoplasias , Quimioterapia Adjuvante , Terapia Combinada , Estudos Retrospectivos , Neoplasias Ovarianas/tratamento farmacológicoRESUMO
OBJECTIVE: To define the clinical, histopathological features and the prognostic factors affecting survival in patients with adult granulosa cell tumors of the ovary (AGCT). METHODS: A 322 patients whose final pathologic outcome was AGCT treated at nine tertiary oncology centers between 1988 and 2021 participated in the study. RESULTS: The mean age of the patients was 51.3±11.8 years and ranged from 21 to 82 years. According to the International Federation of Gynecology and Obstetrics 2014, 250 (77.6%) patients were stage I, 24 (7.5%) patients were stage II, 20 (6.2%) patients were stage III, and 3 (7.8%) were stage IV. Lymphadenectomy was added to the surgical procedure in 210 (65.2%) patients. Lymph node involvement was noted in seven (3.3%) patients. Peritoneal cytology was positive in 19 (5.9%) patients, and 13 (4%) had metastases in the omentum. Of 285 patients who underwent hysterectomy, 19 (6.7%) had complex hyperplasia with atypia/endometrial intraepithelial neoplasia, and 8 (2.8%) had grade 1 endometrioid endometrial carcinoma. It was found that 93 (28.9%) patients in the study group received adjuvant treatment. Bleomycin, etoposide, cisplatin was the most commonly used chemotherapy protocol. The median follow-up time of the study group was 41 months (range, 1-276 months). It was noted that 34 (10.6%) patients relapsed during this period, and 9 (2.8%) patients died because of the disease. The entire cohort had a 5-year disease-free survival (DFS) of 86% and a 5-year disease-specific survival of 98%. Recurrences were observed only in the pelvis in 13 patients and the extra-abdominal region in 7 patients. The recurrence rate increased 6.168-fold in patients with positive peritoneal cytology (95% confidence interval [CI]=1.914-19.878; p=0.002), 3.755-fold in stage II-IV (95% CI=1.275-11.063; p=0.016), and 2.517-fold in postmenopausal women (95% CI=1.017-6.233; p=0.046) increased. CONCLUSION: In this study, lymph node involvement was detected in 3.3% of patients with AGCT. Therefore, it was concluded that lymphadenectomy can be avoided in primary surgical treatment. Positive peritoneal cytology, stage, and menopausal status were independent prognostic predictors of DFS.
Assuntos
Tumor de Células da Granulosa , Neoplasias Ovarianas , Humanos , Feminino , Pessoa de Meia-Idade , Tumor de Células da Granulosa/patologia , Tumor de Células da Granulosa/terapia , Tumor de Células da Granulosa/mortalidade , Adulto , Estudos Retrospectivos , Idoso , Prognóstico , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/terapia , Turquia/epidemiologia , Idoso de 80 Anos ou mais , Adulto Jovem , Excisão de Linfonodo , Estadiamento de Neoplasias , Histerectomia , Quimioterapia Adjuvante , Metástase LinfáticaRESUMO
PURPOSE: The objective of this study was to evaluate the diagnostic concordance characteristics of oral cavity lesions by comparing the clinical diagnosis of the lesions with the histopathologic diagnosis. MATERIAL AND METHOD: A retrospective analysis was conducted on the patients, who were admitted with oral cavity pathology and underwent biopsy procedure between 2007 and 2011. The oral cavity lesions were classified into 6 different groups as odontogenic cysts, nonodontogenic cysts, odontogenic tumors, nonodontogenic tumors, malignant tumors, and precancerous lesions in accordance with the 2005 WHO classification. The diagnoses were also recategorized into 3 groups expressing prognostic implications as benign, precancerous, and malignant. The initial clinical diagnoses were compared with the histopathologic diagnoses. Data were analyzed statistically. RESULTS: A total of 2718 cases were included. Histopathologic diagnosis did not match the clinical diagnosis in 6.7% of the cases. Nonodontogenic tumors and malignant tumors had the highest misdiagnosis rates (11.5% and 9%, resp.), followed by odontogenic tumors (7.7%), precancerous lesions (6.9%), and odontogenic cysts (4.4%). Clinicians were excelled in diagnosis of benign and precancerous lesions in clinical setting. CONCLUSION: The detailed discordance characteristics for each specific lesion should be considered during oral pathology practice to provide early detection without delay.
