A rare case of cervical metastatis of glioblastoma after cranial tumor resection: case report and review of literature.

Glioblastoma multiforme (GBM) is the most common and the most malignant primary intracranial tumor in adults. GBM extraneural metastases occur in only approximately 0.2-0.4% of patients. We present a case of a cervical metastasis of glioblastoma after cranial tumor resection. In concord with case presentation, we reviewed the metastatic location and metastasis time of the gliablastomas seen in the literature.

Giant composite pheochromocytoma and gastrointestinal stromal tumor in a patient with neurofibromatosis: A case report.

A 54-year-old male was admitted to our department with neurofibromatosis and hypertension. During his examination, a mass was detected in the abdomen, and he was transferred to a surgical clinic. At the first examination of the patient, extensive café-au-lait spots and granulomas were detected on the body and the mass occupying right abdomen quadrant was palpable. The patient's medical history indicated that he had hypertension for almost a decade. The patient also stated that nodules on the body existed from his earliest recollection and he had relatives with neurofibromatosis. The patient was taken to a surgical operation. A mass with 30×23 cm in size was removed. The area of the nodular structure, with 0.5 cm in diameter, in the stomach serosa was also removed. The tumor was composed of phaeochromocytoma in the larger spaces and ganglioneuromas in the relatively narrow spaces. The nodular area removed in gastric serosa was reported as a very low-risk gastrointestinal stromal tumor. Apart from this rare combination, adrenal mass removed from the patient was considerably larger than the masses in the literature until now. Therefore, we aimed to present this rare case with a literature background.

Comparison of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in patients with thyroiditis and papillary tumors.

OBJECTIVE: The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have recently been introduced as prognostic markers of thyroid cancer and strong inflammatory markers. The study was performed to investigate the association of the PLR and NLR with thyroid inflammation and papillary cancer. METHODS: Patients with thyroiditis and patients with papillary carcinomas were compared with sex-, age-, and body mass index-matched healthy controls. The NLR and PLR were calculated and compared among the three groups. RESULTS: The NLR was significantly higher in patients with thyroiditis and non-significantly higher in patients with papillary cancer than in healthy controls. The PLR was significantly higher in both patients with thyroiditis and papillary cancer than in healthy controls. Like the NLR, the PLR was not different between patients with thyroiditis and papillary cancer. The NLR was significantly and positively associated with the PLR and white blood cell count. CONCLUSION: The PLR and NLR showed similar results in both thyroid inflammation and cancer. It seems difficult to obtain clear results in separating cancer from inflammatory events using these parameters. We suggest using them as supportive parameters of thyroid papillary cancer or inflammation.

Histopathological investigation of intranodular echogenic foci detected by thyroid ultrasonography.

OBJECTIVE: To determine the predictability of sonography for detection of calcifications in thyroid nodules by histopathologic examination and to demonstrate the association between calcification pattern and malignancy. METHODS: We prospectively evaluated 81 dominant nodules from 81 patients. Thyroid glands were assessed preoperatively with thyroid ultrasonography, and the presence of sonographic calcification was specified as intranodular macro (coarse) and micro calcification. Micro and macro calcification in surgery specimens were specified postoperatively as present or absent in the histopathological evaluation. The correlation between sonographic and histopathologic calcifications and the relationship between malignancy and calcification patterns were determined. RESULTS: Calcification was detected histopathologically in 66.7% of the sonographically calcified nodules and in 12.8% of the sonographically noncalcified nodules. The sensitivity and specificity of sonography for detecting histopathologic calcification were 84.8 and 70.8%, respectively, while positive and negative predictive values were 66.7 and 87.2%, respectively. The sonographical and histopathological outcomes for detection of macro and micro calcification showed 85 and 50% compatibility, respectively. The difference in malignancy rates between sonographic macro and micro calcified nodules was not significant (p=0.976). Histopathologic detection of calcification showed no significant difference between malignant and benign nodules (p=0.129). CONCLUSION: Histopathology confirmed a high rate of sonographic macrocalcifications. The micro and macro patterns of sonographic calcification showed no particular association with thyroid malignancy. The preoperative risk of malignancy should be determined in conjunction with other known sonographic risk factors and diagnostic tests.

A thoracic vertebral brown tumor presenting with paraparesis in a patient with end-stage renal disease.

Vertebral brown tumors are rare, non-neoplastic bone lesions that occur in the setting of hyperparathyroidism. There are differences in the management of them in the literature. Because brown tumors usually resolve after a parathyroidectomy. We present a case of a thoracic vertebral brown tumor with paraparesis.

Laparoscopic Treatment of Adrenal Tumors: A Single-Center Experience with 58 Patients.

