Brown tumors: Retrospective analysis of 26 cases.

INTRODUCTION: Brown tumors are reactive osteolytic lesions caused by hyperparathyroidism. These rare lesions are non-neoplastic processes that result from bone resorption. The purpose of this study was to retrospectively review a 34-year experience with brown tumors in our institution. MATERIALS AND METHODS: We retrospectively analyzed the records of 26 consecutive patients with brown tumor who were treated in our institution between May 1988 and October 2020, with a mean follow-up of 36,1 months. RESULTS: 17 male (65,4%) and 9 female (34,6%) patients with a mean age of 41,6 were included in the study. Localized bone pain was present in 13 cases (50,0%) as the first presenting symptom. 3 patients (11,5%) presented with diffuse bone pain. 7 patients (26,9%) were diagnosed with brown tumor while being investigated for pathological fractures. The other 3 patients (11,5%) were diagnosed while being evaluated for hypercalcemia symptoms. 7 patients (26,9%) had solitary lesions, while 19 patients (73,1%) had multiple lesions. Pelvis, femur, ribs, tibia, proximal humerus and mandible were the most common sites of localization. 23 patients (88,5%) were diagnosed with primary hyperparathyroidism, while the other 3 patients (11,5%) had secondary hyperparathyroidism. A total of the 65 lesions, 23 (35.4%) underwent orthopedic surgery, and 42 (64.6%) were followed up conservatively after parathyroidectomy. Orthopedic surgery was performed in 21 of 26 patients, the other 5 cases were followed up conservatively. Intralesional curettage was performed in 19 cases (82,6%). The resulting cavity was filled with bone cement in 11 cases (47,8%). Bone grafting was applied in 8 cases (34,8%). No recurrence was observed in any of the patients. CONCLUSION: The diagnosis of brown tumor begins with clinical suspicion. Endocrinology and general surgery consultation is important before surgery. Treatment of brown tumors requires a multidisciplinary approach.

Prognostic value of preoperative inflammation markers in non-muscle invasive bladder cancer.

PURPOSE: To investigate the prediction values of the preoperative neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV) and red cell distribution width (RDW) for recurrence and progression of patients with non-muscle invasive bladder cancer (NMIBC). METHODS: In this prospective study, 94 consecutive patients newly diagnosed with NMIBC between July 2017 and August 2018 were included. The blood samples were collected from patients before transurethral resection of bladder tumour (TURB) and NLR, LMR, PLR, RDW and MPV values were calculated. The effect of these preoperative inflammatory parameters and other clinicopathological parameters on recurrence and progression rates was evaluated. Kaplan-Meier and multivariate Cox regression analyses were performed to identify significant prognostic variables. RESULTS: The mean follow-up was 11 ± 6.4 months. Recurrence was observed in 35.1% and progression was detected in 7.4% of the patients. NLR was statistically significantly associated with both recurrence (P = .01) and progression (P = .035), whereas LMR was only associated with recurrence (P = .038). In the survival analyses, the relationship between recurrence and LMR was confirmed in both univariate (P = .021) and multivariate (P = .022) analyses. The relationship between NLR and recurrence was confirmed in univariate analysis (P = .019); however; in multivariate analysis, it was found to be statistically insignificant (P = .051). CONCLUSIONS: LMR might be an easy obtainable, non-invasive and cost-effective method for predicting recurrence of disease in patients with NMIBC.

Urinary microbiota; Which non-invasive urine collection method should we use?

OBJECTIVE: The aim of this study is to establish the optimal non-invasive urine sample collection method for the microbiota studies. METHODOLOGY: Twelve men with bladder carcinoma underwent first voided and midstream urine collection. Urine samples were analysed using V3-V4 regions of bacterial 16s ribosomal RNAs. Bacterial groups with relative abundance above 1% were analysed in first voided urine and midstream urine samples at phylum, class, order and family level. At the genus level, all of the identified bacterial groups' relative abundances were analysed. The statistical significance (P < .05) of differences between first voided and midstream urine sample microbiota was evaluated using the Wilcoxon test. RESULTS: According to the analysis, 8 phyla, 14 class, 23 orders, 39 families and 29 different genera were identified in the first voided and the midstream urine samples. Statistical differences were not identified between first voided and midstream urine samples of all bacteria groups except the Clostridiales at order level (p:0.04) and Clostridia at class level (P: .04). CONCLUSIONS: Either first voided or midstream urine samples can be used in urinary microbiota studies as we determined that there is no statistically significant difference between them regarding the results of 16s ribosomal RNA analysis.