Assuntos
Doenças da Boca/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Criança , Pré-Escolar , Feminino , Humanos , Doenças Maxilomandibulares/diagnóstico , Doenças Maxilomandibulares/patologia , Neoplasias Maxilomandibulares/diagnóstico , Neoplasias Maxilomandibulares/patologia , Masculino , Pessoa de Meia-Idade , Doenças da Boca/patologia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia , Cistos Odontogênicos/diagnóstico , Cistos Odontogênicos/patologia , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/patologia , Exame Físico , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/patologia , Prevalência , Reprodutibilidade dos Testes , Estudos Retrospectivos , Distribuição por Sexo , Adulto JovemRESUMO
PURPOSE: The aim of this cross-sectional study was to evaluate the effects of smoking on periimplant health status and inflammatory cytokines interleukin-1ß, tumor necrosis factor-α, and prostaglandin E2 levels in periimplant crevicular fluid (PICF) and to determine their correlation with clinical parameters in well-maintained implant recall patients. MATERIAL AND METHODS: A total of 60 dental implants placed in 60 patients (27 patients were smoker and 33 were nonsmoker) were included in the study. Plaque index, gingival index, probing depth, periimplant bone loss, PICF volume, and biochemical cytokine levels in PICF were determined and analyzed statistically. The correlation between PICF cytokine levels and clinical parameters were also analyzed. RESULTS: All clinical parameters with the exception of plaque scores were significantly higher in the smoker group. Significantly increased levels of cytokines were observed in the smoker group. The correlation between the cytokine levels and clinical parameters were more marked in smokers. CONCLUSIONS: Although the implants of the smoker patients seem to be clinically healthy, the results demonstrate that the implants are relatively at risk even if in a well-maintained population.
Assuntos
Implantação Dentária , Dinoprostona/análise , Líquido do Sulco Gengival/química , Interleucina-1beta/análise , Fumar/efeitos adversos , Fator de Necrose Tumoral alfa/análise , Adulto , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/epidemiologia , Estudos Transversais , Implantação Dentária/efeitos adversos , Índice de Placa Dentária , Falha de Restauração Dentária , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , RadiografiaRESUMO
This study aimed to evaluate the frontal bone of Swiss Domestic pigs as an animal model for the histologic-histomorphometric examination of bony tissue around dental implants. We inserted SLA surface implants 4.1 mm in diameter and 10 mm in length into the frontal bones of 9 Swiss-Domestic pigs. Histologic and histomorphometric studies were conducted on the undecalcified sections. Histologic examinations showed that the specimens contain a sufficient amount of bone to provide homogenous bone coverage for standard diameter dental implant placement. The mean bone to implant contact was 61.9% ± 8.7%. Other histomorphometric parameters revealed the regular trabecular architecture at this site. Pigs' frontal bone appears to be a suitable animal model in short-term dental implant studies because it provides a sufficient amount of bone and favorable bone microarchitecture.
Assuntos
Implantes Dentários , Osso Frontal/anatomia & histologia , Modelos Animais , Osseointegração , Suínos , Animais , Densidade ÓsseaRESUMO
INTRODUCTION: There are several studies in the literature about pathological fractures but almost no information about patients whose pathological fracture caused by a malignant lesion misdiagnosed and treated as a simple fracture. The aim of this study was to investigate patient and fracture characteristics, and outcomes in cases where fractures occurred in the presence of a malign pathology but were treated as simple fractures. PATIENTS AND METHODS: Cases of malign bone lesions between 2000 and 2020 were retrospectively reviewed. Patients with a final diagnosis of malign bone lesion but whose pathological fractures were treated ignoring the underlying malign bone disease were included. Demographic, clinical and outcome data were collected from patient's medical records and analyzed. RESULTS: Six patients met the inclusion criteria. Three of the patients were female and the cohort mean age was 56.8 ± 21.8 years at the time of admission. Patient diagnoses were: renal cell carcinoma metastasis (n = 1); colon cancer metastasis (n = 1); chondrosarcoma (n = 2); osteosarcoma (n = 1); and undifferentiated pleomorphic sarcoma of bone (n = 1). In all cases surgical management differed from those that should have been applied if the pathological fracture had been identified. Furthermore, surgical management after definitive histological diagnosis were more aggressive compared to if the malignancy had been identified at first admission. All patients died after a mean follow-up of 16.67 ± 11.7 months and the complication rate was 100%. CONCLUSION: When a pathological fracture is misdiagnosed and managed as a simple bone fracture, outcomes are extremely poor. In these situations, remedial surgery is more extensive, with increased complication rates and there is poor life expectancy.