1
|
Karaman AK, Özgen KH, Korkmazer B, Hamid R, Kübra Yıldırım H, Kemerdere R, Çomunoğlu N, Tanrıöver N, Arslan S, Kızılkılıç O. Comparison of MRI findings of hypothalamic-optic chiasmatic gliomas and craniopharyngiomas. Acta Radiol 2024:2841851241241527. [PMID: 38613353 DOI: 10.1177/02841851241241527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
BACKGROUND Differential diagnosis of hypothalamic-optic chiasmatic gliomas (HOCGs) and craniopharyngiomas on magnetic resonance imaging (MRI) can be quite challenging. PURPOSE To compare the MRI features of HOCGs and cranipharyngiomas. MATERIAL AND METHODS Patients diagnosed with HOCG or craniopharyngioma in histopathological evaluation between 2012 and 2022 and who underwent preoperative contrast-enhanced brain MRI were included. Various MRI features were retrospectively evaluated for each lesion: T2-weighted imaging and fluid attenuation inversion recovery hyperintensity, calcification, cystic change, T1-weighted (T1W) imaging hyperintensity of the cystic component, hemorrhage, involvement of sellar, suprasellar or other adjacent structures, lobulated appearance, presence of hydrocephalus, and contrast enhancement pattern. Apparent diffusion coefficient (ADC) values were also evaluated and compared. RESULTS Among 38 patients included, 13 (34%) had HOCG and 25 (66%) had craniopharyngioma. Craniopharyngiomas had a significantly higher rate of cystic changes, calcification, and T1W imaging hyperintensity of the cystic component than HOCGs (P <0.05). Of HOCGs, 92% had chiasm involvement, 23% had optic nerve involvement, and 31% had brain stem involvement. On the other hand, chiasm involvement was observed in 8% of craniopharyngiomas, but none had optic nerve and/or brain stem involvement (P <0.05). While 62% (8/13) of HOCGs had diffuse homogeneous enhancement, 80% (20/25) of craniopharyngiomas had a diffuse heterogeneous enhancement pattern. Mean ADC values were significantly higher in craniopharyngiomas compared to HOCGs (2.1 vs. 1.6 ×10-3mm2/s, P <0.05). CONCLUSION Although some neuroimaging findings may overlap, features such as presence of cyst and calcification, brain stem and optic pathway involvement, different enhancement patterns, and ADC values may be helpful in the differential diagnosis of HOCGs and craniopharyngiomas.
Collapse
Affiliation(s)
- Ahmet Kursat Karaman
- Department of Radiology, Sureyyapasa Chest Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey
| | - Kerime Hatun Özgen
- Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Bora Korkmazer
- Division of Neuroradiology, Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Rauf Hamid
- Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | | | - Rahşan Kemerdere
- Department of Neurosurgery, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nil Çomunoğlu
- Department of Pathology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Necmettin Tanrıöver
- Department of Neurosurgery, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Serdar Arslan
- Division of Neuroradiology, Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Osman Kızılkılıç
- Division of Neuroradiology, Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| |
Collapse
|
2
|
Benibol Y, Önenerk Men AM, Hakalmaz AE, Çomunoğlu N, Topuzlu Tekant G, Özcan R. The Effect of the Ganglionic Segment Inflammatory Response to Postoperative Enterocolitis in Hirschsprung Disease. Fetal Pediatr Pathol 2024; 43:140-150. [PMID: 38268442 DOI: 10.1080/15513815.2024.2306280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
INTRODUCTION We examined the relationship between proinflammatory cytokines that occur in the inflammatory reaction in the intestine in Hirschsprung disease (HD) and Hirschsprung-associated enterocolitis (HAEC). METHODS Thirty cases (M:27, F:3) operated on due to HD. The cases were divided into three groups: group 1 with pre and post operative EC, group 2 with post-operative, and group 3 with pre-operative EC. The intestinal segments were evaluated by immunohistochemistry for interleukin 1 beta (IL-1ß), tumor necrosis factor-alpha (TNF-α), and interleukin 6 (IL-6). RESULTS IL-1β staining was significantly higher in the ganglionic zone of groups with enterocolitis compared to the control group (p = 0.012). TNF-α staining in the transitional zone of Group 3 and IL-1β staining in the ganglionic zone of Group 1 was significantly higher than the control group (p = 0.030, p = 0.020). CONCLUSION In our study, older age at diagnosis and more than 20% IL-1ß staining in the ganglionic segment were found to be risk factors for HAEC. It is noteworthy that the increase in IL-1ß can be associated with HAEC.