A newly described imaging finding for idiopathic normal pressure hydrocephalus: Can hummingbird sign contribute to the diagnosis?

Background/aim: In this study, we aimed to evaluate whether morphological changes in the mesencephalon, which were previously described as a diagnostic tool for progressive supranuclear palsy, could be associated also with idiopathic normal pressure hydrocephal Materials and methods: Consecutive 52 patients with a possible diagnosis of idiopathic normal pressure hydrocephalus (32 female, mean age 73.6 years) and 40 controls (23 female, mean age 72.7 years) with similar demographic characteristics were included the study. The morphologic changes in mesencephalon, hummingbird sign, and the vascular compression to mesencephalon were noted. Besides, three independent observers evaluated the imaging parameters for idiopathic normal pressure hydrocephalus in magnetic resonance imaging. Inter-observer reliabilities for qualitative and quantitative data were assessed using the Cronbach's alpha and intra class correlation coefficient. The correlation of the imaging parameters with each other was evaluated with Pearson correlation. Results: Hummingbird sign was found to be significantly more common among patients with idiopathic normal pressure hydrocephalus (p < 0.0001). A statistically significant correlation was found between hummingbird sign and vascular compression of patients in the study group (p < 0.0001). A substantial, good, and perfect agreement was found between observers at all levels except callosal angle (fair agreement). Conclusion: Hummingbird sign can be used to support the diagnosis of idiopathic normal pressure hydrocephalus in addition to other radiological findings. A significant correlation between vascular compression and hummingbird sign in the patient group may explain the morphological changes in the mesencephalon that resemble the Hummingbird sign, which was previously described for progressive supranuclear palsy.

Construction of efficient bioelectrochemical devices: Improved electricity production from cyanobacteria (Leptolyngbia sp.) based on π-conjugated conducting polymer/gold nanoparticle composite interfaces.

In this study, gold electrodes (GE) were coated with conducting polymers to obtain a high photocurrent using cyanobacteria from a novel bioelectrochemical fuel cell. For this purpose, 4-(4H-ditiheno[3,2-b:2',3'-d]pyrol-4-yl) aniline and 5-(4H-dithieno[3,2-b:2',3'-d]pyrol-4-yl) napthtalane-1-amine monomers were coated on GE by performing an electropolymerization process. After that, gold nanoparticles (AuNP) were specifically modified by 2-mercaptoethane sulfonic acid and p-aminothiophenol to attach to the electrode surface. The conducting polymers GE coat was modified with functionalized AuNP using a cross-linker. The resulting electrode structures were characterized by cyclic voltammetry and chronoamperometry under on-off illumination using a fiber optic light source. Cyanobacteria Leptolyngbia sp. was added to the GE/conducting polymer/AuNP electrode surface and stabilized by using a cellulose membrane. During the illumination, water was oxidized by the photosynthesis, and oxygen was released. The released oxygen was electrocatalytically reduced at the cathode surface and a 25 nA/cm 2 photocurrent was observed in GE/ Leptolyngbia sp. After the electrode modifications, a significant improvement in the photocurrent up to 630 nA/cm 2 was achieved.

Clinical Characteristics and Surgical Outcomes of Limb-Sparing Surgery with Vascular Reconstruction for Soft Tissue Sarcomas.

