Ectopic bone formation in thyroid gland: report of sixteen cases and comprehensive literature review.

OBJECTIVE: This study aimed to analyze the outcomes of patients with ectopic bone formation (EBF) diagnosed in thyroidectomy specimen. PATIENTS AND METHODS: We retrospectively analyzed the data of 16 patients who underwent thyroidectomy between February 2009 and June 2018 and whose pathology examination diagnosed EBF. RESULTS: Fourteen patients underwent bilateral total thyroidectomy (BTT), one patient required BTT with central lymph node dissection, and one patient was subjected to BTT with functional lymph node dissection. On histopathological examination, left lobe EBF was diagnosed in four patients; left lobe EBF with bilateral papillary thyroid carcinoma (PTC) in two; left lobe EBF with left lobe PTC in one; left lobe EBF with left follicular adenoma in one; left lobe EBF with right lobe papillary thyroid microcarcinoma in one; bilateral EBF in one; right lobe EBF with extramedullary hematopoiesis in one; right lobe EBF in three; right lobe EBF with right lobe medullary thyroid carcinoma in one, and right lobe EBF with bilateral lymphocytic thyroiditis in one. One of the five patients who underwent bone marrow biopsy was diagnosed with myeloproliferative dysplasia, and another with polycythemia vera. Three patients were treated medically for anemia because no other pathological findings could be observed. CONCLUSIONS: There is a lack of literature data about the clinical significance of EBF in the thyroid gland in cases with no concomitant hematological diseases. People who have been diagnosed with EBF in the thyroid gland should be checked for hematological diseases.

Side specific differences of tumor budding on non-metastatic colon cancer.

OBJECTIVE: Recent literature suggests that tumor budding (TB) may have a significant clinical impact on colorectal cancers. Our study aims to reveal the effect of TB on the long-term outcomes of patients and to reveal whether there is a difference in tumor location and TB in colonic cancer. PATIENTS AND METHODS: A cohort of 100 patients with non-metastatic colon cancer was included in the study. The clinicopathological information of the patients was reviewed. Patients' preparations were re-evaluated to identify TB as: low, medium, and high and represent 0-4 buds, 5-9 buds, and 10 or more buds per 0.785 mm2, respectively. Long-term oncological outcomes of patients were analyzed. The recurrence, metastasis, and final status of the patients were determined during the follow-up period. RESULTS: Low TN was associated with <65 year (p = 0.048), absence of lymphatic metastasis (p = 0.003), and absence of perineural invasion (p = 0.023). High TB was associated with higher pT stage (p = 0.017) and tumor stage (p = 0.005). Additionally, right-sided tumors had a high TB score than left side (82.3% vs. 23.6%, p = 0.011). Patients with high TB had lower overall survival, but these were not statically significant. According to multiple regression analysis, mortality risk was associated with age (p = 0.046), pN status (p = 0.003) and TB (p = 0.040). CONCLUSIONS: High TB is associated with mortality in colon cancer and is more common in right colonic carcinoma.

Retrospective analysis of echinococcosis in an endemic region of Turkey, a review of 193 cases.

BACKGROUND: The hydatidosis is endemic in our region. Some of the recent studies revealed that hydatid cyst prevalence is decreasing gradually in Turkey. The aim of this study was to investigate the actual prevalence of hydatidosis in an endemic region of Turkey, and to share our experiences in the medical and surgical management of hydatidosis. METHODS: Data were collected retrospectively from the records of 193 patients who had a diagnosis of hydatidosis, and admitted to Diyarbakir Education and Research Hospital. Imaging techniques, histology and serology were used for diagnosis. RESULTS: From records of 772 cystic patients whose cysts were localized in the lung and liver, 193 (25%) of them were diagnosed with cyst hydatidosis. Lung hydatidosis was found statistically significant among these cases (Chi-square=24.88, P< 0.0001). Postoperative recurrence was detected in seven (3.62%) patients. All postoperative recurrences were observed in the consequent three years period. CONCLUSION: The prevalence of hydatidosis is still high in southeast Turkey and not only in children but also in adult cases in our region lung hydatidosis is frequent corresponding with other organ hydatidosis. We also found that the most risky period in recurrence rates is the consequent post-operative three years. According to our experiences, transthoracic approach in lung hydatidosis, external drainage, and cystectomy in liver hydatidosis is safe and effective choices in surgical treatment.

Appendicular tuberculosis: review of 155 published cases and a report of two cases.

PURPOSE: This paper provides an overview of the literature on appendicular tuberculosis (ATB) between 1909 and 2010. METHODS: We present two cases of primary ATB and a literature review of studies on ATB published in English and accessed via the Pubmed and Google Scholar databases. RESULTS: One hundred fifty-five published cases of ATB were reviewed, and two patients with primary ATB, treated and followed in our clinic, were reported. The age range of the patients (62 females, 60 males and 33 with unnoted gender) was between 2 and 60 years, with a mean age of 27.1 ± 10.6 years. Of the patients who had applied to hospital, 59 had acute right lower quadrant pain, 46 had recurrent right lower quadrant pain, 19 had generalized pain, and 10 had chronic abdominal symptoms suggestive of subacute intestinal obstruction, while 47 patients were operated on with a diagnosis of acute appendicitis, 24 with recurrent appendicitis, 19 with TB peritonitis, 14 with mass in the right lower quadrant, 13 with subacute intestinal obstruction, and 7 with ATB. While appendectomy was not performed on 4 patients, one or more of the following procedures were done in the other 151 cases: appendectomy, hemicolectomy, ileocecal resection, or cecectomy. Different anti-tubercular treatment regimens with durations varying from 3 weeks to 18 months were applied to 60 patients. During the follow-up period of 3 weeks to 15 years, mortality occurred in 14 patients, sinus in five, and fistula in one patient. Secondary ATB was detected in 86 patients, primary ATB in 50, and no differential diagnosis could be made in 19 cases. CONCLUSIONS: Tuberculosis is a systemic disease with localized manifestations; therefore, anti-TB therapy must be initiated in any patient whose pathologic specimen reveals tuberculosis.