Collapse
Affiliation(s)
- Yalım Benibol
- Cerrahpasa Faculty of Medicine, Department of Pediatric Surgery, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ayşe Mine Önenerk Men
- Cerrahpasa Faculty of Medicine, Department of Pathology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ali Ekber Hakalmaz
- Cerrahpasa Faculty of Medicine, Department of Pediatric Surgery, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nil Çomunoğlu
- Cerrahpasa Faculty of Medicine, Department of Pathology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Gonca Topuzlu Tekant
- Cerrahpasa Faculty of Medicine, Department of Pediatric Surgery, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Rahşan Özcan
- Cerrahpasa Faculty of Medicine, Department of Pediatric Surgery, Istanbul University-Cerrahpasa, Istanbul, Turkey
| |
Collapse
|
3
|
Şahin S, Başkurt O, Çomunoğlu N, Kadıoğlu P, Gazioğlu N. Germinoma Misdiagnosed as Lymphocytic Hypophysitis. Balkan Med J 2023. [PMID: 37227236 DOI: 10.4274/balkanmedj.galenos.2023.2023-3-60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Affiliation(s)
- Serdar Şahin
- Department of Endocrinology and Metabolism, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Ozan Başkurt
- Department of Neurosurgery, İstinye University Faculty of Medicine, İstanbul, Turkey
| | - Nil Çomunoğlu
- Department of Pathology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Pınar Kadıoğlu
- Department of Endocrinology and Metabolism, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Nurperi Gazioğlu
- Department of Neurosurgery, İstinye University Faculty of Medicine, İstanbul, Turkey
| |
Collapse
|
4
|
Çomunoğlu N, Çomunoğlu C, Özcan R, Ocak S. Ewing Sarcoma Displaying Extensive Well Differentiated Neuroblastomatous Differentiation: A Case Report. Fetal Pediatr Pathol 2023; 42:156-160. [PMID: 35535964 DOI: 10.1080/15513815.2022.2072420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION A tumor with EWSR1/FLI fusion displaying extensive well differentiated neuroblastomatous differentiation is presented. CASE REPORT A nine-year-old female patient had a thoracic vertebra 8 paraspinal mass. The lesion was resected incompletely. Histopathologically, a small round cell tumor with gangliomatous differentiation was seen. This was initially diagnosed as an intermixed ganglioneuroblastoma. In the completion surgery biopsy material, the small round cell component was more prominent. Immunohistochemistry for both samples showed membrane positivity for CD99 and nuclear positivity for NKX2.2 in the small round cell component of the tumor. Molecular analysis revealed EWSR1/FLI fusion. The diagnosis then considered a "Ewing Sarcoma Displaying Extensive Well Differentiated Neuroblastomatous Differentiation". CONCLUSION Tumors with the EWSR1/FLI fusion may show neuroblastomatous differentiation. We chose to treat this as an Ewing Sarcoma (ES). Recognition of this phenomenon in ES cases may prevent a possible misinterpretation and a failure in oncologic treatment.