BACKGROUND: The standard treatment for lower extremity soft tissue sarcoma (STS) is limb-sparing surgery. For a small subset of patients, concomitant vascular reconstruction may be required to preserve limb viability and function while completely excising the tumor with an adequate resection margin. The aim of this study was to evaluate the surgical outcomes and clinical characteristics of patients with STS of the extremities requiring vascular reconstructions. METHODS: From January 2002 through December 2014, 13 patients with limb STS presenting with vascular invasion underwent surgical resection, followed by vascular reconstruction. The medical records such as demographics, histopathological findings, complications, success of vascular reconstruction, and clinical and oncological outcomes were retrospectively reviewed from a prospectively collected clinical database. RESULTS: With a mean follow-up period of 80.6 months, a total of 24 vascular reconstruction procedures (1 only arterial, 1 only venous, and 11 both arterial and venous) were performed. Contralateral great saphenous vein graft was the conduit of choice for vascular replacement. Five graft thromboses were observed in 4 patients. Arterial occlusion occurred in two cases, and venous bypasses occluded in three patients. The overall five-year patency for arterial and venous reconstructions was 84.6% and 75.2%, respectively. The mean survival period of patients was 105.5 months, with a 5-year disease-free survival rate and overall survival rate of 59.3% and 68.4%, respectively. CONCLUSIONS: Vascular resection and reconstruction for STSs of extremity can be safely performed with acceptable short- and long-term surgical and oncological outcomes. Regardless of the surgical procedure, amputation or limb-sparing surgery, the primary focus should be to adhere to strict oncological principles. In addition, because of the complexity of these tumors, an appropriate preoperative planning and meticulous multidisciplinary approach are also crucial.

Calixarene assembly with enhanced photocurrents using P(SNS-NH2)/CdS nanoparticle structure modified Au electrode systems.

Two novel calix[n]arene-adorned gold electrodes producing high photocurrent intensities were successfully constructed by embedding gold electrode surfaces with both P(4-(2,5-di(thiophen-2-yl)-1H-pyrrol-1-yl)benzenamine) conducting polymer and 4-mercaptoboronic acid-functionalized semiconductor CdS nanoparticles to facilitate the binding of calix[n]arene sulfonic acids with nanoparticles. This structure enabled an electron transfer cascade that both induced effective charge separation and efficiently generated photocurrent. The prepared electrodes were used to generate photocurrent by relying on the host-guest interactions of guests Br3(-) and I3(-), which if positioned well in the system was able to fill electron-hole pairs of CdS nanoparticles. As a result, host calixarene derivatives crucially held Br3(-) and I3(-) ions at a substantial distance from CdS nanoparticles. Furthermore, the effects of various calixarenes on the photocurrent obtained indicate that the generation of photocurrent intensities by the system depends on the cavity sizes of calixarene derivatives, which provide an essential center for Br3(-) and I3(-) ions.

Thermal necrosis induced by electrocauterization as a local adjuvant therapy in local aggressive bone tumors, what is the safe limit for surgical margins? An experimental study.

OBJECTIVE: In the current study, it was aimed to investigate the temperature change in the cavity wall and pathologic necrosis occurred during cauterization, which was applied at different voltages and time intervals. MATERIALS AND METHODS: The right tibias of 32 male rabbits were used. Three 2-mm-diameter holes were created on the cortical surface of the tibia using a hand-held drill. Using an electrocautery device, 55 mV was applied for 3 and 5 s and 65 mV was applied for 3 and 5 s. Maximum temperatures at 3 and 6 mm distance from the application site were measured. Biopsy specimens obtained at 3 and 6 mm distance from the application site were evaluated microscopically for bone cell viability and periosteal necrosis. RESULTS: Thirty-two rabbits were divided into four groups. In all groups, periosteal bone cells located at the region, extending from the application site to 3 mm distance, died. In this region, application of 55 mV for 3 s caused peripheral necrosis. There were significant differences between the four groups in terms of maximum temperatures measured at 3 mm distance from the application site (p = 0.027). On the other hand, no significant differences were noted between the four groups in terms of maximum temperatures measured at 6 mm distance from the application site (p > 0.05). CONCLUSIONS: Cauterization of the cavity wall in the spray mode at 55 mV for 3 s after tumor resection caused necrosis in the cavity wall, extending from the application site to 3 mm distance. LEVEL OF EVIDENCE: Experimental animal study, Level II.