Background. The aim of this study is to discuss the laparoscopic approach and assess the immunohistochemical expression profiles of synaptophysin, Ki-67, and inhibin and patient outcomes in adrenal masses through a series of cases treated at our institution. Method. The study was conducted on 58 patients who were diagnosed with adrenal masses. All cases were operated on laparoscopically for adrenal masses. Results. Both inhibin and synaptophysin were found positive in 45 patients (77,6%). Ki-67 was negative in 11 patients, whereas it was found positive in 42 with a rate of 1%. The size of the masses ranged from 1 up to 9 cm (mean 4,3 ± 1,5). Urine hormone excretion was measured within normal ranges in 47 out of 58 patients (81%). Most of the diagnosed patients were harboring Cortical Adenoma (n: 38; 65,5%). All of the masses were successfully resected without complication except 3 patients. Because of complications of bleeding, the operation was converted to open surgery for 2 patients. Conclusion. Morbidity, mortality, and healing were comparable, regardless of tumor size, yet involvement in both laparoscopic and adrenal surgery was required. Our results suggested that laparoscopic adrenalectomy should replace open surgery as the standard treatment for most adrenal masses.

Facial localization of malignant chondroid syringoma: a rare case report.

First described by Hirsch and Helwig in 1961, chondroid syringomas (CSs) are rare, benign tumors of the skin arising from the eccrine sweat glands with tumor differentiation in the epithelial and mesenchymal tissues. They most commonly occur in the head and neck, although they may be also found in the axilla, trunk, limbs, and genitalia. The incidence of CS is <0.01% of all primary skin tumors. Malingnant chondroid syringomas (MCS), which are also called malignant mixed tumors of the skin, are extremely uncommon. MCSs commonly involve the limbs and rarely head and neck. In this article, we present a case of malignant chondroid syringoma localized in the face at the left nasolabial region in the light of literature review.

Metachronous rectum metastases from gastric adenocarcinoma: a case report.

Introduction. Hepatic metastases of gastric adenocarcinomas are frequently observed due to the drainage into portal vein. Intestinal metastases disseminate from gastrocolic and mesenteric ligaments but they are seen very rarely and in most cases detected in postmortem studies. Case Report. A 74-year-old female patient with no known history of disease. Her complaints on application were epigastric pain, burning, and constipation. Gastroscopy showed a submucosal mass in the greater curvature of fundus and in colonoscopy, a mass with polypoid appearance that narrows the lumen at the rectum was detected. No far metastases or pathology were detected. Pathology report from gastric biopsy material demonstrated well-differentiated adenocarcinoma. Cytokeratin 7 (CK7) was found to be extensively strongly positive, Cytokeratin 20 (CK20) was negative in the immunohistochemical staining of the biopsy obtained from rectosigmoid area. Conclusion. Gastric cancer is among the frequent cancers today, most of which are adenocarcinomas. Although most of the metastases are observed in the liver, lungs, lymph nodes, and peritoneum, it should be remembered that intestinal metastases may be seen without the presence of any other metastatic focus. Our case is the first in literature reporting a rectum metastasis without any other organ metastasis.

Bilateral tonsillar adenoid cystic carcinoma.

Adenoid cystic carcinoma is a malignant epithelial tumor of the salivary glands. It accounts for less than 1% of all head and neck cancers and less than 10% of all salivary gland neoplasms. It shows slow and indolent growth rate, low probability of regional nodal metastases, high propensity for perineural invasion, multiple and/or delayed recurrences and high incidence of distant metastases. It is the most frequently encountered malignant tumor of the minor salivary glands. The oral cavity and the oropharynx are the most common sites followed by the parotid, submandibular gland, paranasal sinuses, larynx, trachea, and pharynx, in frequency order. In this report an adenoid cystic carcinoma of oral cavity localized in the left palatine tonsil and right peritonsillar tissue was presented.

Ancient schwannoma of the tongue: a case report.

A 45-year-old male patient had left sided submucosal swelling extending backwards from the tip of the tongue disturbing articulation and swallowing. Submucosally located lesion was 3 x 2 x 1.5 cm in size and totally excised under local anesthesia. In this article, we present a case of ancient schwannoma of tongue. Although a very rare entity, ancient schwannoma should be considered in differential diagnosis of tongue lesions.

Comparing the clinical, histopathological and myoepithelial features of estrogen receptor positive and negative mammary carcinomas.

OBJECTIVE: The purpose of this study is to examine the relationship between hormone-receptor status and histological parameters, considering that some estrogen receptor (ER)-negative breast carcinoma are suggested to be of myoepithelial origin or differentiation; and to examine the presence of significant difference by myoepithelial markers and define their morphologies. METHODS: For this research, 30 estrogen receptor-negative and 31 estrogen receptor-positive breast carcinomas diagnosed at the Pathology Department, Istanbul Training and Education Hospital, Istanbul, Turkey, between February 2003 and October 2004 were considered and compared clinically, microscopically and immunohistochemically considering myoepithelial markers using SMA, S100, keratin14. RESULTS: We found a higher amount of grade 3 frequency pushing margins, solid islets, and presence of central necrosis in the estrogen receptor-negative group than in the positive group (p<0.001 and p<0.05). Six estrogen-negative and 2 estrogen-positive cases were found positive for myoepithelial markers; a difference which is non-significant (p=0.147). The presence of solid islets, fusiform, and clear cells was detected higher in myoepithelial positive tumors than in negative group (p<0.05). CONCLUSION: For daily pathologic applications, some morphological properties of a breast carcinoma can give clues about ER and myoepithelial features. In estrogen receptor-negative tumors, there is a remarkable myoepithelial marker positivity. Studies involving broader series and different myoepithelial markers could give more reliable results.