Collapse
Affiliation(s)
- Nil Çomunoğlu
- Department of Pathology, Istanbul University-Cerrahpaşa Carrahpaşa Faculty of Medicine, Istanbul, Turkey
| | - Cem Çomunoğlu
- Department of Pathology, Prof. Dr. C. Taşçıoğlu Ş. Hospital, Istanbul, Turkey
| | - Rahşan Özcan
- Department of Pediatric Surgery, Istanbul University-Cerrahpaşa Carrahpaşa Faculty of Medicine, Istanbul, Turkey
| | - Süheyla Ocak
- Department of Pediatric Hematology and Oncology, Istanbul University-Cerrahpaşa Carrahpaşa Faculty of Medicine, Istanbul, Turkey
| |
Collapse
|
5
|
Sulu C, Bektaş AB, Şahin S, Durcan E, Kara Z, Demir AN, Özkaya HM, Tanrıöver N, Çomunoğlu N, Kızılkılıç O, Gazioğlu N, Gönen M, Kadıoğlu P. Machine learning as a clinical decision support tool for patients with acromegaly. Pituitary 2022; 25:486-495. [PMID: 35435565 DOI: 10.1007/s11102-022-01216-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To develop machine learning (ML) models that predict postoperative remission, remission at last visit, and resistance to somatostatin receptor ligands (SRL) in patients with acromegaly and to determine the clinical features associated with the prognosis. METHODS We studied outcomes using the area under the receiver operating characteristics (AUROC) values, which were reported as the performance metric. To determine the importance of each feature and easy interpretation, Shapley Additive explanations (SHAP) values, which help explain the outputs of ML models, are used. RESULTS One-hundred fifty-two patients with acromegaly were included in the final analysis. The mean AUROC values resulting from 100 independent replications were 0.728 for postoperative 3 months remission status classification, 0.879 for remission at last visit classification, and 0.753 for SRL resistance status classification. Extreme gradient boosting model demonstrated that preoperative growth hormone (GH) level, age at operation, and preoperative tumor size were the most important predictors for early remission; resistance to SRL and preoperative tumor size represented the most important predictors of remission at last visit, and postoperative 3-month insulin-like growth factor 1 (IGF1) and GH levels (random and nadir) together with the sparsely granulated somatotroph adenoma subtype served as the most important predictors of SRL resistance. CONCLUSIONS ML models may serve as valuable tools in the prediction of remission and SRL resistance.
Collapse
Affiliation(s)
- Cem Sulu
- Department of Internal Medicine, Division of Endocrinology, Metabolism, and Diabetes, Cerrahpasa Medical School, Istanbul University-Cerrahpaşa, Kocamustafapaşa Street No:53, 34098 Fatih, Istanbul, Turkey
| | - Ayyüce Begüm Bektaş
- Graduate School of Sciences and Engineering, Koç University, Istanbul, Turkey
| | - Serdar Şahin
- Department of Internal Medicine, Division of Endocrinology, Metabolism, and Diabetes, Cerrahpasa Medical School, Istanbul University-Cerrahpaşa, Kocamustafapaşa Street No:53, 34098 Fatih, Istanbul, Turkey
| | - Emre Durcan
- Department of Internal Medicine, Division of Endocrinology, Metabolism, and Diabetes, Cerrahpasa Medical School, Istanbul University-Cerrahpaşa, Kocamustafapaşa Street No:53, 34098 Fatih, Istanbul, Turkey
| | - Zehra Kara
- Department of Internal Medicine, Division of Endocrinology, Metabolism, and Diabetes, Cerrahpasa Medical School, Istanbul University-Cerrahpaşa, Kocamustafapaşa Street No:53, 34098 Fatih, Istanbul, Turkey
| | - Ahmet Numan Demir
- Department of Internal Medicine, Division of Endocrinology, Metabolism, and Diabetes, Cerrahpasa Medical School, Istanbul University-Cerrahpaşa, Kocamustafapaşa Street No:53, 34098 Fatih, Istanbul, Turkey
| | - Hande Mefkure Özkaya
- Department of Internal Medicine, Division of Endocrinology, Metabolism, and Diabetes, Cerrahpasa Medical School, Istanbul University-Cerrahpaşa, Kocamustafapaşa Street No:53, 34098 Fatih, Istanbul, Turkey
- Pituitary Center, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Necmettin Tanrıöver
- Pituitary Center, Istanbul University-Cerrahpasa, Istanbul, Turkey
- Department of Neurosurgery, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nil Çomunoğlu
- Department of Medical Pathology, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Osman Kızılkılıç
- Pituitary Center, Istanbul University-Cerrahpasa, Istanbul, Turkey
- Department of Radiology, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nurperi Gazioğlu
- Pituitary Center, Istanbul University-Cerrahpasa, Istanbul, Turkey
- Department of Neurosurgery, Istinye University, Istanbul, Turkey
| | - Mehmet Gönen
- Department of Industrial Engineering, College of Engineering, Koç University, Istanbul, Turkey
- School of Medicine, Koç University, Istanbul, Turkey
| | - Pınar Kadıoğlu
- Department of Internal Medicine, Division of Endocrinology, Metabolism, and Diabetes, Cerrahpasa Medical School, Istanbul University-Cerrahpaşa, Kocamustafapaşa Street No:53, 34098 Fatih, Istanbul, Turkey.