Redox regulation of antioxidant enzymes: post-translational modulation of catalase and glutathione peroxidase activity by resveratrol in diabetic rat liver.

Resveratrol is a strong antioxidant that exhibits blood glucose-lowering effects, which might contribute to its usefulness in preventing complications associated with diabetes. The present study aimed to investigate resveratrol effects on catalase (CAT) and glutathione peroxidase (GPx) gene and protein expression, their phosphorylation states and activities in rat liver of STZ-induced diabetes. Diabetes increased the levels of total protein phosphorylation and p-CAT, while mRNA expression, protein levels, and activity were reduced. Although diabetes induced transcriptional repression over GPx, it did not affect the protein levels and activity. When resveratrol was administered to diabetic rats, an increase in activity was associated with an increase in p-GPx levels. Decrease in Sirtuin1 (SIRT1) and nuclear factor erythroid 2-related factor (Nrf2) and increase in nuclear factor kappa B (NFκB) gene expression in diabetes were associated with a decrease in CAT and GPx mRNA expression. A possible compensatory mechanism for reduced gene expression of antioxidant enzymes is proved to be nuclear translocation of redox-sensitive Nrf2 and NFκB in diabetes which is confirmed by the increase in nuclear and decrease in cytoplasmic protein levels of Nrf2 and NFκB. Taken together, these findings revealed that an increase in the oxidized state in diabetes intricately modified the cellular phosphorylation status and regulation of antioxidant enzymes. Gene regulation of antioxidant enzymes was accompanied by nuclear translocation of Nrf2 and NFκB. Resveratrol administration also activated a coordinated cytoprotective response against diabetes-induced changes in liver tissues.

Photo-electrochemical communication between cyanobacteria (Leptolyngbia sp.) and osmium redox polymer modified electrodes.

Photosynthetic microbial fuel cells (PMFCs) are an emerging technology for renewable solar energy conversion. Major efforts have been made to explore the electrogenic activity of cyanobacteria, mostly using practically unsustainable reagents. Here we report on photocurrent generation (≈8.64 µA cm(-2)) from cyanobacteria immobilized on electrodes modified with an efficient electron mediator, an Os(2+/3+) redox polymer. Upon addition of ferricyanide to the electrolyte, cyanobacteria generate the maximum current density of ≈48.2 µA cm(-2).

The effect of radiofrequency thermal ablation method on nasal mucociliary activity in patients with inferior turbinate hypertrophy.

OBJECTIVES: This study aims to investigate the effect of radiofrequency thermal ablation (RFTA) treatment on nasal mucociliary activity before and after treatment in inferior turbinate hypertrophy. PATIENTS AND METHODS: Thirty-nine patients (21 males, 18 females; mean age 36.3±13.9 years; range 16 to 67 years) admitted to our clinic with complaint of nasal obstruction and diagnosed with stromal inferior turbinate hypertrophy were included in this study. Effect of RFTA treatment on nasal mucociliary activity was investigated by saccharine test before treatment and two months after treatment. Grade of nasal obstruction was evaluated by visual analog scale (VAS) before treatment and two months after treatment. Results were compared with paired t-test. RESULTS: Mean mucociliary activity times were 9.8±4.4 minutes before treatment and 9.6±4.1 minutes two months after treatment, and the difference between two tests was not statistically significant (p=0.3). Mean VAS scores for nasal obstruction were 6.5±1.2 before treatment and 3.8±1.0 two months after treatment, and the difference between two results was statistically significant (p=0.001). Difference between sexes in terms of saccharine transit time and VAS values before and after treatment was not statistically significant (p>0.05). CONCLUSION: It was detected that RFTA has no adverse effect on mucociliary activity in the treatment of inferior turbinate hypertrophy, and this method is notably effective in relieving the nasal obstruction caused by inferior turbinate hypertrophy.

Ear protrusion after tympanoplasty and the use of mastoid dressing.

OBJECTIVES: This study aims to assess possible wound complications of tympanoplasty and tympanomastoidectomy with or without postoperative mastoid dressing. PATIENTS AND METHODS: A total of 37 patients (22 females, 15 males; mean age: 23.88 years; range 9 to 64 years) who underwent middle ear or mastoid operations via postauricular incision were included in this prospective, randomized, controlled study. The patients were divided into two groups as having mastoid dressing (n=17) and nonmastoid dressing (n=20). Through a close follow-up, postoperative complications were noted and distance from mastoid scalp and auricular rim was measured. RESULTS: The mean mastoid-helix distance of non-mastoid dressing group was found 17.2 mm in operated and 16.9 mm in non-operated ears. The mean mastoid-helix distance of mastoid dressing group was 15.53 mm in operated ears and 16.47 mm in non-operated ears. Skin erythema was seen in a patient. There was no statistically significant increase in mastoid-helix distance (p>0.05). CONCLUSION: Tympanoplasty with or without mastoidectomy does not cause postoperative complication or protrusion of the ear, even if no mastoid dressing is used. Our study results suggest no benefit of mastoid dressing after tympanoplasty with or without mastoidectomy.

Construction of a Conductive Polymer/AuNP/Cyanobacteria-Based Biophotovoltaic Cell Harnessing Solar Energy to Generate Electricity via Photosynthesis and Its Usage as a Photoelectrochemical Pesticide Biosensor: Atrazine as a Case Study.

In this research, a cyanobacteria (Leptolyngbia sp.)-based biological photovoltaic cell (BPV) was designed. This clean energy-friendly BPV produced a photocurrent as a result of illuminating the photoanode and cathode electrodes immersed in the aqueous medium with solar energy. For this purpose, both electrodes were first coated with conductive polymers with aniline functional groups on the gold electrodes. In the cell, the photoanode was first coated with a gold-modified poly 4-(2,5-di(thiophen-2-yl)-1H-pyrrol-1-yl)benzamine polymer, P(SNS-Aniline). Thioaniline-functionalized gold nanoparticles were used to provide a cross-link formation with bis-aniline conductive bonds with the conductive polymer using electrochemical techniques. Leptolyngbia sp., one of the cyanobacteria that can convert light energy into chemical energy, was attached to this layered electrode surface. The cathode of the cell was attached to the gold electrode surface with P(SNS-Aniline). Then, the bilirubin oxidase (BOx) enzyme was immobilized on this film surface with glutaraldehyde activation. This cell, which can use light, thanks to cyanobacteria, oxidized and split water, and oxygen was obtained at the photoanode electrode. At the cathode electrode, the oxygen gas was reduced to water by the bioelectrocatalytic method. To obtain a high photocurrent from the BPV, necessary optimizations were made during the design of the system to increase electron transport and strengthen its transfer. While the photocurrent value obtained with the designed BPV in optimum conditions and in the pseudosteady state was 10 mA/m2, the maximum power value obtained was 46.5 mW/m2. In addition to storing the light energy of the system, studies have been carried out on this system as a pesticide biosensor. Atrazine biosensing via the BPV system was analytically characterized between 0.1 and 1.2 µM concentrations for atrazine, and a very low detection limit was found as 0.024 µM. In addition, response time and recovery studies related to pesticide biosensor properties of the BPV were also investigated.

Chondromyxoid fibroma: A retrospective evaluation of 31 cases.