- Pituitary Center, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| |
Collapse
|
6
|
Çebi MN, Yılmaz G, Çelikdemir G, Özcan R, Ocak S, Celkan TT, Çomunoğlu N. Primitive neuroectodermal tumor in a child with currarino syndrome. Turk J Pediatr 2022; 64:385-388. [DOI: 10.24953/turkjped.2021.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
7
|
Kebudi R, Sezer A, Eliçevik M, Ocak S, Çomunoğlu N, Birgen D, Kervancıoğlu ME, Kuruğoğlu S. Bilateral Synchronous Testicular Germ Cell Tumors in Children: Case Report and Review of the Literature. Urology 2020; 140:155-158. [PMID: 32199873 DOI: 10.1016/j.urology.2020.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/03/2020] [Accepted: 03/09/2020] [Indexed: 11/17/2022]
Abstract
Bilateral testicular tumors are very rare in pediatric patients and only a few case reports have been reported. These patients have a high risk of sterility due to bilateral orchiectomy and subsequent gonadotoxic treatments. Therefore, if possible, testis-sparing surgery should be performed in patients with benign masses and testicular tissue preservation may be recommended in order to maintain fertility in later life. We present a 23 months old boy with synchronous bilateral testicular tumor managed with unilateral orchiectomy and testis-sparing surgery and testicular tissue cryopreservation performed to the controlateral side. We also review the literature on bilateral testis tumors in children.
Collapse
Affiliation(s)
- Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey; Department of Pediatrics, Division of Pediatric Hematology-Oncology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Ali Sezer
- Department of Pediatric Surgery, Division of Pediatric Urology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Mehmet Eliçevik
- Department of Pediatric Surgery, Division of Pediatric Urology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Süheyla Ocak
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nil Çomunoğlu
- Department of Pathology, Cerrahpasa Faculty of Medicine Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Dilek Birgen
- Division of Pediatric Oncology, Burhan Nalbantgil Hospital, Nicosia, Cyprus
| | - Mehmet Ertan Kervancıoğlu
- Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sebuh Kuruğoğlu
- Department of Radiology, Cerrahpasa Faculty of Medicine Istanbul University-Cerrahpasa, Istanbul, Turkey
| |
Collapse
|
8
|
Abstract
Carney complex (CNC) is a multiple neoplasia syndrome, characterized by pigmented lesions of the skin and mucosa, cardiac, cutaneous and other myxomas and multiple endocrine and non-endocrine tumors. Most of the cases have an inactivating mutation in the PRKAR1A gene. Osteochondromyxoma (OMX) is an extremely rare myxomatous tumor of bone, affecting 1% of CNC patients. Large cell calcifying Sertoli cell tumor (LCCSCT) is a testicular tumor affecting more than 75% of males with CNC. Here, we report an atypical case of CNC without typical pigmented skin lesions, presenting with a bone based tumor as the first manifestation. Initial presentation was for a recurrent, locally invasive intranasal tumor without definite diagnosis. Further clinical developments during follow up, central precocious puberty and testicular tumor with calcification, led to the diagnosis of LCCSCT, a CNC-related tumor. Histopathologic examination of the intranasal tumor was re-evaluated with this knowledge and OMX was diagnosed. Coexistence of OMX and LCCSCT suggested CNC. Genetic analysis revealed a heterozygous non-sense p.Trp 224* (c.672G>A) in the PRKAR1A gene. In our case, the diagnosis of OMX was delayed, because it is extremely rare and little is known about this tumor. Thus the aim of this report was to alert other clinicians to consider CNC if OMX is diagnosed.