OBJECTIVES: This study aimed to review a 35-year experience with chondromyxoid fibroma at our institution. PATIENTS AND METHODS: The study retrospectively analyzed the records of 31 consecutive patients (17 males, 14 females; mean age: 30.5±15.7 years; range, 6 to 63 years) with chondromyxoid fibroma who were treated between January 1988 and December 2021. The clinical and radiological characteristics of lesions, tumor volume, and recurrence rates were assessed using the tumor archive of the hospital. RESULTS: The mean follow-up duration was 65.9±42.0 months. Pelvis, proximal tibia, and distal femur were the most common sites of localization. The initial surgical treatment was performed on 27 patients at our clinic, while four patients were referred to the clinic after recurrence. The overall recurrence rate was 16.1%. Intralesional curettage was applied to 21 (77.8%) out of 27 patients. The cavity created after curettage was filled with bone graft (autograft or allograft) in 15 (55.5%) cases. Bone cement was applied in four (14.8%) cases. Resection was applied to five (18.5%) patients. In two (7.4%) cases, intralesional curettage alone was performed. One of these two patients experienced recurrence, resulting in a recurrence rate of 50% in this patient group. No recurrence was observed in other treatment groups. CONCLUSION: Intralesional curettage and filling the defect with bone graft or cement were effective for local control in most cases. Curettage alone was associated with high recurrence rates.

The revealing of the Cyto-genotoxic properties (Allium and MTT) and the effect of chicken meat quality of characterized zein-eugenol nanofibers.

Electrospun zein-based eugenol nanofibers (ZEnF) with diameters (148.19-631.52 nm) were fabricated. Thermal degradation was found as <15 % until 300 °C while the nanofiber diffraction pattern presented three main peaks among the 5o and 45o positions. ZEnF was not only evaluated as non-toxic to cells but also possessed anticancer characteristics revealing with the MCF-7 cell line at 800 µg/mL (reduction: 18.08 %) and 1600 µg/mL (reduction: 41.64 %). Allium tests revealed that ZEnF did not have any adverse impact on the health status (chromosomes-DNA) of exposed organisms. Following the nanofiber coating for chicken meat parts (thigh and breast), it was observed up to 1.25 log CFU/g limitation in total viable bacteria counts (p < 0.05). The sensory score (difference: 3.64 in 10 points scoring on the 6th day of the cold storage) and odor score of chicken meat samples were found to be as higher than control samples (p < 0.05).

Enhancing microalgae classification accuracy in marine ecosystems through convolutional neural networks and support vector machines.

Accurately classifying microalgae species is vital for monitoring marine ecosystems and managing the emergence of marine mucilage, which is crucial for monitoring mucilage phenomena in marine environments. Traditional methods have been inadequate due to time-consuming processes and the need for expert knowledge. The purpose of this article is to employ convolutional neural networks (CNNs) and support vector machines (SVMs) to improve classification accuracy and efficiency. By employing advanced computational techniques, including MobileNet and GoogleNet models, alongside SVM classification, the study demonstrates significant advancements over conventional identification methods. In the classification of a dataset consisting of 7820 images using four different SVM kernel functions, the linear kernel achieved the highest success rate at 98.79 %. It is followed by the RBF kernel at 98.73 %, the polynomial kernel at 97.84 %, and the sigmoid kernel at 97.20 %. This research not only provides a methodological framework for future studies in marine biodiversity monitoring but also highlights the potential for real-time applications in ecological conservation and understanding mucilage dynamics amidst climate change and environmental pollution.

Prognostic factors in endometrial cancer patients with bone metastasis.

OBJECTIVES: This study aims to examine the pattern and prognosis of osseous involvement and the role of orthopedic surgery in patients with endometrial cancer (EC) and to evaluate the quality of life, local tumor control, and survival of patients. PATIENTS AND METHODS: Between January 2011 and December 2018, a total of 14 patients (median age: 60.5 years; range, 55 to 73 years) who were surgically treated for osseous metastasis of EC and followed for minimum 12 months were retrospectively analyzed. All patients were evaluated for their primary malignancy, characteristics of bone metastasis, and type of treatment related to musculoskeletal involvement. For evaluating the functional outcomes, the Visual Analog Scale (VAS) for pain and Eastern Cooperative Oncology Group (ECOG) performance status scale were used in the pre- and postoperative period. RESULTS: The median follow-up was 34.5 (range, 9 to 89) months. All patients had advanced-stage disease (FIGO Stage III-IV). Four patients had solitary and 10 patients had multiple bone metastases. The mean VAS score and ECOG performance status grades improved (p<0.001 and p<0.05, respectively). The median survival after detection of bone metastasis was 61 (range, 41 to 82) months. CONCLUSION: Endometrial cancer patients with musculoskeletal pain should be investigated for the possibility of bone metastasis to tailor a prompt treatment and to achieve a better prognosis. Appropriate surgical treatment of bone metastasis may improve both pain and performance status in carefully selected patients.