Collapse
Affiliation(s)
- Aydilek Dağdeviren Çakır
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey,* Address for Correspondence: İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey Phone: +90 535 922 32 65 E-mail:
| | - Hande Turan
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Tiraje Celkan
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Hematology-Oncology, İstanbul, Turkey
| | - Nil Çomunoğlu
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pathology, İstanbul, Turkey
| | - Oya Ercan
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Olcay Evliyaoğlu
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| |
Collapse
|
9
|
İnan HC, Yener M, Buyru N, Çelebi A, Yilmaz M, Çomunoğlu N. The investigation of hyaluronic acid and hyaluronidase-1 levels as tumour marker in larynx cancer. Clin Otolaryngol 2019; 44:914-918. [PMID: 31207115 DOI: 10.1111/coa.13390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 03/02/2019] [Accepted: 06/03/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the hyaluronic acid (HA) and hyaluronidase-1 (HYAL-1) levels in laryngeal cancer patients. STUDY DESIGN Prospective, controlled clinical trial. SETTING University Medical Center. PARTICIPANTS Fifty laryngeal squamous cell carcinoma patients and 50 volunteers who gave saliva samples investigated prospectively between 2016 and 2017. METHODS Hyaluronidase-1 expression was measured by RT-PCR in normal and tumour tissue samples; hyaluronic acid values of saliva and tumour tissues were measured by ELISA method. RESULTS HYAL-1 expression increased 2.5-fold in tumour tissues compared to normal tissues, and the difference was statistically significant (P < 0.001).Mean saliva HA levels were 103.93 ± 69.04 ng/mL and 177.29 ± 98.44 ng/mL in the patients and controls' saliva specimens, respectively. The difference was not statistically significant (P = 0.657). HA levels were higher in tumour tissue samples than saliva samples, but there was not statistically significant difference between saliva and tumour tissue HA levels. CONCLUSION HYAL-1 expression in laryngeal squamous cell carcinomas is elevated compared to normal tissues of same patients. Targeting this gene and HA catabolism products may use treatment of larynx cancer in the future.
Collapse
Affiliation(s)
- Hakkı Caner İnan
- Department of Otorhinolaryngology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Murat Yener
- Department of Otorhinolaryngology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Nur Buyru
- Department of Medical Biology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Asuman Çelebi
- Department of Medical Biology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Mehmet Yilmaz
- Department of Otorhinolaryngology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Nil Çomunoğlu
- Department of Medical Pathology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| |
Collapse
|
10
|
Emre Ş, Özcan R, Bakır AC, Kuruğoğlu S, Çomunoğlu N, Şen HS, Celkan T, Tekant GT. Adrenal masses in children: Imaging, surgical treatment and outcome. Asian J Surg 2019; 43:207-212. [PMID: 30962018 DOI: 10.1016/j.asjsur.2019.03.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 02/06/2019] [Accepted: 03/11/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND/OBJECTIVE This study aims to evaluate the current surgical approach to adrenal masses in the pediatric age group. METHODS We retrospectively analyzed cases that underwent surgery for adrenal masses between 2007 and 2017. Patients were assessed regarding age, sex, primary diagnosis, image defined risk factors (IDRF), surgical treatment method, complications, duration of hospital stay, and follow-up. RESULTS We examined 50 patients who underwent surgery for adrenal mass (mean age: 4.8 years; range: 5 days-14 years). For IDRF assessment, Ultrasonography was used in 42, Computed Tomography in 36, and Magnetic Resonance Imaging in 36 patients. Lesions were present on the right in 25, left in 21, and bilateral in 4 patients. Histopathological findings were neuroblastoma (n = 29), ganglioneuroma (n = 6), adrenal cortex tumor (n = 5), ganglioneuroblastoma (n = 4), pheochromocytoma (n = 3), cyst (n = 1), and adrenal hematoma (n = 2). Laparotomy was performed on 37 patients, and laparoscopy on 13 patients. None of the cases had any operative complications. CONCLUSION The crucial factors determining the surgical approach to adrenal masses in pediatric cases are the histopathology of the mass, volume, and IDRF. Minimally invasive procedures could be reliably performed in appropriate cases.
Collapse
Affiliation(s)
- Şenol Emre
- Department of Pediatric Surgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Turkey.
| | - Rahşan Özcan
- Department of Pediatric Surgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Turkey
| | - Ayten Ceren Bakır
- Department of Pediatric Surgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Turkey
| | - Sebuh Kuruğoğlu
- Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Turkey
| | - Nil Çomunoğlu
- Department of Medical Pathology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Turkey
| | - Hilal Susam Şen
- Division of Pediatric Oncology, Istanbul Okmeydanı Training and Research Hospital, Turkey
| | - Tiraje Celkan
- Department of Pediatrics, Division of Pediatric Haematology and Oncology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Turkey
| | - Gonca Topuzlu Tekant
- Department of Pediatric Surgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Turkey
| |
Collapse
|
11
|
Çomunoğlu N, Kepil N, Dervişoğlu S. Histopathology of giant cell tumors of the bone: With special emphasis on fibrohistiocytic and aneurysmal bone cyst like components. Acta Orthop Traumatol Turc 2019; 53:35-39. [PMID: 30392920 PMCID: PMC6424663 DOI: 10.1016/j.aott.2018.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/13/2018] [Accepted: 10/08/2018] [Indexed: 11/25/2022]
Abstract
Objective The aim of this study was to define histopathological features of giant cell tumor of bone, especially accompanying fibrohistiocytic or aneurysmal bone cyst like components, in the light of our institutions experience. Methods A total of 120 cases (64 females and 56 males; mean age: 36.2 (12–80)) with ‘GCT’ diagnosed between the years 1996–2016 were included in this retrospective analysis. Cases were evaluated according to clinical features such as age, gender, localization, recurrence, metastasis and histopathological features. Results Tumors were localized most frequently at proximal tibia and distal femur, respectively. In 11 cases areas rich in fibrohistiocytic component and in 20 cases aneurysmal bone cyst like component were observed. In 2 cases both components were present. Twenty three cases recurred. In 1 case which was primarily located at calcaneus, tumor metastasized to lung 4 years later during follow-up. Conclusion GCT can be confused with other tumor or tumor-like lesions involving giant cells. Secondary changes such as fibrohistiocytic or aneurysmal bone cyst-like components and coagulation necrosis were frequently seen in conventional giant cell tumor of bone. For tumors having prominent fibrohistiocytic and/or aneurysmal bone cyst-like components, in order to detect characteristic areas representing GCT, additional sampling is essential. Although secondary histopathological changes do not appear to affect clinical outcome, these features are important in differential diagnosis. Approximately one fifth of GCT cases show recurrence and sacrum and foot bones were the most frequent sites for recurrence. Level of evidence Level IV, diagnostic study.