Combined medical and surgical therapy improves olfaction in patients with nasal polyposis.

OBJECTIVE: The aim of the present study was to evaluate the outcomes of combined oral steroid, nasal steroid and surgical therapy in patients with impaired olfaction due to nasal polyposis. PATIENTS AND METHODS: This prospective observational study was undertaken in the otolaryngology department of a university hospital. During the study, 19 nasal polyposis patients were evaluated three times, i.e. before oral steroid therapy, before surgery (after steroid therapy) and after surgery, with smell identification tests, acoustic rhinometry, subjective smell score, endoscopic grading and a visual analog scale for nasal obstruction. RESULTS: All subjective and objective measures were significantly improved after medical and surgical therapy (p < 0.01). The median smell identification score improved from 2 (interquartile range 0-4) to 5 (interquartile range 4-7) after combined therapy. Smell identification scores were found to be modestly correlated with all other examination findings. CONCLUSION: Combined therapy seems efficient in improving smell identification scores of nasal polyposis patients.

Sclerosing polycystic adenosis of the parotid gland presenting with a Warthin tumor.

Sclerosing polycystic adenosis (SPA) frequently presents as an isolated process, however it may involve adjacent benign salivary gland neoplasia. In this article, we present a 77-year-old female case with a 10-year history of a slow-growing mass of the left parotid gland of SPA presenting with a Warthin tumor. The patient underwent left superficial parotidectomy. The histopathological examination revealed SPA and multifocal Warthin tumor.

External and internal hemipelvectomy: A retrospective analysis of 68 cases.

OBJECTIVES: This study aims to investigate the factors that may be associated with surgical site infection and mortality in pelvic resection surgeries. PATIENTS AND METHODS: A total of 68 patients (40 males, 28 females; mean age: 43±16.2 years; range, 11 to 70 years) who underwent internal or external hemipelvectomy between January 2010 and January 2020 were retrospectively analyzed. We reviewed data concerning histopathological diagnosis, surgical technique, pelvic resection type, tumor size, postoperative infection, duration of follow-up, and mortality. RESULTS: The mean follow-up was 45.5±42.2 months. Among 68 patients, 29 (42.6%) cases underwent external hemipelvectomy and 39 (57.4%) cases underwent internal hemipelvectomy. Reconstruction was performed in 14 (20.6%) patients who underwent internal hemipelvectomy. Of all patients, 61 had primary malignant pelvic tumors and two had metastatic pelvic tumors. Of the other five patients, two had a giant cell tumor, two had a pelvic hydatid cyst, and one had an aneurysmal bone cyst. The three most common pelvic tumors were chondrosarcoma (n=25, 36.7%), osteosarcoma (n=13, 19.1%), and Ewing sarcoma (n=8, 11.8%). Surgical site infections were observed in 34 (50.0%) patients. Of 34 patients, 15 (22.1%) had superficial infections and 19 (27.9%) had deep surgical infections. The superficial and deep infection rates were higher in the external hemipelvectomy group compared to internal hemipelvectomy (p=0.02). Patients with postoperative infection had a mean survival period of 36.0 months compared to 79.8 months in patients without infection (p=0.037). The patients treated with internal hemipelvectomy had a mean survival of 97.0 months compared to 25.7 months in patients treated with external hemipelvectomy (p<0.0001). The effect of Enneking stages of malignant pelvic tumors on survival was investigated using the Kaplan-Meier analysis. Cumulative survival decreased, as the stage progressed (p<0.0001). CONCLUSION: The type of surgical technique affects the possibility of postoperative infection. Postoperative infection, surgical method, and stage of the tumor are associated with survival.