Collapse
|
12
|
Abstract
Osteosarcoma (OS) is a malignant bone tumor and it is very rare in head and neck region. If it arises in this area, most common localizations of this tumor are mandible and maxilla and ethmoid sinus is very rare site for this malignancy. A 43-year-old female admitted to our clinic with the complaint of pain in the right half of the face and headache persisting for 2 months. According to the clinical symptoms and imaging studies, sinonasal ossifying fibroma was suspected. For this reason, patient was operated endoscopically and histopathological examination revealed that osteoid matrix producing atypical osteoblastic cells so these findings identified osteoblastic variant OS. This article is about a very rare case of OS of ethmoid sinus. The differential diagnosis, general characteristics, and classification of this tumor, radiological features, and surgical techniques are also presented.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Çiğdem Papila
- Department of Internal Medicine, Division of Medical Oncology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Harun Cansiz
- Department of Otolaryngology Head and Neck Surgery
| |
Collapse
|
13
|
Türkmen İnanır N, Eren F, Akgöz S, Eren B, Çetin S, Gündoğmuş UN, Çomunoğlu N, Çomunoğlu C. The importance of hemosiderin deposition in the infant brain: an autopsy study. Hippokratia 2015; 19:164-171. [PMID: 27418767 PMCID: PMC4938109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND/AIM Iron is an essential element involved in many metabolic processes. Presence and accumulation of iron in various body systems can result in different outcomes. Its accumulation in the central nervous system (CNS) cannot be detected routinely by application of hematoxylin-eosin staining. Detection of the presence of hemosiderin in the brain and cerebellum by application of Perls' dye is of importance in cases of infant deaths. MATERIAL AND METHODS In this study, brain and cerebellar specimens obtained from 52 eligible infants (aged 0-1 years) autopsied in our institute between the years 2010 and 2013, independent of the cause of death, were analyzed in order to detect possible presence of hemosiderin. Perls' dye was used to detect histopathological staining intensity and distribution of hemosiderin in the brain and cerebellum. RESULTS Cases did not differ significantly as for the patients' age and gender (p =0.473), type of the culprit trauma (p =0.414), death/crime scene (p =0.587), and diagnosis groups (p =0.550). In this autopsy study blue colored hemosiderin granulations, stained with Perls' dye were detected in the brain (n: 39, 75%), and cerebellum (n: 35, 67.3%). A weakly negative, but significant correlation was detected between the postmortem interval and intensity values of cerebellar hemosiderin (Spearman's correlation coefficient: -0.381, p =0.024). A statistically significant difference was found between the distribution scores of cerebral hemosiderin in cases with and without trauma history (p =0.03). Median cerebral hemosiderin distribution scores were 2.5 and 2, respectively. CONCLUSIONS The detection of a correlation between the presence of cerebral and cerebellar hemosiderin, and postmortem interval in the age group of 0-1 years, should be interpreted as an important finding in the analysis of cerebral iron. The presence of hemosiderin in the CNS may be a significant finding in the elucidation of infant deaths and this procedure should be carried out on a routine basis.Hippokratia 2015; 19 (2):164-171.
Collapse
Affiliation(s)
- N Türkmen İnanır
- Forensic Medicine Department, Uludağ University Medical Faculty, Council of Forensic Medicine of Turkey, Bursa Morgue Department, Bursa, Turkey
| | - F Eren
- Bursa Morgue Department, Council of Forensic Medicine of Turkey, Bursa, Turkey
| | - S Akgöz
- Biostatistics Department, Çanakkale Onsekizmart University Medical Faculty, Çanakkale, Turkey
| | - B Eren
- Bursa Morgue Department, Council of Forensic Medicine of Turkey, Bursa, Turkey
| | - S Çetin
- Kayseri Morgue Department, Council of Forensic Medicine of Turkey, Kayseri, Turkey
| | - U N Gündoğmuş
- Forensic Medicine Institute, Istanbul University, Council of Forensic Medicine of Turkey, Istanbul, Turkey
| | - N Çomunoğlu
- Pathology Department, Istanbul University Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - C Çomunoğlu
- Pathology Department, Acıbadem University Medical Faculty, Istanbul, Turkey
| |
Collapse
|